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Why Tšepong is overcrowded

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MASERU – QUEEN ’Mamohato Memorial Hospital (Tšepong) is grappling with overcrowding after some government officials and politicians allegedly forced it to admit undeserving patients.
Health Minister Nkaku Kabi told a press conference last Saturday that top government officials and politicians put pressure on the national referral hospital management to take in patients who don’t have referral letters from district hospitals.

The agreement between Tšepong and the government is that the hospital will only deal with referral cases.
The idea was that as a referral hospital Tšepong should take major cases that can not be handled by district hospitals and clinics. District hospitals themselves deal with referral cases from clinics which they can escalate to the Tšepong.

The ultimate goal was to allow Tšepong to concentrate on providing secondary health care.
But over the years that system has been corrupted, resulting in the hospital taking minor cases normally treated at district hospitals and village clinics.
By last week the situation at Tšepong was so bad that the maternity ward of 40 beds had 60 mothers. Some mothers have been allocated to general wards.
“When the hospital refused to admit them they would come to our offices and we would take the phone and instructed the management to admit them,” Kabi said, adding that the ministry was reacting to public pressure.

He said sometimes the patients would be coming from hard-to-reach areas and have to be admitted out of pity even if their illnesses could be treated in the district hospitals.
Kabi gave an example of a patient who came to Tšepong “for just a minor treatment of a nail”.
“We as the ministry do take the blame for this crisis,” he said.

The minister said the problem is not that the health system is broken but that people are deliberately bypassing their local hospitals and clinics from which they are supposed to be referred to Tšepong. The result, Kabi said, is that Tšepong has now been turned into both a referral and transfer hospital.
That means it is playing the role of even a small clinic in the rural areas.

And there is little Tšepong can do to stop the influx of undeserving patients because it is under immense political pressure to treat everyone who comes through its doors.
Doctors at Tšepong now find themselves handling cases of headaches, common colds and fever.
Kabi said apart from Maseru’s three filter clinics run by Tšepong, a consortium managing the hospital, tens of other health centres in the district refer patients to the hospital because Maseru does not have a district hospital.

Queen Elizabeth II Hospital, reopened to the public in 2014 after a three-year closure, is supposed to serve as the district hospital but offers limited services.
It only serves as a clinic for outpatients and some lab tests. The three Maseru filter clinics that are under Tšepong are Mabote Filter Clinic, Likotsi Filter Clinic and Gateway, which is situated at the Queen ’Mamohato Memorial Hospital’s main entrance. Patients from all these clinics, including Queen Elizabeth II Hospital, are referred to the hospital for more serious illnesses.
There are also five public clinics scattered around the Maseru City that refer their patients to Tšepong.

This is in addition to other clinics in the rural areas of the Maseru district that refer their patients to the hospital.
Other clinics in the district refer their patients to St Joseph’s Hospital in Roma and Scott Hospital in Morija, which also rely on Tšepong.
Being the national referral hospital, Queen ’Mamohato also caters for patients referred privately-owned hospitals.
Kabi said under the agreement the government and the hospital, only patients referred by district hospitals should be admitted.

“It is not a secret that patients come from as far as Quthing without any referral letter and want to be admitted at Tšepong,” Kabi said.
“They jump over their area clinics and district hospitals and come to Tšepong for minor illnesses that can be treated at clinic level.”
Kabi said such patients easily attract media attention when the hospital refuses to admit them and many a times the ministry is under pressure to force the hospital’s hand.
The hospital is said to employ 819 staff members and directly serves a population of over 500 000 in Maseru district.
The hospital opened its doors in October 2011.

In 2012, its first year of operation, 404 400 outpatients and 24 247 inpatients received healthcare through it.
A total number of 6 458 births were recorded and 6 502 surgical procedures were performed.
The Queen ’Mamohato Memorial Hospital forms the pinnacle of an innovatively structured, landmark Public Private Investment Partnership (PPIP) between the Lesotho Government and Tšepong, a regional consortium led by Netcare.

The project involved the building of the 414-bed hospital and the refurbishment of the Mabote, Qoaling and Likotsi semi-urban filter clinics, which opened to the public in May 2010.
The hospital, which cost M1 billion, has eight operating rooms, a maternity wing including a 40-bed nursery, a 10-bed adult Intensive Care Unit, an ophthalmology unit and a well-trained, privately-managed cadre of health care professionals.

The hospital is part of a wider health care network Lesotho has developed with support from the World Bank Group.
The World Bank provided Lesotho with a US$6.25 million (about M90 million) grant from the Global Partnership for Output-based Aid.
The International Finance Corporation advised Lesotho’s government on its partnership with the Tšepong consortium, led by South African health care investment holding company Netcare.
Under the partnership, Lesotho’s government contracted Tšepong to build, manage and operate the new public hospital without increasing costs to patients.
The Health Ministry’s Director General Dr ’Nyane Letsie said the overcrowding has reached a crisis level to an extent that the hospital has stopped admitting patients without referral letters.
This started last weekend.

