The pleas of a desperate woman

The pleas of a desperate woman

BEREA – ’MANTSANE Nkome-Nyoni has uncontrollable bowel movements, has lost control of her bladder, is paralysed and her body is in pain almost all the time.
The 45-year-old reckons she could have been well on her way to recovery by now after she received offers to be treated at South Africa’s Chris Hani Baragwanath Hospital.
Yet, even after failing to treat her, Lesotho’s health system seems to be conspiring to prolong her misery, she says.
Nkome-Nyoni blames the management of Berea Hospital for her worsening condition after they allegedly refused to release her health records to the Chris Hani Baragwanath Hospital to enable her to get further treatment.

On its part, the Ministry of Health refuses to take responsibility and in fact considers her case as “closed”. The ministry says “there is no money” to help her financially.
The case highlights how bureaucracy often negatively affects mostly the poor who have neither the financial nor political muscle to deal with the red tape found in government offices.
For Nkome-Nyoni, efforts to get local health authorities to cooperate have been so sluggish that at some point all she wanted was to die.
“I had enough pain and I wanted to go and die at home in peace,” she told thepost, visibly dejected.

A divorcee with little means of supporting herself, Nkome-Nyoni fell ill in February 2014 and was diagnosed with meningitis.
Doctors at the hospital attempted a spinal tap to collect cerebrospinal fluid (CSF) to ascertain the type of meningitis she was suffering from and failed two times.
They only succeeded on the third attempt after Nkome-Nyoni spent two months bedridden in hospital.

Nkome-Nyoni from Teya-Teyaneng Ha-Motjoka said the symptoms started as headaches for about two months.
Medication prescribed by both the hospital and pharmacies seemed not to work.
It was then that Nkome-Nyoni decided to go back to Berea hospital for tests.

“On my arrival there, I slept on casualty (department) chairs until I was admitted as I had watery eyes,” she said.
That was when the doctors suggested CFS tests. For a conclusive diagnosis of meningitis, a spinal tap to collect cerebrospinal fluid is needed.
In people with meningitis, the CSF often shows a low sugar (glucose) level along with an increased white blood cell count and increased protein.
“After failing (CFS) two times, I felt numb and I was unable to move.”

She said the doctor said he would try for the last time and if he still failed, she would be referred to another doctor.
“He did (the fluid collection) but still failed,” she said.
Nkome-Nyoni said she had given up and asked the hospital authorities to discharge her.

However, the doctor asked a nurse to talk to her and convince her that they had found a doctor who could help her.
“I was heartbroken after realising that I could no longer walk,” she said, adding: “As if that was not enough, I lost control of my bladder and bowels as well.”
Help did come and for a while she improved.

“My headache got better but the problem was now walking,” she said.
Nkome-Nyoni said the “merciful” doctor wrote a letter to the Ministry of Social Development seeking assistance for her to get a wheelchair and grants so that she could be able to travel to health centres.
That was the start of her agonising dealings with a bureaucracy that seems not to flinch even in life-threatening situations.
“I was told to bring my village chief’s letter as proof,” she said.

She did as was requested but the problem was no longer the letter. Officials told her to go back to the hospital “to tell the doctor to pay for the medication expenses as he earned a salary”.
“This broke my heart,” Nkome-Nyoni said, adding she had no other pillar of support at that time except the State and the health professionals who seemed to dither.
“I was now staying with my children only.”

The condition began to take a turn for the worse again, prompting her boyfriend to take up the matter and offer to take her to Chris Hani Baragwanath Hospital in Johannesburg.
“I was admitted there and the doctor told me that my spinal cartilage was splintered,” she says.
To help her, the doctors there wanted her health records and other information held by Berea Hospital.

To her shock, authorities at the hospital refused to produce the records.
Nkome-Nyoni said the hospital authorities seemed so determined not to help her that they rejected pleas by her doctor to allow him to talk to his Chris Hani Baragwanath Hospital counterparts.
Meanwhile, her misery continues. She is now bound to a wheelchair.

Upon her return to Lesotho, Nkome-Nyoni went back to Berea Hospital and asked for the letter requested by Chris Hani Baragwanath Hospital.
“I was told a whole lot of things that forced me to go back to the doctor who helped me,” she said.
The doctor allegedly tried to talk to the hospital management in his personal capacity but all was in vain.
“The doctor offered to share his salary with me but I refused because all I wanted was to go to the hospital.”
Adding to her woes, her boyfriend who helped her financially died.

“I cried out to anyone who cared to listen for assistance and some people came forward, even the Health Ministry got involved,” she said.
When the government changed in 2017, the help from the ministry stopped.
She said that it was only last year when she was called to the Health Ministry and she was interrogated.
She said the ministry also demanded her health booklet, which she provided as instructed.

She said that the doctor whom she found at the ministry told her not to blame the doctor who treated her at Berea Hospital.
However, after seeing her health booklet “she said they would call me again but to date they haven’t”.
Nkome-Nyoni is receiving M700 after every three months for groceries and receives disposable nappies from the Ministry of Social Development.
The disposable nappies are so few that when they run out she resorts to baby nappies.

For someone used to working to feed her family, Nkome-Nyoni’s condition makes her feel hopeless.
“My life has changed for the worse. I am the hands-on type of person but now that I cannot walk, it is a major setback,” she said.
“If only I can be assisted with painkillers and some things to use so that I won’t stink around people,” she said, referring to instances when she cannot control her bowel movements and end up relieving herself in public.

Nkome-Nyoni recalled her embarrassment when she relieved herself in a taxi on her way to consult a doctor in Bloemfontein.
“I did not even feel the faeces sliding down my legs and a man who was sitting next to me pointed to the mess and asked me what was happening,” she said.
Instead of answering the man, Nkome-Nyoni wept.
“I am always miserable,” she said.

The Ministry of Health’s Director of Clinical Services, Dr ’Makhothatso Mapota-Masoabi, insisted the ministry dealt with Nkome-Nyoni’s case “a while” back – never mind the pain she is in now.
“It has been a while now,” Dr Mapota-Masoabi told thepost. “The ministry doesn’t have money allocated to assist her. The complication that occurred to her could have been caused by meningitis,” she said.
Dr Mapota-Masoabi said the Lesotho Medical and Dental Practitioners Council suspended the doctor who treated Nkome-Nyoni pending finalisation of their investigation.
The doctor has got his licence back though after spending more than six months without practising, according to Dr. Mapota-Masoabi.

“We found that it was not the doctor’s fault. He took six months to a year without getting his certificate.”
She said Nkome-Nyoni approached the ministry saying she did not blame the doctor who “worked hard to help her while others were not helping”.
“That was when we closed her case,” she said, adding: “If she is unsatisfied about anything, she can call me anytime.”

Dr. Mapota-Masoabi said Nkome-Nyoni was already suffering from epilepsy, which could have exacerbated the meningitis.
“Complications that occur when a person is sick are not in the doctor’s control. It is all about the progression of the illness itself,” she said.
Dr. Mapota-Masoabi said she was surprised that Nkome-Nyoni’s case has resurfaced.

“There is no way the ministry can take responsibility. She already had other illnesses,” said Dr. Mapota-Masoabi, adding that Nkome-Nyoni’s health booklet “reveals that she has the non-curable (meningitis) one”.
But, with the ministry seemingly willing to regard the case as closed and unprepared to chip in to help, life cannot only be worse for Nkome-Nyoni.
And, with signs that no help is coming her way any time soon, Nkome-Nyoni said she is becoming desperate.
“I am so desperate because I have children to take care of,” she said, tears flowing.
“I need help.”

‘Mapule Motsopa

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