By boat and on horseback

By boat and on horseback

QACHA’S NEK – Unable to get a pregnant woman across the river to the nearest hospital, midwife Teboho Phalo had the most hair-raising experience of her career – delivering a baby on a river bank at 2am with her cell phone acting as the only source of light.
“I had to do what I had to do. Eventually the child was born, on the river bank,” she told thepost.
“I could not stop praying for both the mother and the baby,” Phalo says.

The incident highlights the grave risks braved by both patients and medical staff due to the inaccessibility of well-equipped health facilities in some of Lesotho’s outlying areas. When Phalo received an emergency call from her boss, Dr Michael Luaba Kamangu, to go and help a woman about to deliver, her instincts were to rush.

The problem is the clinic is five kilometres away across the Senqu River and only accessible by boat or horseback to many communities. And she had to drive through a rough gravel road to get to the river before catching the boat and then hop into another vehicle to get to the clinic.
But that was nothing compared to what she was about to experience.

At the clinic, the pregnant woman was in bad shape and facilities at the institution were ill-equipped to deal with her condition.
“When I finally arrived at the clinic it was clear that the woman needed the attention of doctors,” she says.
Doctors are only available at Tebellong Hospital in Qacha’s Nek.

To get to the hospital, Phalo, now with the patient and support staff, had to again cross the river as time ran out.
“We anticipated that special equipment and special medical care was needed for both the mother and the baby to survive so we had to travel back,” Phalo says.

The woman was suffering labour pains and they realised that she could deliver at any time.
At 2:40am, they decided to get into the boat and quickly rush to the hospital.
They were late.

“The woman told us she could feel the head of the baby coming out,” Phalo said.
“We had to rush back to the vehicle and lay her down for delivery. Eventually the child was born, on the river bank,” she said.
Phalo’s fear was that the child would run out of breath and die and the mother would bleed to death.
To her relief, both the mother and baby survived.

The baby’s heart was beating healthily and the mother did not have any blood overflow,” she said.
Phalo says they immediately hopped onto the boat to get to a hospital and then into 4×4 taxi waiting on the other side of the river.
In her four years of midwifery, this was Phalo’s first delivery outside a hospital setting.
But it was not the first time to endure such delicate travel arrangements.

The clinic, situated in Ha-Sekake, is one of several that often refer patients to Tebellong.
Her experience is normal for nurses at Tebellong Hospital and clinics in Qabane, bordering Qacha’s Nek and Mohale’s Hoek districts, and some parts of Quthing.

Qabane alone has 113 villages that depend on Tebellong Hospital.
The common mode of transport to get to Qabane community council is by horse.
Skills on horse riding are a requirement because outreaches to Qabane are done on horseback.

Nurses working at the hospital have to learn how to ride on horseback for their outreach services.
The nurses often go out to villages to help or visit local clinics when there is a need.
Patients coming from the other side of the river need a boat ride at a cost of M6.00 to get to Tebellong, then walk up a rocky hill or pay more for a 4×4 vehicle that will be waiting across the river.

Mphasa Marotholi, the boat operator, has 24 years of experience helping people cross the river.
“I have seen the best and worst moments of this river and the hospital,” Marotholi says.

“I have received midnight calls and had to assist nurses pull in and out patients off the boat,” he says.
Marotholi said he is on duty at all times when he is needed.

“My job gets even harder when the river is filled to the brim,” he says.
“When the water covers the trunk of that tree I know it is dangerous and therefore no one will cross the river,” Marotholi says, pointing to a willow tree that stands not too far from his pick and drop point.

Despite these difficulties Tebellong Hospital has recorded 100 percent live births, zero maternal and infant mortality for the past five years.
The hospital is one of the only two hospitals in the Qacha’s Nek District, one being Machabeng Hospital which is in town.

“We do all in our power to avoid referrals to Queen ’Mamohato Memorial Hospital because it would mean a serious struggle to get the patient onto the car,” Dr Kamangu, Tebellong Hospital Medical Superintendent says.
“We have lost patients at the river because of the time it takes to get to the river and cross the river. Just last week we lost a patient while transferring him to Tšepong,” he says.

The lack of a bridge affects both villagers and medical staff.
“When the river is overflowing our staff that stays in town cannot come to work and that affects our work here at the hospital,” Kamangu said.
Deputy Minister of Health, ’Manthabiseng Phohleli, has promised to ask the Ministry of Public Works to construct a bridge across Senqu.

“I am even more excited that you work hard despite the challenges you face,” Phohleli told the staff at a recent event to honour Phalo for her bravery.
“I am mostly delighted to hear you work hard to reduce the number of referrals to Tšepong because we spend just too much as a ministry on Tšepong,” she says.

“The money that can be used to develop and upgrade our hospitals and clinic is used to pay Tšepong,” she says.

Tšepong is a private company running Queen ’Mamohato Memorial Hospital under a Private-Public-Partnership.

Rose Moremoholo

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