Dr Letsie said patients should start at local hospitals. “It is the hospitals that will refer patients to Tšepong. No patient is expected to go to Tšepong without having been referred,” Dr Letsie said.
“This is meant to relieve Tšepong of the burden so that it can carry out its mandate of attending to special cases that cannot be treated at the level of the district hospital,” she said.
Dr Letsie said those who are close to Mafeteng will be referred to the Mafeteng Hospital while others will be referred to Berea Hospital – two districts sandwiching Maseru.
Kabi said some patients will be taken to private hospitals in Maseru under a special arrangement between the government and the hospitals.
He said there are 19 clinics that will offer natal services and “they will be staffed and equipped accordingly”.

“This arrangement was supposed to have started on September 1 but due to unforeseen circumstances it was delayed a little bit,” Kabi said.
Dr Letsie said only high-risk pregnancies will be allowed delivery at Tsepong.
In an interview with thepost Kabi refused to say how much the overcrowding will cost the government. He however said the cost of taking patients to private hospitals will be less than keeping them at Tšepong.

That indicates that despite being a government hospital Tšepong is charging more that private hospitals. The only difference is that at private hospitals it is the patients who pay while at Tšepong it is the government that picks the bill. A 2014 report by Oxfam, a confederation of 20 independent charitable organisation, warned that there was a danger that Tšepong would gobble the bulk of Lesotho’s health budget.

The report said Tšepong was likely to be viewed as a centre of excellence and therefore get much of the resources at the expense of primary health centres in the districts and villages.
That seems to be the case now as government has been grumpy about the charges it says are not justifiable.
The huge influx of patients is likely to translate into a huge bill for the government.
There are however other reports that show that Tšepong is a significant improvement on Queen Elizabeth II, its predecessor.

Staff Reporter

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Lesotho’s own brandy

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ROMA-“Go, eat your food with rejoicing, and drink your wine with a cheerful heart, for already the true God has found pleasure in your works,” so says the Big Book.


Driven by that divine, Mohapi Pule has gone a step further – by coming up with a new type of brandy – to make you merry.
The brandy, Mountain Spels Brandy, will make the heart of the dying man rejoice.
“The healthy nutrients in fruits that make brandy, end up in you when you drink it,” he said.


Pule studied nutrition at the National University of Lesotho.
His brandy is made by fermenting fruits into wine. The wine is then distilled into a brandy. It carries the flavour and the aroma of the original fruits.


The story began when Pule was born in Quthing, Mphaki. He was born to a hardworking mother who brew traditional beer like no other.
“She brew beer well before I was born. She is still making it to this day,” he said.


His passion for brewing was probably “born” even before he was born. Mothers have a hidden way of passing not just their looks but their passions to their children.


As he grew up, he found that he was still intertwined with his mom’s brewing business in one way or another.
“Mostly, I am expected to fetch water for the brewing process. That, I still do to this day when I visit home,” he says.
Two decades later, Pule found himself in the Roma Valley, doing BSc in Nutrition.


“At some point, I found that I had lost purpose in life. There was not a thing that I could say, well, I was passionate about this thing or that thing.”
That situation, of course, threw him into some serious soul-searching.
It brought him back to his roots.


“During this period, I recalled that when I was younger, I used to imagine helping my mom do the packaging of the beer she was making and helping distribute it countrywide,” he said.

From a young age, the issue of subsistence business didn’t appeal to him. But that imagination came and passed. Now here he was, worried that he might not amount to anything in life.


Then, boom! An idea came!
What if he produced an alcoholic drink?

He could have thought about anything to do as a business but, lo and behold! He thought about his mother’s passion!


One of the things he loves about alcoholic beverages is that they are popular.

“I haven’t seen products as popular as alcoholic drinks,” he said.
He might be wrong or right but the reality is, the rest of the world has for generations found delight in alcoholic beverages – some to the extent of overdoing it to their injury!


“Mabele khunoana ralitlhaku thabisa lihoho. Mabele u tsoa kae e le khale re u batla re sa u thole? Ueeeena mabeeeele!” (Loosely translated beer brewed from sorghum make men happy. We’ve been looking for you from afar, you sorghum. In short, this is a praise poem for the Sesotho sorghum brew).
But then came the most difficult part. Which specific beverages should he focus on and how would he do it?


He decided that he would focus on ciders. He realised that not many people in Lesotho were making ciders.


He started experimenting at home and realized how difficult the process was. He just couldn’t get it right. To worsen matters, he also did not have the right equipment.

But like most successful innovators, he just knew that he had to start his business right away.


