The rot at  Queen II

The rot at Queen II

MASERU – QUEEN Elizabeth II Hospital used to be a centre of excellence. If other clinics and hospitals in the districts failed to treat your illness this was the place where your troubles ended.

It is in its wards that most of us were born. Here is where most of us came to be repaired by hardworking doctors and nurses whose salaries were paid by the government.  Then things functioned well, from the toilets to the kitchen. Those times are gone, to be replaced by what looks like a ghost town deserted by its people.

The only difference is that people still come here. On this day I am drawn to the hospital by curiosity.
I was invited by filth surrounding the buildings.At the main gate I was welcomed by scores of plastics blown towards me by the wind, a sure sign that garbage collection at the hospital is not good.

Broken chairs and tables are piled in the yard. I head to the main entrance where a foul smell greets me. There were tens of people waiting for the doctor. I could see some covering their noses with hands or cloths from the stench. The repulsive smell is coming from the toilets which, I am later told, have been blocked for the past few days.  A pool of water has covered the floor.

I feel like throwing up. Raw sewage is overflowing from the toilet seats. It’s a mixture of toilet paper, human waste and sanitary pads.
A yellow-like liquid is flowing from the sink. Disgusted, I walk out of the toilet and head to the manager’s office.
The manager’s office is an old, dilapidated stone building with steep stairs at the entrance.

The manager’s office is probably the cleanest room in the hospital yet it too tells the sad story of how things have been allowed to rot at the country’s oldest hospital. Tiles have been chipped off the floor and the furniture is rickety. Something has gone horribly wrong at this hospital.

The old kitchen, which is no longer used to cook for the patients after Queen II stopped admitting patients five years ago when it was closed and replaced by Queen ’Mamohato Memorial Hospital as the referral hospital, has been left to crumble.

The shrubs, empty soft drink cans and plastics blown by the wind made the kitchen and the entire health facility look like a makeshift medical camp and not a hospital in the capital city. It’s hard to believe that this is hospital in a country that spends billions of maloti on its health services.
There is poor management and there is just utter neglect. It doesn’t look like the management has gone out of its way to bungle things.
They just happen to be in charge of a hospital that has been allowed to fall apart.

The manager, ’Makhothatso Masoabi, is in charge of a team she says is passionate about its work but is hamstrung by a dire lack of resources.
The hospital did not have any money for the better part of the year, Masoabi says.

Masoabi said the hospital was last included in the budget for the 2015/2016 financial year. “We are not able to buy toilet paper, we can’t procure the services of a plumber and many other essential services because of lack of funds,” Masoabi explains. “It is a pity that some patients use socks, stones and newspapers and they block the toilet’s drainage system.”  However, the hospital was included in the 2016/2017 budget but Masoabi did not want to say why the funds for that financial year were not used for the improvement of the hospital.  “We take cleanliness as a critical aspect at the hospital.”

She says patients visit the hospital in order to be “treated of their ailments and not to be subjected to any harmful conditions”.
In the past, Masoabi says, “we were able to unblock the toilets once blocked but we are now fighting a losing battle”.
“And now we need the plumber to come and do major maintenance.” She says a number of plumbers had already submitted quotations.

“It is our biggest outcry to fix the situation as it is out of control now,” she says. Masoabi says what makes the situation worse is that the toilets are also used by the public because the Maseru City Council does not have any public toilets nearby.

She also says pipes were damaged during the maintenance of the road connecting Mpilo Boulevard and Kingsway, which passes through the main gate. Last Wednesday officials from the Health Ministry were at the hospital supposedly to assess the situation.
The new Minister of Health, Nyapane Kaya, says he sees a “political hand” in the mess the hospital has become.

“Some workers work because they belong to ruling parties while others don’t work because their parties are not ruling,” Kaya said after a tour.
“Respect yourselves; remember what brought you to work. Do not say you don’t belong to a political party and so you do not work.”
Kaya says what he saw at the hospital did not reflect what had been told.

Kaya says it looked like the hospital had been cleaned after he announced that he would be visiting.
“If ever one does not do their job, we will take drastic action,” he says.

