NAPO Khusu likes to think of himself as a taxi driver–educator.
Behind the wheel of his Toyota Corolla, white with a signature marigold stripe along its side, Khusu calls out for passengers in Maseru in between explaining to me the benefits of voluntary medical male circumcision: better hygiene and decreased risk of contracting HIV, other sexually transmitted infections, penile cancer and cervical cancer.
Khusu is one of 15 taxi drivers in Maseru who have spent the past month educating their passengers about the methods and benefits of the procedure. The driver mobilization scheme, a pilot programme that was started in April by Jhpiego, a United States-based health nonprofit, is part of a wider initiative called Rola Katiba, which aims to get more men circumcised and reduce HIV rates across Lesotho.
“I’m talking to them about VMMC,” says Khusu, 32, employing the commonly used abbreviation for voluntary medical male circumcision. He has to speak loudly over the traditional accordion music, known as famo, that pumps from the stereo. “Some people don’t understand, so I explain for them. Some of them, they are not interested. Some are interested.”
Lesotho, a mountainous country of 2 million people that is entirely surrounded by South Africa, has the second-highest HIV prevalence rate in the world at 23 percent.
According to the World Health Organization, VMMC reduces the risk of female-to-male HIV transmission by 60 percent. The procedure works because the foreskin, which can be torn easily, creates tiny gateways for the virus to enter the body and is a warm part of the body, meaning viruses could multiply more easily there, says Malijo Baji, a VMMC counselor at the Apex Clinic on Moshoeshoe I Road, where Khusu and others refer intrigued, uncircumcised taxi passengers.
Since the start of the Rola Katiba programme in 2013, more than 108 000 men have been circumcised, around 10 percent of the country’s male population, according to Jhpiego.
Rola Katiba means “take off your hat” in the local Sesotho language, a gesture that is a sign of respect referring to the country’s symbol, the Basotho hat.
The mascot for the programme, which is funded by USAID and designed to target 15- to 29-year-old men and boys, is a jovial orange penis, giving a thumbs-up while holding a yellow sun hat, that appears on VMMC pamphlets with the tagline “Be Fresh and Stylish.”
We drive through Maseru, past the Ouh La La French café and dozens of fruit stands, in Khusu’s “4+1” cab (four passengers, one driver) during an off-peak hour of the morning. Still, we manage to pick up two female passengers.
Speaking about circumcision with women is one of the challenges of his job, Khusu says; often his lesson and gentle suggestion to pass the message on to male family members are interpreted as rude.
Some women have defensively asked him how he knows their husbands aren’t circumcised, says Khusu. “I’m saying to them, ‘If you know someone who hasn’t been circumcised, you have to tell them. Your younger brother, your husband,’” says Khusu. “You have to put it in a nice way.”
When passengers are interested in VMMC, either for themselves or a family member, Khusu gives them a blue referral slip to take for a clinic consultation.
In Lesotho, a VMMC procedure is available for free to anyone who wants it. There are two options: a surgical and a nonsurgical method using Prepex, a device left on the penis for seven days in order to stop blood flowing to the foreskin, which dies and is cut off.
“Some people, they fear to cut [and] the blood” that comes with the surgical method, says Khusu. In addition, those who choose Prepex receive 50 loti (about $3.30, paid for by the clinic) for phone airtime and transportation for a checkup two days after the foreskin is removed.
The 15 taxi driver–educators are paid in fuel coupons; even if they don’t refer anyone, they still receive a monthly petrol allowance of 5 liters (1.3 gallons), also paid for by Jhpiego.
In the last five years, 10 million men on the African continent have undergone circumcision.
But promotion of VMMC in countries near Lesotho has been a challenge. Issues around cultural and social acceptance of VMMC prevented a wide-scale rollout in nearby Swaziland, which saw just 32 000 men, a fifth of the target number, undergo the procedure between 2010 and 2012.
Stephanie Reinhardt, senior programmes manager at Jhpiego, says Lesotho, in contrast, is succeeding due to the Ministry of Health’s efforts to engage with traditional and community leaders early on.