Pule says he then learnt about other forms of beverages: the spirits. Spirits are very high in alcohol content. Here we are talking the likes of whiskey, vodka and brandy.


He was particularly interested in vodka. He went into one NUL laboratory and, with necessary permission, began testing a number of spirits and doing a lot of research about them.


He began saving some of the money he earned from the National Manpower Development Secretariat in the form of student allowance so he could buy equipment. Saving was not easy. The subsistence money was already not that much. Having to share it with a business was asking a little too much.


But Pule was so determined that he did it, bought equipment that allowed him to develop what he thought was “vodka”.


However, after buying the equipment he immediately realised that the equipment was to make brandy not vodka.


“Now I was forced to get into brandy by chance,” he said.
It was a mistake that he has never regretted having realised that there are very few individuals who were making brandy in Lesotho.


Pule had to throw himself fully into experiments. He read books about brandy production. He even enrolled for an online course on distillation.
In the end, he began to see some light.

“I began to feel some difference in the taste of my produce,” he said. “When I shared my produce with my lecturers, they were over the moon!”
With that encouragement, Pule began packaging his brandy and is now selling it to family and friends.


“My small equipment means that I can’t produce much. However, If I were to get bigger equipment, things would be much better.”

Own Correspondent

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Ready-to-cook vegetables

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ROMA – ’MATUMANE Matela, a National University of Lesotho (NUL)-trained nutritionist, is an example of how a nutritionist should think and act.
Matela makes and sells ready-to-cook vegetables out of produce from her own farm or produce she preferably buys from local farms.
“When I make a dish, as a nutritionist, I make choices that ensure a typical package is packed with nutrition,” Matela said.

Today, we examine an interesting story of the lady who is determined to ensure that you eat healthy despite your busy schedule.
It started with her experiences in life.
She describes herself as an extremely busy woman.
She likes getting things done.
As the busy amongst us will say, the busier you become, the less you watch your diet.
She couldn’t escape the trap!

“My busy schedule meant that I ended up eating junk and I was gaining weight,” she said.
With time, she came to her senses.
As a nutritionist, she recalled that the best way to preach was to preach by example.
So, was she preaching what she practised?
Clearly, she wasn’t.
She had to find an option to maintain the busy schedule and eat healthy at the same time.

The beautiful thing about nutrition is that the healthiest foods are the closest to us: fruits and vegetables.
Some scientists even claim that our bodies seem to be designed to thrive on fruits and vegetables.
“Have you ever wondered why looking at a ripe raw peach on a tree is mouth-watering but looking at a fat cow isn’t?” asked one scientist.
Well, whether we were designed for fruits and vegetables or not, the truth is that they are good for our bodies.
That’s what good science tells us.

And we somehow “know it” too if you have heard about anything called intuition.
So one day she found herself increasingly eating fruits and vegetables.
It’s easier to change a religion than a diet, they say.
So it is commendable that she changed her diet at all.
“The idea was to chop as much vegetables as possible and put them in a fridge so that in future, I will just pull them out and cook.”
She wasn’t proposing something new.
Who amongst us doesn’t enjoy the convenience of just pulling up chopped frozen vegetables and cooking?

Little did she know that what she was doing was putting her on a path to a brilliant business.
It took a post on a social media to achieve just that.
“I took a pic of the chopped and packaged vegetables and posted them on my social media account. The reaction was swift. I began getting questions like, “how much?””
It immediately dawned on her that she could be sitting on a great business idea, after all.

So she gave it a try and started selling.
To her surprise, people started buying.
In fact, “I get orders for my products almost on a daily basis.”
That is how interested people really are.
This to an extent that her business now gets up to four irregular employees, she included, when the demand is high.
She said her training in Agriculture, Home Economics and Nutrition has helped her to give a thought into what she was doing.

For instance, where possible, she grows her own crops and sells them as first preference.
She has grown spinach, butternut, green pepper, onion, herbs and beans.
She is also in the process of renting more fields to grow more vegetables.
Then she empowers Basotho producers by requesting them to supply.
Going for foreign produce is the last resort.
Look at her packages and you realise something.
The “7 colours” proverb comes alive.

Those seven colours (several colours actually) may have been designed to appeal to your eyes but that is just the tip of the iceberg.
The colours of vegetables mean a lot in terms of nutrition.
Each colour gives you something different.
So, the more colours in one meal, the merrier.
To drive this home, let’s go a scientific route for a second.
Red, Blue and Purple: These vegetables contain substances that are good at reducing the risk of stroke, cancer and memory problems.
White: The likes of onion or garlic may help lower your risk of high blood pressure, high cholesterol, cancer and heart disease.

