HEALTH CARE
The main goals to be achieved between 1990 and 2015 are to reduce the mortality rate of children aged under five by 66%; to reduce maternal mortality by 75% and to halt the spread of HIV/AIDS, TB, malaria and other major diseases. The HIV/AIDS pandemic has compounded the problem of TB and is impacting on government finances. As noted elsewhere, the disease has substantially reduced average life expectancy to as low as 37.5 years. This is despite improved health care and the availability of anti-retroviral drugs. More than 8,000 TB patients are diagnosed each year, about 80% of whom are HIV positive, and therefore more susceptible to the disease. It is estimated that close to 40% of the overall population and 42.5% of pregnant women are HIV positive, although indications are also that this may have decreased slightly. The government budget allocation for the health sector does not reflect the gravity of the situation, although these efforts are complemented by the work of NERCHA and other health-oriented NGOs, to whom local and international funding is allocated. The budget allocation for expanding the anti-retroviral drugs program is E100 million and E94 million has been set aside to care for the elderly.
Hospitals and Clinics
The National Health Policy aims for a hospital or rural clinic to be easily accessible to everyone, and provides for preventive and promotive, curative, rehabilitative and supportive services. An ongoing expansion programme to increase the country’s medical centres is in place in order to achieve this goal and the latest statistics available indicated that 70% of the population is within eight kilometres of a health facility. Between 93% and 99% of children of immunisable age are fully immunised and infant mortality has reduced from 15% to 7% of births, while childhood mortality is down from 14% to 8.9%. No clinically confirmed cases of polio have occurred since 1990. There are 187 hospitals, clinics and health centres in the country run by government, NGOs, missions, industry or privately owned. There are also 162 outreach clinics run by various sectors. Treatment at all government-run medical centres is highly subsidised in an effort to place health care within the reach of everyone. It is planned to equip the Mbabane Government Hospital so that fewer people will have to go to South Africa for treatment and the major upgrading and expansion of this facility is continuing. Government’s efforts are supplemented by organisations such as The Salvation Army, which runs an affordable clinic and AIDS counselling centre at the densely populated Mbabane suburb of Msunduza. There are private clinics at Mbabane, Ezulwini, Piggs Peak and Manzini. Most patients who use these facilities subscribe to medical aid or insurance schemes to cover costs. Many of the larger companies and agricultural estates have fully equipped clinics on their premises for staff and their families and these facilities are sometimes extended to local communities. Occupational Health Services, a Matsaphabased NGO, is a managed health care operation which provides the preventative aspects of occupational health and runs a curative out-patients service. Pre-payment or contract agreements with companies are encouraged.
Other Health Care
Efforts to improve the health services are made through international organisations such as UNICEF and WHO, which have offices in Swaziland. General health in the family environment and spaced, smaller families are promoted by the Family Life Association of Swaziland, a self-supporting NGO, while Swaziland Hospice at Home provides home care and counselling for the terminally ill. The Good Shepherd Hospital, a government health centre in Siteki, has been accredited as a teaching hospital in the specialised field of eye surgery. Medical rescue schemes also operate, enabling patients to be moved to South Africa if specialist care needed is not available in Swaziland. This movement may be by air or road and it is advisable to subscribe to a medical scheme to cover costs in the eventuality of needing such a service. Comprehensive medical aid and insurance cover are available through a local society as well as through South African and overseas schemes.
Bayler Clinic
This vital facility, which is sponsored by Bayler and Bristol Myers, opened in Mbabane during 2006 with the specific objective of treating HIV positive children. However, the parents of these children will also be assessed and receive treatment if necessary. Education, training and prevention are also key components of this project, with for example, efforts made to prevent mother-tochild transmission. The dedicated clinic doctors aim to expand their work to cover the whole country and in this respect, an outreach program is in place. Children and their parents who receive appropriate treatment are given the opportunity to live a normal life span and their prognosis improves as medical breakthroughs are achieved
Vision Care Centre
In operation since 1991, this specialist optometrist has three branches conveniently located at the Mall in Mbabane, the Hub in Manzini and the Big Tree Shopping Complex in Matsapha. All these outlets offer the latest innovations in highly specialised eye health care. Services include consultation with professional eye care practitioners and primary eye health care, as well as industrial eye screening, as conducted internationally, plus low vision apparatus and referrals. Free vision test are given for public driver’s license applicants. Among the products available are all types of contact lenses and solutions, protective eyewear, cosmetic lenses and a full range famous name designer lenses, as well as affordable lenses. Binoculars, telescopes, and night vision and spotting scopes (Bushnell and Tasco) are also available. Vision care offers a one hour laboratory service on selected prescriptions and medical aid schemes are accepted for consultations and prescription eyewear. All this is complemented by excellent service from the friendly and efficient staff.
