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Campaign to ban illicit tobacco gains traction

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In this case the evidence is before our eyes. The dominant street vendors and sellers of single tobacco sticks or cigarettes all around Botswana are the most economically vulnerable in the community, women and unfortunately the children particularly young girls down to the age of 16-years.

These women and children are at the tail end of the Tobacco Industry which includes Manufacturers, Distributers and Wholesalers. Despite this, street vendors are reported to sell more volumes of cigarettes compared to Wholesalers.

Their competitive advantage being that they sell single cigarettes (or Mezanga in street lingo). A quick look around the regular street vending places such as the outside of clinics, hospitals and schools, shopping malls, tuck shops (semausu), bus ranks and road side taxi and kombi spots shows the packages of cigarettes (at times illegal cigarettes) lying on the small and sometimes makeshift tables.

The cigarettes are placed in the midst of the rest of the sellable ware including biscuits, sweets, oranges, apples, bananas, peanuts and chewing gums.  You need to take a closer look to spot the cigarette packages, almost as if they are being disguised or enveloped by the confectionary; or possibly that the seller is conscious of the fact that they are in the wrong.

Small talk with the Gaborone street vendors indicates that they are selling the cigarettes under the guise of ‘Poverty Eradication’ as do the Sex-workers. What else should they do to feed their families they throw back? What about the dangerous effect of smoking on the children they sell cigarettes to? Their main concern is today, not the future.

Single cigarettes are readily accessible and the smaller quantity means they are also more affordable compared to the full packet, giving potential customers like school-going children leverage to purchase. Advocates such as the Anti-Tobacco Network Botswana, Cancer Association of Botswana, Stop Smoking Support Group and the Ministry of Health’s Tobacco Control Unit have launched a campaign against this sale of single sticks of cigarettes.

Their main argument is that, single cigarettes make it easier for customers like school-going children to afford the lethal habit. Even the manufactures agree or have been coerced to place the warning on all cigarette packets that ‘Smoking is bad for your health’. The immediate repercussions of the sale of these single cigarettes are already tangible.

“Girls are now smoking more than boys. Young girls are really taking to smoking like it’s some kind of fashion trend. School kids are smoking a lot now. It’s a real crisis,” observes and cautions Onkemetse Ramato, the Health Officer from the Tobacco Control Unit at Ministry of Health.    

Ramato was speaking at the recent talks centered on the ‘Botswana Implementation Strategy for Protocol to Eliminate Trade on Illicit Tobacco Products’. The main attendees on 16th December 2015 were representatives from NGO’s and government sectors all aiming to eliminate trade on tobacco products; with voices raised from Ministry of Health, World Bank, World Health Organisation (WHO), BOSASNet and the Anti-Tobacco Network Botswana.

The second session involved the regulatory bodies such as the Botswana Unified Revenue Services (BURS), Ministry of Trade, Ministry of Agriculture and Office of the President.

Back in 2013/2014 an intense anti-illicit tobacco campaign was publicised with the feedback and reports aired on national television, radio and newspapers. Images of major tobacco related raids by authorities in houses, shops and streets were shown. This current concerted, aggressive and collective approach to eliminate the sale of illicit tobacco and its products is still justified if you talk to Dr. Malebogo Pusoentsi from the Ministry of Health.

She is of the opinion that in the long run, if unmonitored the effect of tobacco on users and the community will cost the nation millions of Pula. “Investment in control of Nicotine will go a long way. As a country we stand to gain in terms of the Pula benefit,” advises Dr. Pusoentsi. The doctor is of the view that if the community is aware of the ‘badness of the smoking habit’ they will also help to control its use. “Sniffing tobacco is not better. There is no safe use of Tobacco,” cautions the good doctor.

Nicotine alone causes a barrage of non-communicable diseases such as Heart disease, Cancer, Diabetes and Chronic Respiratory diseases. Dr. H. Jibril, the Deputy PS at the Ministry of Health reiterated the obvious that, “By 2020, the WHO projects that deaths caused by NCD in Africa, which contribute to poverty, burden health systems and impede the overall development, will outnumber the deaths from communicable, maternal, prenatal, and nutritional diseases.”

