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HIV/AIDS fight takes a knock



MASERU – LESOTHO is one of the countries that has recorded commendable progress in the fight against HIV/AIDS, eight years ahead of the 2030 target which seeks to end the HIV/AIDS epidemic as a public health threat.

Compared to other developing countries, Lesotho achieved the 90-90-90 target in 2020, which requires that 90 percent of all people living with HIV will know their HIV status, 90 percent of those diagnosed will receive sustained treatment, and 90 percent will have viral load suppression.

But, many warn that such success is no reason for complacency.

According to official figures, the country recorded 7,700 new HIV infections in 2020, while 280 000 Basotho are living with the virus.

Be in the Know, an online HIV magazine, says at least 4,700 Basotho died of AIDS-related illnesses in 2020, the latest available statistics.

With 1.5 million new HIV infections recorded across the world in 2021, UNAIDS Country Director, Pepukai Chikukwa, says the virus remains a crisis globally. The figure is one million above the global 2020 target set at 500 000 per year.

“We are failing in terms of the target that we set ourselves,” Chikukwa said.

Despite effective HIV treatment and tools to prevent, detect and treat opportunistic infections, she said 650 000 people died of AIDS-related illnesses globally as the HIV pandemic took a life every minute on average.

“During the last two years of Covid-19 and other global crises, progress against the HIV pandemic has faltered,” she said.

Chikukwa said globally, new infections dropped by 3.6 percent only between 2020 and 2021, “the lowest annual decline in new HIV infections since 2016”.

“From 2016, our declines have been averaging 10 percent or more.”

“Resources have been shrinking, with many major bilateral donors reducing international assistance for AIDS, some by over 57 percent,” she added.

Chikukwa said low and middle income countries, including Lesotho, are struggling under the greater fiscal burdens caused by the Covid-19 pandemic.

Four decades into the HIV response, she said, inequalities persist for the most basic services like testing, treatment, condoms and even more so for new technologies.

“These inequalities have been further exacerbated in the last two years.”

She said young women in Africa remain disproportionately affected by HIV, while coverage of dedicated programmes for them “remain too low”.

In 19 high burden countries in Africa, dedicated combination prevention programmes for adolescent girls and young women are operating in only 40 percent of the high incidence locations, she said.

“Only a third of people in key populations, including gay men and other men who have sex with men, transgender people, people who use drugs, sex workers and prisoners have regular access,” she said.

“Key populations face major legal barriers including criminalisation, discrimination and stigma.”

In the East and Southern African countries, including Lesotho, adolescent girls and young women are three times likely to acquire HIV as adolescent boys and young men, she said.

Chikukwa said 4 200 adolescent girls and young women aged between 15 and 24 years become infected with HIV every week.

Chikukwa said the gendered HIV impact, particularly for young African women and girls, occurred amidst a disruption of key HIV treatment and prevention services, millions of girls and boys are out of school due to the Covid-19 pandemic and spikes in teenage pregnancies and Gender-Based Violence (GBV).

“We have only eight years left before the 2030 goal of ending AIDS as a global health threat,” Chikukwa said.

“Therefore, economic, social, cultural and legal inequalities must be addressed as a matter of urgency,” she said.

“In a pandemic, inequalities exacerbate the dangers for everyone.”

She said the end of HIV/AIDS can only be achieved if we tackle the inequalities.

Leaders, she said, need to act with bold and accountable leadership and “all of us must do all we can to help them”.

Chikukwa said this as Lesotho joins the world in the commemoration of World AIDS Day today under the theme “Let’s equalise: HIV & AIDS services for all. Leave no one behind”.

“The ‘equalise’ slogan is a call for action,” she said.

The National Aids Commission (NAC) Chief Executive Officer (CEO), Lebohang Mothae, said Lesotho has made remarkable progress in its HIV/AIDS response as reflected in LePHIA 2020 and the medium term review of the national HIV & AIDS strategic plan.

“We are on the right track but we are also in a fragile state because if we don’t, in any way, attend to these inequalities we will regress,” Mothae said.

She said although Lesotho has achieved beyond the 90-90-90 targets, “we realised that the progress is slow”.