His deputy ’Manthabiseng Phohleli says “cleanliness starts with you as a person, starts with a healthy environment, so that whoever comes here becomes cured by just seeing a clean environment”. Themba Fobo, former Principal Inspector of the Ministry of Health, recommends the hospital management to invite a health financial director to observe the situation.

“After exploring, it is then that the maintenance department can be granted money to unblock the toilets,” Fobo says.
The Director General of Health Services, Dr ’Nyane Letsie says “each department has cleaners, and an allocated person should be known and (each department) should have schedule of work”.

“This will enable the responsible person to take charge,” Letsie says.
“At times like this, it will be easy to direct the ‘why part’ to the right person. They should be categorised so that whoever fails to do his or her job suffers the consequences of his or her actions,” she says.

‘‘We should examine the toilets to see whether the problem is solved or not. There are options to avoid using such toilets and use temporary ones.’’
“It’s not just about the toilets being dirty but controlling diseases such as diarrhoea,’’ Letsie, a public health expert, says.
The hospital was closed after former Prime Minister Pakalitha Mosisili’s administration replaced it with Queen ’Mamohato Memorial Hospital in 2011 as the national referral hospital.

It was however reopened, albeit partly, to serve the Maseru urban community in 2014 during Thomas Thabane’s administration.
Last year the government invited tenders from construction companies to demolish the hospital to make way for what the Ministry of Health has called a state-of-the-art district hospital.  While Queen II is battling to get funds, more than half of Lesotho’s entire health budget has been spent on payments to the private consortium, Netcare, which runs the Queen ’Mamohato Memorial Hospital.

The South Africa-based Netcare is the biggest private healthcare provider in the United Kingdom.
A report by Oxfam, an international confederation of 20 NGOs working with partners in over 90 countries to end the injustices that cause poverty, reports that the healthcare of the poorest people is at risk as the Queen Mamohato Memorial Hospital gobbles money that is badly needed for clinics in rural areas.
The government is spending US$67 million (about M1911.2 million) a year on the hospital complex, which includes several primary care clinics, loan repayments and the cost of patient care, Oxfam said in a report that has been strenuously rejected by Netcare.
Netcare has insisted that the report was based on unreliable data and even conjecture. Oxfam says Public/Private partnerships to build hospitals have a poor track record even in rich countries.

“PFIs (public finance initiatives) have proved a heavy financial burden on the NHS in England, where 22 hospital trusts in 2012 said repayments were endangering their clinical and financial future and one has since gone into administration because of PFI debts,” reads the 2015 report.
Oxfam says this is a dangerous model for low-income countries in Africa.

In Lesotho, it warns that the situation is unsustainable. When the hospital was built Queen Elizabeth II Hospital’s 100-year-old buildings were falling apart. Basic equipment was in a state of disrepair, drugs in short supply and nurses overworked.
Mortality was high.

The idea was that the new hospital would function better because it would be managed by an experienced company, Netcare, which had hospitals around the world.  But Oxfam argues that the improvements, by building the Queen ’Mamohato with the administration of Netcare, have come at a high and spiralling financial cost.

The Lesotho government, which introduced free healthcare for all, is billed by the Netcare-led consortium, called Tsepong Ltd, for additional patients.
Oxfam reports that Lesotho is increasing its health budget in order to meet the costs of the hospital.
The then Health Minister Dr ’Molotsi Monyamane is quoted as saying: “Health is increasing but this will be at the expense of something else. We may be able to treat people if they get ill but we will not be able to ensure they have enough to eat.”

“I don’t think it is currently a financial problem but it has the potential to create a big gap in terms of healthcare funding for the rest of the country,” he told Oxfam.  The contract runs for 18 years, at the end of which the hospital will come under government ownership.
However, the Lesotho-Boston Health Association (LEBOHA) published quite a positive report about the private-public-partnership (PPP) between the Lesotho government and Netcare in 2015.

The report shows that the project represented the first time a (PPIP) was established in sub-Saharan Africa and, moreover, in a lower income country anywhere in the world. It says the project was also the largest government procurement of health services in Lesotho history.

’Mapule Motsopa

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