In view of this global challenge Botswana is said to have been one of the first countries to sign and ratify the Framework Convention on Tobacco Control (FCTC) in 2003 and 2005 respectively. “Botswana automatically became a Party to this important public health treaty,” added Dr. Jibril.

Dr. Pusoentsi explains that strategies should include public awareness of the danger of smoking and a price increase for tobacco products. Currently one cigarette sells for P2.50 to P3.00 and a packet of 10 cigarettes sticks is around P18 – P25. A packet of 20 cigarettes costs in the range of P30.00.

The contraband cigarettes from Zimbabwe are said to cost P10 for a packet of 20 cigarettes. “Crushed contraband cigarettes from Zimbabwe are sold in bulk. On the streets the crushed cigarettes cost P4.00 for a 250ml cup, or P100 for a 20 litre bucket,” shares Thabo Katholo of the Anti-Tobacco Network Botswana.

Katholo explains that this smuggled Tobacco “Is cheaper and more hazardous.” Katholo also explains that women and girls in rural and peri-urban centres are at higher risk of being targeted to sell illicit tobacco.  

In Botswana the Tobacco Industry consists of one cigarette manufacturer and one cigarette distributer and numerous wholesalers. Although it is nowhere near scaling the heights of the international cigarette industry, Katholo explains that the Tobacco Industry is very vigorous in Botswana. “The Ministry of Agriculture is currently in a joint venture with Japan Tobacco Inc,” explains Katholo.  

At the end of the conference one of the conclusions was that the only way to outsmart the Tobacco industry is via information. How much volumes of cigarettes entered legally? How much levy was paid? How many cigarettes were confiscated and destroyed? The use of latest technologies including Apps to, ‘track and trace’ the use of Tobacco.

In Botswana, the levy on Tobacco and Tobacco Products was effective as of February 2014. The new Tobacco Control Bill is pending parliament approval; the expectation is that it will be effective as of July 2016.

A consultant from the World Bank, Alberto Gonima further cemented how tricky it will be to curb this illicit trade of tobacco. Once you introduce the tax or levies there will be more temptation to bring in illicit tobacco products.

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‘Give us water’ campaign ups the ante

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WHITHER THE WATER: The water tanks in Molepolole have not been of any help to the residents

The ‘Give us water” campaign at Molepolole is gaining momentum. The group made up of the young and old is determined to fight for a basic need of life that has over the years proved scarce in the village – water.

The residents have gone thirsty for many years and to date, the situation remains the same. The taps have completely dried up and they survive by buying water on a daily basis.
Early last year, the people of Molepolole felt enough was enough and even petitioned Water Utilities Corporation (WUC).

According to the campaign’s Publicity Secretary Oreeditse Nyatso, WUC then responded to say that it was aware of the situation in Molepolole and would normalise things in the near future. However, that has not happened and they continue to suffer.

Seeing that things were stagnant, the campaign committee appealed to the community during the festive season to make suggestions on how best to find solutions. “Bakwena have grown impatient and it was evident during the meeting that they go to work dirty, they drink almost any drop, clean or not, to try and quench their thirst,” he said. Nyatso told this publication that the Molepolole people have lost confidence in WUC.

They were even angered by the WUC press release on the 30th of December 2018 which attributed the water challenges to power cuts. They are disappointed that the blame has now being pinned on Botswana Power Corporationn (BPC) when they have been struggling for the longest period.

Given the current situation, Molepolole is said to be planning to ask the government to bring back the Department of Water Affairs. They believe WUC has failed Molepolole dismally since it took over from Department of Water Affairs in 2011.

Another meeting with all stakeholders is slated for 26th January 2019. Meanwhile, WUC has assured residents via a press release a fortnight ago that they are working around the clock to restore the situation.

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‘It breaks my heart to see my child sick’

Keletso Thobega

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A CRY FOR HELP: Young mother Lesedi Pilane is appealing for help as she seeks to get her child healed. The liver transplant will cost P400 000

A Mochudi mother of a baby with liver disease is praying day and night for her child to get a liver transplant. A sick child is every mother’s nightmare. All one can do is hope for the best. This is the situation that 23-year old Lesedi Pilane finds herself in. Pretty with beady bright eyes and soft features, the soft-spoken mother is heartbroken by the pain and anguish that her child Rorisang Nathan Pilane endures.