“Because of the risks that are persisting from time to time, we are actually going to be in danger if we don’t act at a faster pace than the inequalities and the risks that we are confronting.”

She said gender inequality needs to be dealt with decisively.

“We see it culminating into GBV, which include sexual offences and intimate partner violence, the inequality that leads to having a high number of early and unintended pregnancies, early marriages and the type of inequalities that put a huge risk adolescent girls and young women,” she said.

She said some parts of the society still have low access to and uptake of services.

“In some services for young people, we are still performing lower prevention services and now we have to accelerate all the efforts geared towards closing that gap that we see between our young people.”

Mothae said key populations are another group of concern.

She said they are also disproportionately affected as ease of access of services is still a challenge and yet HIV prevalence amongst them is high.

“If we don’t attend to this inequality of denial to access services, there is going to be a high risk to the general public.”

She said geographical location is another inequality experienced in Lesotho.

“These inequalities and barriers that affect different populations drive new infections…we need to work hard and accelerate all the efforts to bring everybody to make them central to the response.”

Mothae said: “As long as we leave anyone behind, we are at risk. We need to start reprioritising HIV and put it back on a national development agenda.”

According to LePHIA 2020 statistics, there is high prevalence among women aged 15-44 at 29.4 percent, 71.9 percent among female sex workers while 32.9 percent among male sex workers.

The report shows that 80 percent of new infections are among young women aged 15-34 and the largest number of new infections occur among women who have never married (29 percent) and 26 percent among uncircumcised men who never married and 13.5 percent among couples with male partners of positive status.

’Mapule Motsopa


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[BREAKING NEWS] Lebona sets curfew



MASERU– In an effort to curb the rampant increase of homicides in Lesotho, the Minister of Police Lebona Lephema has announced a 10:00pm-4:00am curfew, effective Tuesday May 16, 2023. Failure to comply with the curfew attracts a 2 years imprisonment or a fine.

Staff Reporter

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Two nurses deleted for misconduct



MASERU – A Kolonyama midwife, ’Mamalibeng Ralenkoane, who allegedly neglected a woman during labour has been deleted from the nurses’ register for the next six months.

The woman went on to deliver her baby by herself without professional assistance.

In another case the secretary-general of the Lesotho Nursing Council (LNC), ’Mamonica Makhoswonke Mokhesi, has also been deleted for violating a patient’s privacy.

The LNC’s disciplinary chairman, Advocate Rapapa Sepiriti, said Ralenkoane had committed an act of serious misconduct and deserved severe punishment.

Advocate Sepiriti ruled that Ralenkoane “should not be seen anywhere attending (to) patients”.

Ralenkoane was working as a midwife at the Little Flower Health Centre in Kolonyama, Leribe, when ’Mateboho Letlala was admitted there for labour in August 2020.

Letlala told the panel that Ralenkoane took her to the examination room and later left her despite that there were signs that she could give birth anytime.

“At 19:00 pm Ralenkoane examined the patient but left her unattended and the patient had to deliver on her own,” Advocate Sepiriti said in his verdict.

“Clearly the blame has to be put at the door of Ralenkoane,” he said.

Adv. Sepiriti ruled that she should be deleted with immediate effect for 12 months, half of which was suspended.

“During these six months period, Ralenkoane is prohibited in any way from attending patients and this judgment should be delivered at her place of work,” he said.

Letlala in her testimony said by the time Ralenkoane arrived, she was already having severe labour pains and was told to go to the labour ward for assessment.

She said when she stepped down the labour bed Ralenkoane said to her: “Ua seke ua tatela ho hema empa molomo oa popelo o buleile ka 3cm’ (meaning she seemed to be in a hurry yet the cervix had opened by 3cm only).

“I was so surprised because I could feel I was very close to delivering because this was my second child and I could say I have experience,” she said.

She said she told the nurse that she needed to use the toilet but was instructed to use a pan instead.

“As she left me on the bed pan I could not stand from the pan as the pains were severe. I called for help but to no avail,” she said.

She said the moment she got energy to stand from the bed pan she saw blood, she called her but there was no response.

“Ralenkoane promised to come after two hours but there were no instructions on what to do in case I needed help prior to two hours,” she said.

“I wheeled myself to the bed and sat on it, still calling to no avail.”

