In the house of death

In the house of death

MASERU – When Dr Lefatle Phakoana was growing up, he could not have imagined that he would one day work with blood, let alone dead bodies.
The mere sight of blood would send him scattering away in panic.
Yet today, Dr Phakoana, as one of Lesotho’s only two trained pathologists, spends the bulk of his time cutting up and sewing dead bodies while investigating the cause of death.

It is a dreary career, and a scary one for the uninitiated, that puts him in constant contact with the dead.
One could imagine that he would need a certain degree of numbness to get the job done every day; a certain desensitization to be able to handle dead bodies, on a daily basis and continue to eat meat.

As a Mosotho who grew up in a traditional set-up deep in the mountains of ’Matsaile in Qacha’s Nek, Dr Phakoana is a product of his cultural environment. That is why he found himself struggling to shake-off the fear of the dead when he first entered medical school at the University of Havana in Cuba.

Basotho generally believe in the African concept of the “living dead”; that the dead are not really dead but remain major players in the affairs of the living. You cross their path at your own risk because they can come back to haunt you. But when you appease them, then they can shower endless blessings on you.

It is a philosophical concept that has a fundamental bearing on how Basotho relate to the dead.
Yet for Dr Phakoana working with the corpses comes with the territory in the medical field.
“We are used to corpses,” he says nonchalantly.

“When I am in that mortuary and I feel hungry, I eat. That does not even cross my mind. A dead person is just like a dead dog, excuse me for the analogy.” He says as a medical doctor, he has been trained to deal with death on a daily basis and he would be surprised if there is any doctor who would feel otherwise.

“No doctor can tell you he is afraid of a dead body. He would not have gone to medical school.”
His first contact with a dead body came as a shock though when he was in his first year at the University of Havana Medical School in Cuba.
“They brought the body and it was covered in a sheet during a practical lesson. When they uncovered the sheet, and I saw a human body, I ran away,” he says.

He says he was not the only student who fled the lesson with a number of his first year colleagues walking out as well. It was a major shock to him.
“But I realised that if I was going to make it, I would better get used to this.”

That “baptism of fire” was basically how he found himself being introduced to the medical profession.
After that tough introduction, Dr Phakoana says he soon found himself “fiddling with corpses and cutting dead bodies throughout the night” as he prepared for his school examinations.

That fear was gone. “I had to quickly acclimatise to my new environment. I said if I did not do so, then I was not going to make it here.”
The fear of failing and going back to a life of penury in the village of ’Matsaile egged him on.

As one of only two trained pathologists in Lesotho, (the other is Dr Moorosi), Dr Phakoana says he would still choose the same career path that has taken him where he is right now if he is given a second chance.

“I would still take it. There is nothing wrong with this job unless if you are dealing with criminals within the police,” he says.
Dr Phakoana is a resident doctor at Letšeng Diamonds in Mokhotlong.

He is also currently working with the Lesotho Mounted Police Service (LMPS) assisting them with pathology services.
His key task is to ascertain the cause of death during post-mortems, a critical component for the police as they investigate crime, particularly murder cases.

It is a territory that has proved quite treacherous for Dr Phakoana after he was implicated in the cover-up of the murder of a police officer, Mokalekale Khetheng. Khetheng was kidnapped by the police in March 2016 and his decomposed body was later exhumed at a cemetery on the outskirts of Maseru some eight months later.

Five senior police officers and a former defence minister, Tšeliso Mokhosi, have been arraigned before the courts for Khetheng’s murder.
The six are denying the charge.

“I had a hard time with the Khetheng issue and I was implicated in that rubbish. We were at loggerheads with the police over the matter,” he says.
Dr Phakoana says the police just brought a body which they said belonged to Khetheng “that was so decomposed that I could not ascertain the cause of death”.

“This is what they put before me,” he says.
After he was implicated in the cover-up, Dr Phakoana says he decided to walk away.
However, he says the police later realised they really needed his services and now “I am back with the police” even though he has made “things more stringent when dealing with them”.

He says he sometimes examines about 20 bodies in a day. Yesterday, he had an appointment to carry out post-mortems on five bodies.
“There is a huge backlog and I am still examining bodies from last year.”

He says while every doctor can do a post-mortem, there are still very few trained pathologists working in Lesotho.
“Some people just don’t like it; the job is not something you can write home about.”

He says despite pumping lots of monies in training, Lesotho continues to suffer a critical shortage of medical specialists.
Dr Phakoana says Lesotho does not even have a single trained skin doctor.

“We have very few psychiatrists working in Lesotho. Very few people have had that exposure here.”
He says the fact there are just two trained pathologists in Lesotho boils down to issues of remuneration which he says is poor.
“The remuneration is not too attractive. That is why we have so many learned Basotho who are working in South Africa and do not want to come back and work here at home.”
He says even though he was trained in general pathology at the University of Zimbabwe between 1992 and 1993, there are still areas he feels they still need to improve.

“We have not really gone to the deepest levels of knowledge of pathology but of course as compared to other doctors who have not studied pathology, we are better off.”

Dr Phakoana says the key in retaining qualified medical professionals in Lesotho lies in improving issues of remuneration as well as setting up a medical school in the country.

“That should be the starting point,” he says. “If we have a medical school we will have people who would specialize in programmes in this very country. We need so many specialists.”

As a medical professional, Dr Phakoana says “we must get our primary health care system being managed properly again”.
He also believes health centres must be “manned by knowledgeable people not nurse assistants”.

“We have allowed people with very low qualifications to run the health centres but they are not able to perform certain tasks,” he says.
“We have to make sure more people who are adequately qualified fill up our clinics in the rural areas.”

Dr Phakoana says the political instability in Lesotho over the last five decades has hurt our health delivery system.
“Politics have interfered with our health delivery system. Some ministers who are doctors even forget they are doctors first and politicians second. That is a very big mistake.”

Dr Phakoana was born on November 30, 1961 in ’Matsaile in Qacha’s Nek to a father he says was a tough “old school” high school teacher who would harshly discipline him for even some minor indiscretions.

His methods of enforcing discipline, however, never endeared him to his son who would later rise above all odds to be a medical doctor.
“He never thought I would make it,” he says.

He says growing up, he was just an average student who told himself that he had to “make it in school otherwise he would be doomed”.
It was that outlook that ultimately provided the springboard for his academic success.

Abel Chapatarongo

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