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Why Are Diseases Often Undiagnosed in Lesotho’s Poor Communities?

26 January 2024 by Pascalinah Kabi

 Est Read Time: 4 min(s) 44 sec(s)

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‘Mashebisang Matubatuba, from Maloraneng, Mokhotlong, is earnestly appealing to compassionate individuals for financial support to cover all her medical transportation expenses. Credit: Pascalinah Kabi.

‘Mashebisang Matubatuba’s left eye twitched incessantly, a piercing pain that grew more bizarre and unbearable by the day.

Initially a minor irritant, the condition rapidly deteriorated, resulting in a painful muscle spasm that led to the dislocation of her eye.

Caught in a whirlwind of excruciating pain and impatience, Matubatuba sought a cure in the realms of modern medicine and the ancient remedies of traditional healers.

Ultimately, the pain subsided, and Matubatuba’s eye returned to its normal state.

“I cannot definitively attribute my healing to any specific doctor as I sought advice from numerous modern and traditional practitioners,” explains Matubatuba from her Maloraneng, Mokhotlong home.

New fleet boosts healthcare access in Lesotho’s remote areas

Red, yellow, and white balloons sway on the nose of a brand-new Fortuner parked in the Ministry of Health’s lot in Maseru, Lesotho. Around the colourful display, a small group of just over ten people gathers, including the Minister of Health, Selibe Mochoboroane.

Amidst them, World Bank representative Mathabo Ntai, clad in a blue maxi dress, outlines the purpose of the early December 2023 gathering.

“Today, we’re here to celebrate the arrival of vehicles that will be pivotal in the integrated health services program. We’re officially handing over all 42 cars to the honourable minister,” Ntai announces in a video shared on Mochoboroane’s Facebook page.

In his brief speech, Minister Mochoboroane urges the future drivers of these vehicles to use them responsibly, specifically cautioning against their personal use for transporting building materials.

He emphasises that the fleet of 42 4×4 vehicles is designated to enhance the accessibility of integrated health services in even the most remote areas.

“These vehicles are for the villages of Basotho, both large and small, playing a critical role in saving lives amidst a health crisis,” Mochoboroane states.

He continues, “We must step out of our offices and venture into the villages to deliver these services. Prepare to journey to the furthest corners of our country to provide essential healthcare.”

Health Minister Selibe Mochoboroane. Credit: Pascalinah Kabi.

‘It feels like someone is pumping my eye. It is painful.’

Back in Maloraneng, Mokhotlong, Matubatuba was short-lived. A decade after her initial recovery, in 2018, her world was rocked by the death of her second-born son. This tragedy seemed to precipitate another eye dislocation.

“Since my son died in 2018, my eye has remained dislocated,” she revealed to Uncensored News.

Six years later, her eye still protrudes awkwardly, attracting stares, especially from first-time onlookers.

“The pain is excruciating,” she described.

Seeking help, Matubatuba connected with a doctor from Maloraneng, now at Lesotho’s leading referral hospital, Queen ‘Mamohato Memorial.

In Maseru, Matubatuba was booked for an extensive medical evaluation, starting with a scan. “I missed my appointment due to lack of travel funds,” she recounted.

This financial barrier to healthcare is common in Lesotho’s impoverished, remote communities. The World Health Organisation (WHO) identifies service delivery inequities and challenging terrain as significant obstacles to universal health coverage in the country.

Living in Maloraneng, one of Lesotho’s most isolated villages, Matubatuba faces these challenges daily. The village is accessible only via a 30-45 minute journey on a gravel road, navigable by 4×4 vehicles.

Without a local clinic, residents often walk for eight hours to reach the nearest health facility in Molikaliko. This daunting trek discourages many, particularly without guaranteed medical assistance.

Instead, many villagers depend on monthly community outreach programs for basic health services. However, complex cases like Matubatuba’s necessitate referrals to larger facilities, such as Mokhotlong Government Hospital or Queen Mamohato Memorial Hospital.

Lesotho advances in subsidising health services

A 2018 World Bank study on Universal Health Coverage highlights that many nations, including Lesotho, are implementing pro-poor reforms to advance universal health coverage. In simple terms, the study states that universal health coverage ensures that all individuals in need of health services can access them without facing excessive financial burdens.

Backing this commitment, the Lesotho government initiated a comprehensive health sector reform process in 2010, as outlined in the Lesotho Public Healthcare Revitalisation Plan 2011-2017. The primary objective of this reform was to achieve affordable, universal coverage, and equity in health service delivery.

In the realm of affordability, Lesotho’s government has demonstrated commendable performance, especially when compared to other countries in Sub-Saharan Africa and the SADC region.

Through substantial investments in the health sector, the country has succeeded in providing nearly free health services in state-run facilities nationwide. Patients benefit from cost-free health services at clinics and incur smaller fees at the hospital level, facilitating crucial access to healthcare.

Additionally, the government funds international medical transfers to locations such as Bloemfontein, South Africa, and India. This commitment was evident during the peak of the Covid-19 pandemic when ‘Mashebisang Matubatuba from Maloraneng was transferred to Bloemfontein, South Africa, for specialised medical attention.

Describing her experience, Matubatuba explains, “I went to Bloemfontein, I was scanned and booked for another appointment. I went again, scanned and booked for another appointment. I went for the third time, scanned.”

Tissue growth behind eye causes unending ordeal.

In Bloemfontein, after four years of grappling with an elusive condition, Matubatuba finally learned the root of her distress – a tissue growth behind her left eye, responsible for its dislocation.

However, the revelation did not lead to immediate relief. She was scheduled for surgery to a later date.

On her scheduled day for surgery in Bloemfontein, an unexpected obstacle emerged: the entire region was grappling with a water shortage, rendering her operation impossible.

“I was booked for another appointment,” Matubatuba recalls.

The process of getting to Bloemfontein is bureaucratically challenging. Patients, or their caregivers, must sign a necessary form at the Ministry of Health in Maseru, a step that can only be completed on weekdays.

Matubatuba’s 2022 appointment in Bloemfontein was set for a Monday, requiring her to sign the form by the preceding Friday to facilitate her journey to South Africa.

Yet, financial constraints thwarted her plans. “I missed my appointment because I couldn’t afford the transport from my home to Maseru, before heading to Bloemfontein,” she explains.

Although the government covers the transportation cost from Maseru to Bloemfontein, patients must fund their travel to Maseru independently.

The financial burden of reaching Maseru meant Matubatuba had to restart the entire transfer process from Tšepong (Queen ‘Mamohato Memorial Hospital).

“I haven’t been able to return to Tšepong due to lack of funds,” she shares, her voice tinged with despair. “This is affecting me deeply; I doubt I will ever heal, especially when I see my sick son and feel so helpless.”

Matubatuba is earnestly appealing to compassionate individuals for financial support to cover all her medical transportation expenses. This includes the costs from initiating the transfer process at Queen ‘Mamohato Memorial Hospital again, through to the completion of her treatment journey.

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