The heroes rolling back AIDS

The heroes rolling back AIDS

Health-care volunteers provide services in hard-to-reach districts………………

MOHALE’S HOEK – Lesotho’s barefoot doctors are making a change in rural areas where medical personnel — and general affection — are scarce.
’Mabokang Sello wakes up early daily to trudge long distances to take care of Aids patients in Ha-Phafoli and surrounding villages.
For the past 11 years Sello has helped take care of patients with full-blown AIDS, delivered new babies, fetched medication many kilometres away for people suffering from different ailments.
Often, she is called on to change and wash linen for those with no one else to take care of them.

Sello is one of about 500 community health workers in Mohale’s Hoek popularly known as the “barefoot doctors”.
They are village health workers who have volunteered to provide basic health care in hard to reach areas.
There are more than 6 000 such “barefoot doctors” across the country.

Lesotho adopted the primary health care system in 1979, and community health workers were included in the programme to focus on health promotion, particularly to reach people in marginalised rural areas.

In a 2016 research, a team of academics led by ’Mantiti Khabo noted that although the village health workers programme has been successful, the heavy burden of disease because of HIV and AIDS and tuberculosis shifted resources from health promotion to home-based care.

The research found that roles of village health care workers ranged from offering basic first aid and home-based care to increasing access to health care services by taking patients to the facilities and promoting behaviour change through health education.

Their core roles consist of disease prevention and early detection of ill-health, community advocacy, outreach services, home visits, assisting in accessing services through referrals and follow-ups, treatment of minor ailments by administering basic first aid and providing psycho-social support through support groups.

They act as agents of health promotion, and their comprehensive knowledge of their communities makes them effective agents of health promotion.
Although often not celebrated, barefoot “doctors” such as Sello have managed to bring health care to rural areas where urban-trained doctors would not settle.
Their successes include increased access to health care services and reduced mortality rates.

Little wonder Sello was elated last Friday when Health Minister Nkaku Kabi and the Hloahloeng MP, former Speaker of Parliament Ntlhoi Motsamai, officially opened a clinic in Ha-Phafoli.
Construction of the clinic was completed in 2007 but it was left to lie idle.
Sello and other colleagues actively participated in the construction of the clinic for no payment.

“We gathered stones and I was pushing a wheelbarrow almost every day bringing stones to the construction site,” she says.
The inauguration of the clinic does not only mean that there will be professional nurses in the village, but it will at least cut her gruesome trips to Hloahloeng Ha-Nkau to get pills for her patients.
“I would wake up early in the morning and walk to Ha-Nkau clinic for four or more hours to get drugs for the patients,” Sello says.

“Ha-Nkau is very far from here, which means I would start my journey when it was still dark. In most cases I walked because of lack of transport,” she says.
“The clinic in Ha-Nkau opens at 8am and I would target to be there when it opens or at least a short time after it opened.”
At the Ha-Nkau clinic, she would also get latex gloves to protect herself against contracting infectious diseases, and condoms to distribute freely to the villagers as part of HIV and other sexually transmitted diseases prevention.

“To be a village health worker requires dedication,” she says.
Travelling in Hloahloeng constituency itself is gruesome because of the mountainous terrain full of round basalt rocks that roll when stepped on.
If one is travelling on horseback, they must be a skilled rider.

There is only one road that connects the neighbouring Qacha’s Nek and Maseru.
Many areas in the constituency do not even have primary schools.
Some people in the constituency say they have never seen anybody working for the government except nurses at Ha-Nkau clinic, policemen who often pass through their villages on horseback and of course their chiefs or headmen.

This explains why it is important to have one of their own as a village health worker, someone who has basic training on home-based health care.
Many villagers are illiterate and they need someone to interpret the nurses’ instructions and what is written in their health booklets.
Because of their backward circumstances many still believe they are bewitched when they fall ill.
Sello describes her work as “a sacrifice”.

In Lesotho, temperatures drop to below zero at night and mornings and it is worse in the mountainous regions where Sello sometimes has to visit.
Sello says sometimes she is afraid to walk alone in the dark and she asks her husband to accompany her.
“This job is not easy at all,” she says.

However, her commitment to the health of her fellow rural folk means she will continue despite the poor monetary rewards.
A health worker gets M400 per month, not for her personal use as a stipend but for spending on helping the sick.

“This money is too little. There are too many sick people in these villages and you end up spending your own money on them because this one given by the government is finished,” she says.
Minister Kabi announced last Friday that the government was considering doubling money paid to the health workers.
Kabi also promised that village health workers would be paid some allowance for their personal use after realising the dedication that goes with the work. For villagers, the opening of the clinic came as a relief.

Phoka Seeiso, a local villager, said many people have died while some have used a lot of money travelling to Ha-Nkau Clinic.
He said a return fare is M60 per person, forcing those without the money to stay at home.

Hloahloeng MP Ntlhoi Motsamai said there are only two clinics in that constituency at Ha Nkau and Koebunyane.
“This makes people not to go for regular check-ups,” Motsamai said.

’Makhotso Rakotsoane

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