Ministry officials visited rural areas and provided educational sessions around circumcision, while Jhpiego organised transport to take young men from villages to a nearby health centre to undergo the procedure. “It wasn’t seen as a foreign-led initiative,” says Reinhardt.
Efforts to increase uptake of male circumcision, an extremely sensitive topic in Lesotho, could have been put at risk if too much international, outsider involvement was suspected.
In the capital of Lesotho, talk of VMMC isn’t confined to the backs of taxicabs. Outside the Shoprite supermarket in Maseru’s main shopping stretch, many recognize and point at the smiling orange penis on the Rola Katiba T-shirts worn by Khusu’s fellow drivers Tsitso Mokale and Moholi Mosebetsi.
An 18-year-old at the Shoprite says he learned from a nurse that VMMC prevents HIV and other STIs. At the nearby taxi parking lot, cabdriver Letsekho Motabo says he learned about VMMC at an informational road show hosted by Jhpiego.
“I know that if you are circumcised it prevents you from getting sexually transmitted infections. That includes HIV,” says Motabo, who wears a yellow hoodie declaring “Las Vegas” in white letters. He’s still considering getting circumcised if he can get the time off work.
One particular challenge here has been that “when VMMC came, a lot of people confused it with initiation,” says Polo Motsoari, communications officer at Jhpiego.
Adolescent boys in Lesotho are usually circumcised during initiation ceremonies—the details of which remain incredibly secretive—but a 2011 study published in PLOS One found that nearly a quarter of men in Lesotho who self-reported as circumcised didn’t actually have evidence of any circumcision, suggesting they believed they were fully circumcised but instead underwent a ritual, and incomplete, version.
There was also confusion around language. As the PLOS One study’s authors point out, “the word in Sesotho for going through the initiation process, ‘lebollo,’ is very similar to the word for circumcision. Thus, a male who has attended an initiation school may report that he has been circumcised even if the foreskin was only cut, or only part of the foreskin was removed.”
For drivers like Khusu working to change the minds of men like Motabo, and possibly their wives, sisters or mothers, one of the biggest challenges is broaching that subject in the back of a cab. “There’s not an easy way to say, ‘Let me see it,’” he says. – Newsweek
Reporting this story was made possible by the International Reporting Project
Warning over new deadly drug
MASERU – THE Blue Cross Society, which fights drug and alcohol abuse this week issued a chilling warning about a deadly drug it says could have found its way into Lesotho.
The flesh-eating drug, krokodil, has already killed two people in South Africa.
Krokodil is injected into the body through a hypodermic syringe and keeps its user high for 90 minutes or two hours.
An addict may develop a skin condition that resembles the crocodile’s skin especially when they inject themselves.
According to narconon.com Krokodil gets its name from the fact that the drug causes an addict’s skin to become scaly and bumpy like a crocodile’s.
If the drug misses a vein and is injected into the flesh, that flesh will develop sores.
It is common for some body parts of addicts to decay eventually requiring amputations.
The flesh on some body parts affected by krokodil injections will rot off completely, leaving bare bone.
Introduced in Russia over a decade ago, the drug has found its way into Africa and has recently been discovered to be one of the deadliest drugs to hit South Africa.
The drug has already killed at least two addicts in Port Elizabeth.
Krokodil made headlines in South Africa in July last year when Port Elizabeth’s Herald newspaper reported that Martha Dean staged a protest outside a magistrate’s court where her 25-year-old daughter was appearing on a charge of possessing the drug. “Mr Magistrate please don’t free my daughter to die on the streets,” read the placard she was carrying.
The court ordered Bonita Dean, her daughter, to be sent to the nearby Noupoort Rehabilitation Centre.
She later escaped, made her way back to Port Elizabeth and, four months later, she died.
Krokodil is sold cheap, at only M20 a packet.
When Bonita died, she had been using 13 packs a day. The US online magazine, Time.com, calls krokodil the world’s deadliest drug.
‘Masebuoeng Majara, Blue Cross’s Campaign Coordinator, says unlike many other hard core drugs Krokodile addicts live only for six months or three years if they are stronger.