Orange and Yellow: Carrots immediately come to mind.
These vegetables contain substances called carotenoids which may help improve your immune system and help to improve the health of your eyes.
Basotho, it would appear, have long known a thing or two about the relationship between carrots and eyes.
Hence the famous saying, “o jele lihoete” (they ate carrots), often applied to good sportsmen or women with symbolically “good eyesight”.

Green: Green is life. Green vegetables come packed with chlorophyll, a chemical that scientists believe can boost your immune system, eliminate fungus in your body, clean your blood, lead to healthy intestines and give you boundless energy.
As a bonus, her Home Economics background is such that she is armed with a host of recipes for each of the packages she sells.
She has great dreams for the future.
“I want to see my products decorating the shelves of big supermarkets,” she said.
It’s time!

Own Correspondent

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A new, co-operative chain store

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ROMA – ’MAKUENA Lesiea is spearheading the creation of a cooperative chain store that will sell Lesotho products only.
The store is being developed under the National University of Lesotho (NUL) Innovation Hub and it will be incubated by the Hub.
“Have you seen it? Basotho are producing like never before,” Lesiea said.
“However, their products are hard to see in the markets. We want to change all that.”

The store, she said, will open branches in all districts of Lesotho, starting from Maseru.
Visit any supermarket in Lesotho and check the products on the shelves.
You will be shocked to realise that, in general, just one percent of them are made in Lesotho.
The other 99 percent comes from elsewhere.
Is it because Basotho are not producing or can’t produce at all?
Nope!

“Having worked directly with the NUL Innovation Hub and the Tsa Mahlale TV programme under the Hub, I have travelled the depth and breadth of Lesotho and I was amazed at the amount of work Basotho are doing,” she said.
What is the problem?
Basotho products are not given sufficient platforms to prove themselves.
“Credit where it is due, some shops are beginning to accept and sell Basotho products,” she said.

“However, they are barely making a dent because Basotho products, being at their infancy, cannot receive full attention unless by a store that is designed to give them full attention.”
Such a store doesn’t exist.

She said the idea is not to compete with any of the existing stores because “we are getting into a new territory altogether, we are addressing a different market”.
So listen to Lesiea as she presents some features of the store that will surely persuade you to join the bandwagon:

  1. Customer and producer confidence: The store, she said, will achieve two things.
    First, when they see masses of Lesotho-made products in one place, Basotho customers will slowly grow confidence in them.
    The confidence will shoot to the roof when the customers experience that many of the products made in Lesotho are already way ahead of foreign competitors in terms of quality.
    Secondly, the store will give Basotho producers an assurance that their products have, at least, one store that is willing to take them, dark or blue.
    More production will come from such assurance.
  2. Selling “everything”: The store will sell everything from fruits and vegetables to processed foodstuffs to clothing and building materials (if Thabure car will be in production by then, it will be on the shelves too).
    “Suppose what we want to sell is not locally made, we will never cross the border, any border, to find its equivalence. We will encourage Basotho to produce it until they do.”
  3. We mean business: whereas Basotho are beginning to produce, their products are still all over the place.
    You bump across them in some few willing stores, in expos and trade shows, or as being sold by individual resellers. Those are good efforts, but they are not enough. In fact, many in Lesotho have come to see producing and selling as being more of an art, a hobby, a therapy or a hustling than a business, “so we are seriously moving away from such a casual approach, we mean business this time around.”
  4. Ownership: So when you enter this store, you could be purchasing a product made by you in a store owned by you. What a difference!
  5. Reasonable standards: the store will only demand reasonable standards. As a struggling Mosotho, try taking your products to some of the local shops and you are, at worst, turned away without reason or, at best, given a long list of standards you must meet before they can take your product.
    “In our case, as long as your products are reasonably of good quality, you are in. NUL Innovation Hub is already testing many Basotho products. We won’t ignore quality, but we won’t use it as a way to prevent Basotho products from growing either.”
  6. A cooperative chainstore: From contributing as little as M50 per month, members will use a continuous financing model to ensure that the store doesn’t just end in Maseru but reaches the ten districts of Lesotho.
    Each branch will start at a medium scale in order to grow along with Basotho products. We won’t ask for investors to come from anywhere, “we will be investors ourselves.”
  7. An export launch pad. “We are often told to export our produce. The obvious question is, if you haven’t convinced your own people to consume your own products, how can you convince people in other lands to do so? Why should they take you seriously?”
    However, the store is not meant to be a local store forever.
    It will be a means by which we export our products to other countries in the future.
    When we export the store to Soweto, we export it along with products from Lesotho.
    Don’t say no because we have seen Chinese shops and Indian shops and, of course, South African shops, filled to the brim with Chinese products and Indian products and South African products in many countries.
    “If they can do it,” Lesiea ended, “so can we.”
    “Because if it is there in some of us, it is there in all of us.”

Own Correspondent

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