Windhoek – Citizens from the Southern African Development Community (SADC) are being subjected to high medical fees when accessing health services in their neighbouring countries, despite promises by the SADC Secretariat to standardise health fees in the region.
SADC also has a protocol on health, which says member states should promote, coordinate and support individual and collective efforts of state parties to attain an acceptable standard of health for all people.
But despite the protocol having been signed into an agreement in 1999, nothing concrete has surfaced, and foreign citizens continue to fork out huge sums of money for treatment.
The status quo is in direct contradiction with the regional body’s plans for regional integration, which will translate into the free movement of people and goods plus services.
Apart from universal medical fees for the region and its citizens, SADC government also agreed to do away with roaming charges for SADC citizens. The aim was to remove deterrents to the regional integration projects.
These noble initiatives continue to remain unfulfilled promises to the people of the region, while they continue to be classified as foreigners in their region. For example, in Namibia, a person from other SADC countries is required to pay around R2,000 upfront when being hospitalised in a government hospital, and once that initial payment is depleted, R500 is required per day. In comparison, a Namibian is only charged R30 one-off for the same services.
To use the Intensive Care Unit (ICU), non-Namibians are charged R900 per day, while Namibians only have to pay the one-off R30.
The use of maternity and delivery services will see non-Namibians forking out R400 per day.
“One has to pray that you don’t get ill while you are outside your own country and with the economy at home not doing well it is becoming harder to afford these fees,” a patient from Angola said, as he walked out of Katutura Hospital in Windhoek.
In Botswana, while locals are charged about R7 to be treated at a government hospital, foreigners from SADC are charged about R55 for consultation and over R200 for other services such as admission and medicines.
A foreign national in Zambia is charged 600 Kwacha (R791) per day for admission, while a local will be charged less than 100 kwacha (R131).
The situation is even worse in South Africa where the government has begun the process of sending outstanding health bills for foreigners to their respective embassies because foreigners cannot afford to pay these fees. Although no fee structure was immediately available, The Southern Times understands foreigners pay more than locals in that country.
According to reports, the Gauteng health department is on a mission to recoup R160 million from foreign nationals. The Gauteng health department confirmed that embassies were sent letters indicating the amounts owed by their citizens. The health department owes service providers at least R5 billion, accumulated over two years.
Nationals from Zimbabwe and Malawi owe the largest chunk of R144 million and R11.6 million, respectively, in unpaid health bills. Nigeria is third on the list, with R7.9 million in unpaid bills.
The practice of charging foreigners more than the locals for health services is also found in other SADC countries such as Zimbabwe, Malawi and Swaziland.
Responding to The Southern Times, the SADC Secretariat’s acting director of gender, social and human development, Lomthandazo Mavimbela, said the regional body is busy looking at ways to standardise these fees.
“Currently, it’s one of the areas we are looking at, how all citizens can pay the same fee for health services anywhere in the region, whether he or she is a citizen of that country or not. We must all have access to cheaper medicines,” she said.
She added that the SADC Secretariat has observed that different citizens are paying different fees but said this, however, does not happen at the borders because of SADC’s cross-border initiative.
Part of the cross-border initiative and one of the conditions for the Global Fund grant was for SADC to sign memoranda of understanding (MoUs) with all 12 SADC member states participating in the cross-border initiative.
The 12 SADC member states are Angola, Botswana, Democratic Republic of Congo, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, United Republic of Tanzania, Zambia and Zimbabwe.
The MoUs describe the commitments between SADC, its sub-recipients, and member states, and delineate the member states’ provision of pharmaceuticals, medical supplies, work permits, and exemption from customs duties.
Part of the MoUs required officials from the 12 member states to meet, to introduce the project, agree on location of mobile wellness clinics at border posts, and negotiate and obtain commitments from each member state to support the resourcing and effective functioning of these centres.
“At the borders, there is no difference in fees between the locals and those visiting. There are no issues, the problem is when you travel further inside the country,” said Mavimbela.