Rorisang is in the progressive stage of liver disease and needs an urgent liver transplant. When Pilane spoke to The Midweek Sun yesterday, she had just returned from a check-up at Princess Marina hospital. Mother and child are currently at Deborah Retief Memorial hospital in Mochudi where baby Rorisang has been admitted since 1 January 2019. Pilane and baby have been in and out of hospital for the past few months since Rorisang was diagnosed with biliary artesia (liver disease) at three months old.

Biliary artesia is defined as a rare disease of the liver and bile ducts that occurs in infants and is characterised by obliteration or discontinuity of the extrahepatic biliary system, resulting in obstruction to bile flow. This progressive liver problem is a chronic disease that often becomes evident shortly after birth with signs of yellowing of the skin and whites of the eyes (jaundice). Bile eventually builds up in the liver and damages it, leading to scarring as well as loss of liver function and tissue.

The unemployed Pilane seems overwhelmed by the situation and admits that it has been a tall order to come to terms with living with and taking care of an ill child. Pilane is however taking it all in her stride. After her child was born, she did not suspect that anything was wrong. They went for the usual six weeks check-up after birth and the nurses also gave them a clean bill of health.
“I only realised that something was wrong when the baby’s eyes started turning yellow and his urine was also dark yellow. His tummy was also stiff and slightly swollen. I found this strange and that is when I went back to the clinic.”

That is when Pilane was given a referral to Princess Marina Hospital where they confirmed that Rorisang has biliary artestia. Pilane went to register Rorisang at the transplant unit.
At four months old a Kasai operation (surgical treatments performed on children with biliary artesia) was done on Rorisang but it was not successful. They told her that operations of this nature are often done when a child is two months and below. “At Princess Marina hospital, I was told that his liver was already damaged so he needs a liver transplant. I was even told that the situation was so dire that he would live up to a year and a half.”

She did not receive any assistance. She was informed that the doctors were attending a workshop in India. After some time she was contacted and told that she could be his living donor if a donor is not found. “We did tests and everything seemed to be going well. They told me that they had taken the blood samples to a lab in South Africa but never heard from them again.” Pilane says that they were admitted at Princess Marina hospital in March last year.

In April an operation was done on Rorisang to drain bile from the liver. Rorisang was given medication to support his liver but she says it is not working as his situation is still deteriorating.
Pilane was informed that a liver transplant in India costs P400, 000 and P1.3 million in South Africa. Pilane, who is unemployed, survives off the generosity of family members, who she says have been supportive.

She says it is difficult to leave him with anyone else. “He does not cry or complain when he is sick so it is difficult for those who do not know to take care of him. I know that once he sleeps often or looks drawn then it means that he is not feeling well.” Of late, baby Rorisang has not been eating well. “He only drinks milk. He has now lost a lot of weight. Dieticians have recommended him diets and ordered him some foods but he refuses to eat and if you force him to, he actually vomits,” his mother says.

Oddly, a few months ago, baby Rorisang could gain a kilogramme per day. The doctors told his mother that this was because of water accumulation and explained that it was not good as it would compress the organs such as the lungs and make him struggle to breathe. “They said we could lose him before the operation so they suggested that he be medically tapped in order to reduce the water.” Baby Rorisang still faces medical challenges right now.

His eyes, private parts and legs are swollen but his size has reduced since the tapping. Pilane says that she is unsure what the current state is with the liver transplant. “I was told that government only funds one liver transplant patient per year. My particulars are with them so I do not know whether they will assist me.”

On Monday, Pilane was contacted and asked to come to Princess Marina Hospital for a blood test and cross match. She is praying for a breakthrough for her child and in the meantime she takes each day as it comes. “I can’t eat, I can’t sleep. I am stressed. I have put all my faith in God.” At the time of going to print, Pilane was still waiting for a response regarding the possibility of a liver transplant.  She has also received request to assist from a few people and has already sought assistance to get a trust fund account opened for Rorisang.

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