HEALTH CARE
Since 1990, the main goals to be
achieved up to 2015 in this sector
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 continues to
compound the problem of TB and is
seriously 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 it has been stated
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
(primary), curative, rehabilitative and
supportive services. An ongoing expansion
programme to increase the country’s
Facilities &
Services
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 immunisation 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.
According to a World Health Organisation
Report dated May 2008, there are 154
hospitals, clinics and health centres in the
country run by government, NGOs,
missions, industry or private owners.
There
were 161 general practitioners and specialists
operating in the country.
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 was completed in
2009. 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.
Several 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-to-child transmission. The
dedicated clinic doctors aim to expand their
work to cover the whole country and in thisrespect, 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.
MEDICAL INSURANCE
A number of medical aid schemes
operate in the country, the terms of
which vary based on the extent of
cover taken out, the salary earned and the
number of people in a family. Employers,
particularly the larger companies, may pay
a portion of the monthly premium and
some corporate entities, such as financial
institutions, operate their own schemes.
Swazimed
The concept of Swazimed, which is the
oldest medical aid scheme in the country,
came about in the late 1970s. While it is
administered by Medscheme, one of the
largest schemes of its type in South Africa,
Swazimed is an independent entity which
began operating in 1980 to offer a world
class service. It is a non-profit making
schemes and any surplus money remains
in the fund. It falls under the jurisdiction of
the Ministry of Health. The vision is to be
the preferred provider of affordable medical
aid and health care services while the mission
is to manage a sustainable fund, enabling
members to access diverse, quality and
affordable health care products and services
in a transparent and client-centred manner.
Swazimed cards are accepted throughout
the Kingdom and South Africa.
UTILITIES
Swaziland Electricity Company
Despite the challenging world economic
recession, SEC performed exceptionally well
during the period under review. While
conditions were exacerbated by the high
tariffs for imported electricity, profits for the
year were E73.4 million from E47.6 million.
This is attributed to the stringent financial
controls that are now a culture within the
organisation. Revenue for the year was
E560.5 million against E485.7 million.
Sales grew marginally by 0.5% due to the highly suppressed economy. Energy sent out
was 1163GWh (2008:1143.57 GWh)
against sales of 981.9 GWh (2008:977.1
GWh), a discrepancy mostly attributable to
commercial losses.
Mitigation strategies are
implemented to contain this discrepancy.
The total system losses for the year were
15.5% (2008:14.6%). The implementation
of the pre-payment metering system will
contribute significantly to the mitigation of
this figure. Internal generation improved to
246.14 GWh (2008: 160.22GWh).
The high cost of supply contributed to the
marginal growth in sales. SEC imports
between 70% and 80% of the country’s
electricity requirement, mainly from ESKOM
in South Africa. The tariff of imported
electricity grew by 33% while SEC levied a
tariff increase of only 17%.
The cost of supply is expected to escalate
further due to the revised ESKOM tariff and
SEC has revised her strategy to further improve the cost of supply. Cost mitigation
initiatives include projects such as prepayment
metering, implementation of the
Time-of-Use-Tariff to a selected category of
customers, and the optimisation of
procurement processes and labour costs. It
is envisaged that the increase in tariffs will
further pressurise the economy, resulting in
suppressed growth in energy sales.
With the full support of the Government,
SEC has embarked on the development of
a Coal Fired Thermal Power station with
the objective of decreasing reliance on
imported electricity and as well as mitigating
the cost of supply.
SEC continues to face relatively the same
challenges: it is anticipated that the tariff
of imported electricity will continue to
escalate, imposing more pressure on the
organisation to remain profitable.
SEC subscribes to the dictates of corporate
governance in all its leadership structures.
The accountability and responsibility of the
Board of Directors, as well as of the
Executive Management, is clearly delineated
through succinct terms of reference and
procedures. The Board of Directors executes
some of its responsibilities through Board
Committees which have clearly defined
mandates and scope of work. These
comprise the Audit and Risk, Finance,
Remunerations and Technical and Tender
Committees.
SEC is involved in a number of projects
geared to the social improvement of schools,
non-government organizations and
communities. These include donations, and
the construction of a rural electrification
network extension, which has resulted in
entrepreneurship economic activities that are
assisting communities to improve their
livelihoods. Rural schools have benefited
enormously through electrification programs,
which have resulted in improved
performance in academic activities.
Swaziland Water Services Corporation
In accordance with the Assignment of
Responsibilities to Ministers Notice of 2009
under Legal Notice No.25 of 2009, SWSC
now falls under the Ministry of Natural
Resources and Energy and not the Ministry
of Housing and Urban Development.
However this does affect the role and
functions of the Corporation and its social
and economic obligations.
In terms of Water Services Act, SWSC is
expected to conduct its business on strict
commercial principles in order to realise an
operating profit. However most of its areas
of supply are financially non-viable: for
example, the cost of producing one unit of
water exceeds the unit charge. SWSC has
obligations to provide water and sewerage
services to promote social and economic
sustainability and charging a cost reflective
tariff that fully covers operating and capital
would have an adverse effect on social and economic sustainability.
Hence there is a
need for a Government subsidy in non-viable
areas.
As stated in SWSC’s vision, the
Corporation’s ultimate objective is to delight
customers in the provision of safe drinking
water and quality sanitation services. This
vision has been translated into short to
medium term business objectives which are
implemented annually through the SWSC
business score card, the framework of which
allows the Corporation to measure how its
strategic focus areas create value for business
and stakeholders, particularly its customers.
This has resulted in improved performance
achievement targets under the performance
agreement with Government and the
strategic plan.
Despite adverse operating conditions as a
result of climatic changes and the economic
downturn, the Corporation has shown
resilience which is evident in the continued
sustainable water supply and the
achievement of targets based on its strategic
plan and the Government Performance
Agreement.
During the year under review, SWSC
diversified its product portfolio by launching
a bottled water business under the brand
name “Ëcowater”. This is derived from the
ecosystem and water extracted from the
natural environment and identifies the
product as natural mineral water.
Other
variants of bottled water, such as sparkling
and flavoured, will be considered once the
first market offering has stabilised and the
response observed accordingly. The bottled
water is drawn from an underground aquifer
and is filtered and treated using 0.25 micro
filtration technology. The product’s mineral
content is tested and analysed under strict
laboratory conditions.
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 in
Swaziland are suited to borehole pumps and
these are widely utilised. The Department
of Geology and Mines is also involved in
putting ground water resources to optimum
use.
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 there is no
discrimination in this respect.
Christianity is the most widely observed
religion. There are presently no synagogues
for people of the Jewish faith.
SERVICES CLUBS
Rotary International and Lions
International are all active in
Swaziland.
SOCIAL AND SPECIAL INTEREST
CLUBS
Most of the cities, towns and large
agricultural estates in Swaziland
have clubs offering social and
sporting activities. There are also clubs and
societies that cater for special interests such
as theatre, natural history, 4x4 motoring,
running and other sports and hobbies. Fly
fishing, one of the fastest growing activities
in the world, is carried out in the dams of
the Usutu Forest and other waters on high
ground.