Head of heart unit removed with swift surgical precision

THE Health Ministry has quietly shifted a doctor chosen to head the State’s new heart unit after complaints that he knew little about heart treatment and was regarded by his peers as not suitable for the post.

Dr V. Makuka was brought in as a cardiologist in December, but the authorities have been forced to reverse his planned appointment, and will now search for a new heart specialist, The Namibian has learnt. The appointment has ignited concerns about doctors brought into the public sector by Government.Minister of Health and Social Services Dr Libertina Amathila last week confirmed that Makuka had been earmarked for the post, but Permanent Secretary Kalumbi Shangula said the Ministry had not yet recruited anyone to lead the proposed cardiac unit.”There were some concerns here and there, with the result that the person simply withdrew his candidacy,” said Shangula.”There were concerns that he might not be up to date with the management of patients. The important thing to note here is that Dr Makuka is a properly qualified doctor and a specialist in his field, but the field where he was expected to perform is not the area of his expertise”.Shangula likened the planned appointment of Makuka to a well-qualified tractor operator being expected to drive a car without having a licence for it.Makuka’s background was as a “normal GP” with postgraduate specialisation in “internal medicine”, Shangula said.Repeated attempts last week failed to elicit any comment from Makuka himself.Despite his qualifications, recruitment of the Russian-Tanzanian doctor has once again raised doubts about the competence of foreign doctors whom Government brings into the country without approval from the Medical Board of Namibia.Medical Board president Professor Fillemon Amaambo said any doctor practising in Namibia should be either registered by the board or authorised by the Health and Social Services Minister.Ministerial authorisation made it easier to bring health professionals from other countries to work in public hospitals and clinics, said Shangula.Approached for comment, the vice president of the Medical Association of Namibia, Dr Bernard Haufiku, criticised the dual process whereby doctors are registered in Namibia.Haufiku said he was “unhappy with the backdoor” approach and preferred that all doctors undergo testing by the board.”If somebody comes in here not getting through the process, then one cannot be sure of the person. As a result you would get people coming in here who do not have the clinical acumen to work, but they will bypass the net. Having two different processes would compromise the health of the patients. It undermines the authority of the Medical Board”.Amathila dismissed the criticism, saying some cases of quacks and impostors were related to private doctors accredited by the Medical Board.She dismissed suggestions that Makuka’s competence was in question.Amathila said Makuka’s accusers had targeted him because he was linked to the cardiac unit of the Windhoek Central Hospital, which has been criticised by some established doctors, particularly those in private practice, as an unnecessary extravagance.The unit is expected to become operational in the second half of this year but so far only the building has been completed: equipment and staff are not expected before April.One doctor, who described Makuka as “knowing little about matters of the heart”, said medical supervisors at Windhoek Central and Katutura hospitals had given him a gloomy report.Shangula said Makuka, who came to Namibia in December, had just begun his orientation when “the concerns” were raised.He said there was also a “misconception” that Makuka was a cardiologist, adding “the person did not claim to be a cardiologist”.It is not clear why Government had earmarked him to head the cardiac unit.When Government decided to set up the unit, it argued that a lot of money was being spent to send patients to South Africa.The Ministry has now roped in Kenyan heart specialists to treat patients and help train Namibian doctors.Makuka is still based in Windhoek State hospitals as a general practitioner, according to Amathila.”They are in the process of taking him out,” said one of the doctors who spoke to The Namibian. “They want him to go, but diplomatically”.Amathila said Makuka had been appointed on condition he pass a course of tests, it was “not [intended] that he could come straight in and run the unit”.The appointment has ignited concerns about doctors brought into the public sector by Government. Minister of Health and Social Services Dr Libertina Amathila last week confirmed that Makuka had been earmarked for the post, but Permanent Secretary Kalumbi Shangula said the Ministry had not yet recruited anyone to lead the proposed cardiac unit. “There were some concerns here and there, with the result that the person simply withdrew his candidacy,” said Shangula. “There were concerns that he might not be up to date with the management of patients. The important thing to note here is that Dr Makuka is a properly qualified doctor and a specialist in his field, but the field where he was expected to perform is not the area of his expertise”. Shangula likened the planned appointment of Makuka to a well-qualified tractor operator being expected to drive a car without having a licence for it. Makuka’s background was as a “normal GP” with postgraduate specialisation in “internal medicine”, Shangula said. Repeated attempts last week failed to elicit any comment from Makuka himself. Despite his qualifications, recruitment of the Russian-Tanzanian doctor has once again raised doubts about the competence of foreign doctors whom Government brings into the country without approval from the Medical Board of Namibia. Medical Board president Professor Fillemon Amaambo said any doctor practising in Namibia should be either registered by the board or authorised by the Health and Social Services Minister. Ministerial authorisation made it easier to bring health professionals from other countries to work in public hospitals and clinics, said Shangula. Approached for comment, the vice president of the Medical Association of Namibia, Dr Bernard Haufiku, criticised the dual process whereby doctors are registered in Namibia. Haufiku said he was “unhappy with the backdoor” approach and preferred that all doctors undergo testing by the board. “If somebody comes in here not getting through the process, then one cannot be sure of the person. As a result you would get people coming in here who do not have the clinical acumen to work, but they will bypass the net. Having two different processes would compromise the health of the patients. It undermines the authority of the Medical Board”. Amathila dismissed the criticism, saying some cases of quacks and impostors were related to private doctors accredited by the Medical Board. She dismissed suggestions that Makuka’s competence was in question. Amathila said Makuka’s accusers had targeted him because he was linked to the cardiac unit of the Windhoek Central Hospital, which has been criticised by some established doctors, particularly those in private practice, as an unnecessary extravagance. The unit is expected to become operational in the second half of this year but so far only the building has been completed: equipment and staff are not expected before April. One doctor, who described Makuka as “knowing little about matters of the heart”, said medical supervisors at Windhoek Central and Katutura hospitals had given him a gloomy report. Shangula said Makuka, who came to Namibia in December, had just begun his orientation when “the concerns” were raised. He said there was also a “misconception” that Makuka was a cardiologist, adding “the person did not claim to be a cardiologist”. It is not clear why Government had earmarked him to head the cardiac unit. When Government decided to set up the unit, it argued that a lot of money was being spent to send patients to South Africa. The Ministry has now roped in Kenyan heart specialists to treat patients and help train Namibian doctors. Makuka is still based in Windh
oek State hospitals as a general practitioner, according to Amathila. “They are in the process of taking him out,” said one of the doctors who spoke to The Namibian. “They want him to go, but diplomatically”. Amathila said Makuka had been appointed on condition he pass a course of tests, it was “not [intended] that he could come straight in and run the unit”.