SOCIAL WELFARE
The country’s welfare services place emphasis on vulnerable groups such as children and orphans, the elderly, those with physical and mental disabilities, the chronically ill and the destitute. This sector broadly covers social welfare, rehabilitation services, disaster relief and refugees. ELECTRICITY
Swaziland Electricity Company
The name change from Swaziland Electricity
Board and the legal transformation of the organisation, which changed from a parastatal to a public company, took place in 2008 under the Swaziland Electricity Company Act 2007. While the SEC continues to be wholly owned by Government, the new structure makes it possible for shares to be sold. The 2007/8 financial year saw a record profit of E79.2 million – an increase of 22%. This is despite challenges within the industry and the economy. Total assets were up by 12% to E1.2 billion with borrowings of E281 million to fund various expansion projects. Significant challenges are presently faced due to diminishing energy reserves in the region, which resulted in increased tariffs. ESKOM of South Africa, which supplies about 80% of power to Swaziland, raised its price by 12% and stringent measures were taken to contain costs. Prices are expected to continue to increase up to 2010. A prepayment metering project is in hand to help reduce the debt book and successful campaigns have been conducted to educate customers on the importance of saving energy. The Maguga hydro-power station was commissioned in 2008, adding 19 megawatts of generation capacity to the national grid. This has helped to manage the impact of load shedding by ESKOM, particularly as water levels in the Maguga dam reached 98%. An agreement with EDM of Mozambique will further ease the effects of load shedding. The construction of a thermal power station is being investigated and if successful, will further increase local power generation. In terms of social investment, the Rural Electrification Project has significantly improved living standards in rural communities and SEC supports initiatives to alleviate the impact of HIV/AIDS. SEC has introduced the Performance Management System to develop and mentor its employees to enable them to contribute to the efficiency for the company. PMS is structured to reward exceptional performance annually. The staff complement is currently 626 people. Staff welfare is a crucial aspect
within SEC, as are healthy industrial relations
and the effective handling of any disputes. IR
training programs for both management and
organised labour have taken place to facilitate
this and a new collective agreement has been
signed. A total of E2.9 million was spent on
training in 2007/8.
There is also the possibility of sponsoring the
University of Swaziland’s Engineering Faculty
in order to raise it to international standards
and alleviate the need for expensive training
overseas.
Swaziland Water Services Corporation
Swaziland Water Services Corporation (SWSC) is a public enterprise established by an Act of Parliament. The objects of the Corporation are to extract, store, transport, purify and supply water and collect, convey, treat and dispose of sewage in urban and periurban areas. SWSC’s vision is “to delight our customers through the supply of potable water and sewerage services” and the mission is “to provide quality water and wastewater services, effectively meeting customer needs in a growing market through sound management principles, strategies and improving technology, while maintaining a safe environment for our staff and community”. To this end SWSC developed the core values of good governance, performance and continuous improvement, ownership and accountability, and communication and transparency to support its vision and mission. SWSC acknowledges the current water crises situation due to the prevalent drought, which has resulted in the significant reduction of water sources. Medium to long term plans to mitigate the situation have been drafted and these require resource input from stakeholders. SWSC values its customers and is constantly working on improving service delivery while ensuring compliance with set quality standards based on international standards, such as the WHO Standards for drinking water. SWSC also has social and economic obligations to increase access to clean potable water and sewerage services to improve public health and stimulate economic activity, at the same time ensuring a safer and cleaner environment. The strategic makes provision for stakeholder requirements and as these plans are implemented, so will stakeholder satisfaction be increased.
The Rural Water Supply Board
The Rural Water Supply Board works in conjunction with rural communities and is assisted by finance from donor agencies in an effort to install safe water supplies in the poorer areas. Many rural locations are suitable for borehole pumps, which are widely utilised.
Government Contribution
E41.1 million has been allocated to the Rural Water Project and E6.6 million for sustainable water provision in southern Swaziland.
CHURCHES
Religious denominations enjoy freedom of worship and Christianity is the most widely observed religion.
SERVICE CLUBS
Rotary International, Round Table and
Lions International are all active.
SOCIAL ACTIVITIES
Most of the cities, towns and large agricultural estates in Swaziland have clubs offering social and sporting activities. Several societies cater for interests such as theatre, natural history, 4 x 4 motoring, and sports and hobbies.