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The economic turmoil gripping Botswana has begun to manifest in alarming ways, particularly within the healthcare sector. Patients are increasingly finding themselves without access to vital medications, and the situation is forcing many to confront the harsh realities of a system that is meant to provide universal healthcare. As the country grapples with the repercussions of a diamond market crash, stories of individuals struggling to secure necessary treatments are becoming all too common.
A Struggle for Health and Dignity
In late 2023, Boitumelo Mosege, a 53-year-old farmer from Molepolole, faced a serious health crisis. Her diagnosis of hyperthyroidism came with a host of debilitating symptoms, including swelling in her neck and frequent fainting spells. With her illness forcing her to abandon her work, Mosege has been left reliant on her children and her elderly mother’s pension to cover her medical costs. Despite Botswana’s commitment to free healthcare, she reported that she has struggled to obtain her prescribed medication consistently, often going months without it.
“I felt like I had lost my life right there,” Mosege shared, reflecting on the moment she realised she would need to purchase her own medication. “I felt suicidal.” This sentiment underscores the deep frustration faced by many in a nation where healthcare should be accessible to all.
The Broader Impact of Economic Decline
Mosege’s plight is echoed by others like Kelly Jansen, who is the primary caregiver for her wheelchair-bound father. Jansen spends a significant portion of their modest income on essential medical supplies, including a blood pressure monitor and compression stockings. The rising costs have led her to seek donations for an electric wheelchair, hoping to reclaim some semblance of freedom. “I want my life back,” she lamented, capturing the desperation felt by many in her situation.
The root of this healthcare crisis can be traced back to a public health emergency declared by President Duma Boko last year, following months of severe shortages in essential medicines. In a February opinion piece for The Guardian, Boko attributed the crisis to a combination of prolonged economic decline and systemic failures within the Central Medical Stores (CMS), the agency responsible for health procurement. This agency has faced criticism for inefficiency and increasing drug prices, issues that have persisted for over a decade.
Economic Woes and Unemployment Rise
Botswana’s economy, once buoyed by its diamond industry—responsible for 80% of its exports—has seen significant downturns. The price of diamonds has plummeted by 60% over the past four years, exacerbated by a growing preference for lab-grown alternatives. The International Monetary Fund (IMF) recorded a 3% contraction in 2024 and a further 1% decline the following year. In response to these economic challenges, unemployment surged to 21% as of March 2025, with youth unemployment nearing 29%.
Oratile Olorato Kgatle, a 26-year-old aspiring public relations professional, is one of many feeling the brunt of this economic malaise. Despite diligently applying for jobs over the past 18 months, she has yet to secure a single interview, leading to a decline in her mental health. “I could feel that light just dimming with each day,” she expressed, illustrating the psychological toll of prolonged joblessness.
Coping with Change: Resilience Amidst Adversity
For families like the Tankas, the economic downturn has prompted significant lifestyle changes. Phenyo Tanka, a mother of four, has had to forgo dining out and let go of their domestic worker after her husband lost his job as a mining engineer. Despite holding a degree in agriculture, Tanka has struggled to find work in her field since graduating in 2011. However, she remains determined to carve out a path for her family, starting a small business selling homemade cakes and eyeing plans to set up a toilet paper factory. “I want my daughters to know that they can also be independent,” she stated, showcasing a spirit of resilience amidst hardship.
Why it Matters
The intertwining crises of economic decline and healthcare shortages in Botswana highlight the fragility of systems that are meant to support citizens in times of need. As the impacts of the diamond market collapse continue to unfold, the stories of individuals like Mosege and Tanka serve as poignant reminders of the human cost of economic turmoil. Addressing these systemic issues is not merely an economic imperative; it is a moral responsibility to ensure that the most vulnerable members of society are not left to bear the burden alone.