“This depends on each individual’s body type and organ strength,” Majara said.
Majara said it would be difficult to say whether the drug is already in the country. “The channels that drug dealers smuggle in drugs and introduce them, make it hard to even monitor (krokodil’s) availability,” Majara said.
She however added that our boundaries are porous and therefore many drugs come in easily. “Like nyaope, this drug is made from the comfort of people’s homes and back-doors through mixing different over-the-counter medications,” Majara said.
Majara said the drug is a cheaper version of heroin and it is likely to hit the drug market with no mercy unless the youths look out for themselves.
According to Majara drug abuse among youths start at the age of ten to 15 years. The Step Away Treatment Centre, an anti-drug abuse organisation in South Africa, says “while Krokodil addiction in South Africa is not yet as prevalent as heroin addiction, the numbers of reported cases have begun to rise”.
South African National Council on Alcoholism and Drug Dependence (SANCA) told the Mail & Guardian newspaper in November last year that it had four users of krokodil in its 33 centres nationally. “Three new cases have been reported in Emalahleni and two in Port Elizabeth. All three clients needed immediate medical attention due to the serious consequences of this drug,” Adrien Vermeulen, SANCA’s official, said.
The most common drugs in Lesotho are alcohol, tobacco and dagga. “We still have other hard core drugs in the country but they are not as prevalent as these that I have mentioned,” Majara said.
“We have people who use heroin, mandrax, cocaine, ecstasy, tik and others and we have treated such patients at our centre but because these drugs are expensive they are used by certain people who can afford them,” she said.
The legacy of Thomas Mofolo
Sesotho is a language full of beautiful proverbs and idioms of expression, and among them is the quintessential:
Monna ke ‘mokopu’ oa nama (A man spreads like the tendrils of a pumpkin)
Excuse the pun but the figure I am referring to this day bears the name ‘Mokopu (Pumpkin)’ and his influence on the literature of the world has spread to all the corners of the world. His work has been translated into more than seven languages, and there are more translations of his work than any other author in Southern Africa, and he has been given the rightful title of “The Father of the African Novel”. I guess that there is one thing that a lot of us Basotho lack; the right spirit of giving respect where it is due, that is, acknowledging the contribution and impact the arts in this country have in influencing the minds of the citizens and informing the politics of governance in this kingdom.
More times than less, we honour authors and artists from other countries than we do our own and, what we seem to forget is that this mountain land gave birth to some of the best minds and pioneers in different fields of study and the pursuit for knowledge. A man noted by the world as the pioneer of the African novel should by right be taught in schools from primary level, but due to a spirit of iconoclasm and a penchant to destroy images of individuals sacred to the history and the progress of this land, many vital names and individuals whose lives served as beacons for the masses are forgotten.
This occurs until some stranger from a foreign land comes across such a forgotten figure and rekindles the flame that lit the fire in whose warmth those children of the past who are mothers to the present generation used to bask in.
I was fortunate enough to be invited to the promotional presentation of the release of the publication ‘Translating Mofolo’ edited by Professors Chris Dunton of NUL and Antjie Krog of the University of the Western Cape.
Present were the members of the Mofolo family, Ntate Stephen Gill who serves as the Morija Museum’s curator, Ntate Gerard Mathot of Family Art and Literacy Centre, Professor Chris Dunton of NUL, Dr Limakatso Chaka of NUL, Ntate Percy Mangoaela who proved to be an exceptional Master of Ceremonies, dignitaries from Alliance Franḉaise where the presentation was held, Ntate Meshu Mokitimi, and a host of other scholars, artists, teachers, creative individuals, and respectable Basotho from varied spheres and occupations. All of us had come to witness the re-kindling of the spark that lit the flame which grew into a roaring blaze and, as the caption on the invitation programme states:
A Trophy or Living Legacy?
Literary icons and other famous persons are not of great value to a nation (or the wider world) if they are merely placed on display as one would do with a trophy; rather, each generation must deeply engage with and re-assess the contribution which such figures have to the broader legacy. As Basotho celebrate 50 years of their re-emergence as an independent nation this year, it is appropriate to remember and honour icons such as Thomas Mofolo who pioneered new forms of literature. We do so in the hope that valuable lessons will be learned, and that others may be inspired to similar greatness.