She said while still alone, her membranes raptured and the time of birth came and the baby was delivered.

“The child did not fall as I was able to hold him,” she said.

She phoned her aunt who told her to find s scissor to cut the umbilical cord.

She said she bled a lot and ran out of energy, then Ralenkoane arrived at around midnight.

“When she came in she asked where the baby was and I pointed to where I had put him where he clamped the cord,” she said.

She said it was then that she got assistance.

The investigator for Professional Conduct Committee (PCC), one Nteso, told Advocate Sepiriti that his findings were that “the mother’s life was in danger as she was found having bled heavily and tired and the baby’s life was also in danger from prolonged exposure which could lead to hypothermia and brain damage”.

“Ralenkoane was not there for the mother until she delivered in the absence of the midwife, this is a case of negligence,” he said.

However, in mitigation Ralenkoane said this was her first time to appear before the panel and has been a nurse for more than nine years.

She said she has two children to support and she has already been punished by the clinic as she was dismissed and that she has policies and loans.

She pleaded with the panel to have mercy on her.

In another case Mokhesi who was the Secretary General of LNC was also deleted from the register for two years after she was found guilty of sharing a patient’s picture on social media without their consent.

She was accused of defamation of character and violating the patient’s privacy by posting pictures of the injuries he had incurred.

’Malimpho Majoro

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Nurses back at work



MASERU -NURSES who have been on strike since Monday are set to resume work this morning after the government started paying their salaries.

The nurses went on a go-slow last week but escalated to a full-fledged strike on Monday after the government delayed their salaries. Some nurses claimed they had not been paid since March.

Morephe Santi, the secretary general of the Lesotho Nurses’ Association (LNA), said they have started telling members to go back to work after the government said the salaries will start reflecting in their accounts last night.

The strike has inflicted huge reputational damage on Prime Minister Sam Matekane’s government which came to power on promises of efficiency.

Minister of Public Service Richard Ramoeletsi blamed the Integrated Financial Management Information System (IFMIS) and the Human Resource Management System (HRMS) for the delay in April salaries.

Ramoeletsi told parliament last week that the two financial management systems were unable to reconcile, leading to delays in salaries.

But that explanation was little consolation for patients who bore the brunt of the strike.

At least 20 expectant mothers at Machabeng Hospital in Qacha’s Nek were told to go home because nurses could not help them.

Some of the women were later admitted at Tebellong Hospital, a facility under the Christian Health Association of Lesotho (CHAL).

“We were staying at the hospital’s roundavel awaiting our time to go to labour but on Thursday afternoon (last week we were called by the nurses and they told us to go to other hospitals or go back home,” said Maretlotliloe Mpeli, who is heavily pregnant.

She said the nurses told them that they could not work on empty stomachs.

’Matlotla Poling, 19, from Ha-Rankakala said she had to call her parents because she did not have any money to either go back home or to Tebellong Hospital.

The Machabeng Hospital management declined to comment, referring thepost to the ministry’s headquarters in Maseru.

Ministry of Health spokesperson, ’Mateboho Mosebekoa, said Machabeng Hospital “did not expel the expecting mothers but merely sent them back home”.

“Due to the ongoing strike by doctors countrywide …they decided to take those women to the places where they would get help,” Mosebekoa said.

There was similar anguish at Queen ’Mamohato Memorial Hospital.

“The strike has affected all the departments including the kitchen, maternity, and emergencies, but the managers are on duty,” said ’Makananelo Sepipi, the hospital’s spokesperson.

Sepipi said managers were forced to hold the forte “because some sections cannot be left unattended utterly due to their importance”.

“The operations are happening in the emergency section, even though they do not operate in a normal way.”

She said patients whose operations were scheduled for this week were sent back home.

Santi, the LNA’s secretary general, blamed the government for the chaos caused by the strike.

Santi said as much as the government likes to call them an essential service they do not prioritise their ministry.

“They do not appreciate us, it is like they do not see the importance of our job,” Santi said.

“The government turns a blind eye to the fact that our working environment alone can put us at risk of contracting diseases.”

“Now we are not able to buy food and other necessities.”

Nkheli Liphoto & Thooe Ramolibeli

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