Mohale o tsoa maroleng.
In the words of one of the leading figures in the project, Professor Chris Dunton from the National University of Lesotho, the main motivation lies in a question raised by Professor Antjie Krog of the University of the Western Cape, in which she raised the paradoxical statement, that is, ‘talking about not talking’ borrowed from C. Booth’s Listening Rhetoric which in a lot of ways I believe borrows from the philosophies of tolerance as lived by King Moshoeshoe I.
The professor revealed the significance of translation and how it at the end of the day helps world communities to build understanding. We live in a world where circumstance or choice force us to live next to individuals or communities whose languages we do not understand, and this issue of misunderstanding causes a lot of problems when it comes to dealing with conflicts that naturally come up where people are neighbours.
Of significance in his speech as well was the mention that Thomas Mofolo was revered by such great American figures as William Edward Burghardt du Bois and Gertrude Stein both of whom held him in high regard. Thomas Mofolo’s Chaka remains one of those books that have been translated into many languages and have been cherished by readers from days long gone to the present day.
Doctor Limakatso Chaka’s presentation (titled New Insights into Mofolo’s 2nd Novel, Pitseng) largely focused on the beauty of Mofolo’s language and its multiple layers of meaning in the novel Pitseng, and it covered such aspects as the autobiographical nature of his (Mofolo’s) novels, the landscape narratives he wrote which were largely patriotic in nature, and which to a large extent revealed elements of economic progress, individual independence, and women empowerment, his role in Leselinyana la Lesotho, and the love narrative in Sesotho.
One found in the Doctor’s presentation the exposition of those elements about this great author that the reader would easily miss if they are not made aware of them. In the paper she read, one realises that it would indeed be a loss to this generation and the next if the meanings in the works of Mofolo are not revealed to their full complexity in terms of the salient themes explored. That we have been independent for 50 years means that we should transform into people who value their past greats.
In Pitseng, there is a feeling of progress, a movement forward from the old into the new era of colonialism. Post-colonially speaking, there should be a movement forward into a new era where the works of pioneers should be given their rightful places on the pantheons of heroes. That the writer taught the world the first words should be noted and the meanings thereof should be explored for all to understand them.
That he was a great penman and jack of all trades and master of all of them came to the attention of every member of the audience when Ntate Stephen Gill (Curator at the Morija Museum & Archives) took the floor. In the presentation titled The Man, the Writer and His Contexts pointed to the fact that the quest to understand a writer is a process that demands the understanding of his background, and as is the case with Ntate Mofolo’s story; understanding the writer’s clan and ancestral roots helps one who comes as a critic or analyst to fully know him.
The writer’s daughter fondly known Rakhali ‘Mapheko was introduced to those present, and from that point on, Ntate Morojele revealed the multiplicity of the talents of Thomas Mofolo. From teacher to astronomer, carpenter to editor, labour recruiter to being a political activist, the list of the professions Mofolo the quintessential Mosotho writer occupied is long and endless. Mofolo is an author respected even by the Communist Party in the days of the old Soviet Union, due to his multiplicity of talent and occupation; he was a figure they respected as ‘the man for all seasons’.
In essence, the skies he watched as Abraham did were in every way what came to influence the generations of writers in Africa and the world that came to read his work and translate it into their own languages. His words would go on to develop into many languages from the original one he wrote in, and in real terms, his success internationally is of Abraham proportions.
Associate Professor P. V. Shava and Lesole Kolobe’s paper The Mofolo Effect and the Substance of Lesotho Literature in English covers such salient issues as the reciprocal and symbiotic nature between the author and the traditions within which he is socialised. It went further to show the uniqueness of Lesotho literature as a national literature and as an integral part of African literature. Having been translated by such greats as Leopold Senghor in works such as Chaka, the form and the sensibility of Mofolo’s literature in English has carved distinct niche in world history; and though erroneously classified as South African, Lesotho literature has its own element of uniqueness.
It is perhaps the earliest literature of its form in Africa, the autonomy stemming from the fact that the socio-political contexts within which it was birthed mark it as different from the other literatures of the world. Notably influenced by the French missionaries who gave the Basotho the first orthography (officially registered in 1906, and many years older than the Bantu version of South Africa which was registered only in 1959 by the Apartheid government) with which to transcribe words, the first lessons into Western education, and the publishing of the first newspapers and works of literature by giants like Thomas Mofolo.
There are constant transnational and cross-border interactions between the Basotho and their other Southern African fellows, but it seems, the words of Thomas Mokopu Mofolo have gone on to constitute what can be deemed as an ‘effect’ on the psyches and consciences of writers across the world such as Chinua Achebe, Ngũgĩ wa Thiong’o and others. The professor and his fellow writer’s words go on to make a wish that the current generation cultivates a more active and dynamic reading culture in appreciation of the precedent fictive role played by Ntate Mofolo. That the novel is dying as a mode of literature should be curbed, that is, we should work hard towards reviving it, so plead the two scholars, one from Zimbabwe, and the other from Lesotho.
After the words of thanks by Ntate Mofolo’s granddaughter, the MC, Ntate Percy Mangoaela, capped the day with a plea to all the youth to rejuvenate the literature and the arts. In his own words he thus spoke, “We need our language now more than we did in the past… because we have come to a point where we are polarised as a nation.” This wisdom is further fortified by the MC’s suggestion that an institution to promote the arts and the literatures of Lesotho should be established, and also that the division in the two Sesotho orthographies should be addressed. With those words we parted ways, but before doing so, signed our names and left our contact details after a successful first presentation of The Mofolo Edition, Tydskrif Vir Letterkunde (a journal published by the University of Pretoria) organised by Friends of Morija Museum & Archives hosted at Alliance Franḉaise Hall, Maseru.
The pumpkin spreads, and when its season passes, it leaves behind seeds that will grow into other pumpkins that will spread far and wide even in fields foreign and far away from the original field it sprouted from. And in dedication, I pen a translation from a brief poem inspired by the reverend Thomas Mokopu Mofolo:
Nama Mokopu, rakalla Motaung! Leraka ha le shoe, le namalla feela, le re siela lithotse morao re leme! Se thoasitse selemo, ha re uteng Mokopu mobung… (Stretch out your legs Mokopu, spread far Motaung! The climbing tendril dies not, it merely prostates itself, and leaves seeds behind for us to sow! The spring has sprung, let us sow seeds of Mokopu into the soil…)
33.2% of children suffer from stunted growth
MASERU – AT least 33.2 percent of all children under the age of five in Lesotho suffer from stunted growth, according to a World Bank report released last week.
The report says Lesotho’s rate of stunting for children aged five and below is higher than its lower income peers like Ghana, Guinea, Mali, Mauritania, Sao Tome, Uganda and Zimbabwe.
The Kick-off and Validation of Cost of Hunger in Africa (COHA) study says there is a bigger price to pay for undernutrition than it is anticipated.
Margaret Agama-Anyetei, the African Union head of division for health, nutrition and population said Lesotho and other African countries have the potential to reap a demographic dividend from a young, educated and skilled work-force.
“But this potential can only be harnessed if the gains of early investments in the health and nutrition of its people, particularly its women and children, are maintained and result in the desired economic growth,” Anyetei said.
The COHA study was sanctioned by the African Union Commission (AUC) and the New Partnership for Africa’s Development (NEPAD), Planning and Coordinating Agency (NPCA), supported by the UN Economic Commission for Africa (ECA), Economic Commission for Latin American and the Caribbean (ECLAC) as well as the UN World Food Programme.
The study is implemented in multiple countries across the continent and aims at estimating the economic and social impact of child under-nutrition in Africa.
The preliminary results of the study have demonstrated the magnitude and devastating social and economic consequences of child malnutrition in Lesotho.
“In fact, the preliminary results show that the country is losing M1.9 billion per year which is equivalent to approximately 7 percent of the country’s GDP in 2014,” Thomas Yanga, the Director of Africa Office and Representation to the African Union and UNECA, said.
Yanga said these results are not only an evidence based revelation but a call for action for all, especially policy makers.
“The expected economic development and growth results will only be achieved when all children in this country are free from hunger and malnutrition as well as have the opportunity to have access to adequate education and better health care,” Yanga said.
“We cannot change the past but we can jointly shape the future of the young Basotho girls and boys.”
Yanga added that while Lesotho managed to reduce the rate of stunting from 53 percent to 33.2 percent, the figure was still too high revealing that chronic food insecurity and malnutrition are still prevailing in the country.
“Hunger has a negative effect on the national economy. The impacts of under-nutrition are intertwined, impeding national performance in terms of health, education and productivity objectives,” Yanga said.
The team delegated to run the study has completed the collection and analysis of data and the report will be published on October 27.
Kimetso Mathaba, the Minister in the Prime Minister’s Office, said Lesotho took part in the study due to the prevailing problems of malnutrition in the country.
“The rate of malnutrition has not been improving significantly from 1992 up to date. Stunting is the main problem in Lesotho which currently stands at 33.2 percent and which according to the WHO (World Health Organisation) standards indicates chronic malnutrition,” Mathaba said.
“There is evidence that addressing malnutrition is a basic foundation for the social and economic development of any country,” he said.
Cosmos Mokone, the Head of National Implementation Team (NIT), said under-nutrition is estimated to contribute to 2.8 percent as a risk to education.
“Out of 100 students, 2.8 percent of them will fail or drop out of school because of under-nutrition or stunting,” Mokone said.
However, Mokone said there is no immediate cost for those that drop out to the government but those that repeat a class put more costs on the government.
“The highest cost of under-nutrition is in the labour market because the performance of under-nutrition people is very low and therefore costing the country a lot of money for low production both in skilled and unskilled related production,” Mokone said.
A child that is stunted is at risk of performing less in class or even drop out to an extent that when they join the labour market they become unproductive in the economy.
Lesotho has lost 7.2 percent of working age population for 2014, Mokone said.
The study shows that a child who is suffering from under-nutrition is at risk of suffering from cognitive and physical impairment which impacts the quality of life as a child and as an adult within the society.
The study shows that in humans the first two years of life is a critical period of vulnerability for the brain’s development and under-nutrition early in life causes changes in the brain cells and development thus reducing the connectivity and branching of brain cells.
“Children who are stunted have increased probability of repeating a class,” Mokone said.
In a population of 47 547 students who had to repeat class recorded in 2014, 17 044 of the total number of repeaters were associated with stunting which cost the government at least M115 million.
Mamane Salissou, a member of the NIT, said under-nutrition causes 19.5 percent of all children’s deaths, where 9 272 deaths were experienced from the year 2008 to 2014.
“For every additional case of child illness, both the family and health sector are faced with additional cost,” Salissou.
At least 88 900 children are stunted in a total of 100 000 children.
“A lot of work still needs to be done,” Salissou said.
The study also showed that 51 percent cost in health associated to under-nutrition happened on children before turning 24 months.
It further says 939 842 of working adults were stunted as children.
The study says the health sector uses at least M4.2 million while the education sector spends at least M11.7 million on stunted people and the labour sector loses almost M180 million in productivity costs.
“You can imagine how we can use that money in investment as a country if we prevented stunting in the first place,” Tiisetso Elias, the coordinator of NIT, said.
Elias said if the country can work hard to reduce stunting by 50 percent then the country would have saved M1.8 billion by 2025.
“We have to focus on prevention particularly in children during the early years of under five which will yield social and economic return,” Elias said.
He further said Lesotho youth are being disproportionally affected by the consequences of malnutrition but it is also a group that will gain the most from improved nutrition.
“Better nutrition will impact health, education and labour productivity so we need sustained investment in nutrition,” Elias said.
Eliminating stunting in Lesotho is not an option it is a necessary step for inclusive development in the country, he said.
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