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New dangers to HIV fight

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MAFETENG – Mafeteng, which is the district with the highest HIV prevalence rate at 24 percent, is grappling with challenges that are threatening to roll back achievements that have been scored in recent years.

The challenges include a low uptake in Pre-exposure Prophylaxis with others defaulting on their Antiretroviral Therapy (ART) as well as poor partner notification.

The district is also grappling with a lack of enough professional counsellors in most of its health care facilities. HIV testing service kits and condoms sometimes run out.

Nthatisi Molefi, the District Health Management Team (DHMT) HIV Clinical Mentor, revealed these challenges at a two-day gatekeepers meeting held by the National AIDS Commission (NAC) last week.

The gatekeepers who attended the meeting were chiefs, traditional doctors, community councillors, clergy and representatives of government ministries.

Molefi said although they have several HIV prevention strategies, Mafeteng is at risk with HIV infections.

“We have to find ways around our collaboration to prevent new infections,” she said.

In a bid to prevent new HIV infections, the community gatekeepers were capacitated on the five HIV prevention pillars such as combination prevention for adolescent girls, young women and their male partners.

They were also capacitated on combination prevention for key populations, comprehensive condom programming, voluntary medical male circumcision (VMMC), and Sexual and Reproductive Health (SRH) services for men and boys and initiation to Pre-exposure Prophylaxis.

They were also familiarised with the gateway approach which places the local authorities on the forefront of the fight and prevention of HIV/AIDS, while also linking it with community services.

The aim was to put services at the centre of the response and also aligning with the National Strategic Plan to ensure that 40 percent of the HIV response is community-led.

After the training, they are expected to prioritise plans on the impacts and needs of the communities following services brought by different service providers available in the districts.

The Ministry of Local Government HIV & AIDS Coordinator, Malefetsane Nkhabu, said the aim is for the districts to effectively perform duties mandated to them.

The mandate is to decentralise response coordination on HIV & AIDS in local government structures.

“We want to lobby the community gatekeepers to become champions of HIV prevention interventions because they are key in reaching out to communities with HIV services,” Nkhabu said.

“We want them to understand the situation around them,” he said.

He said they expect them to liaise between villagers and HIV prevention service providers after the meeting.

“Advocate for community demand creation of HIV & AIDS services and address issues that perpetuate gender-based violence, stigma and discrimination from the grassroots,” he told them.

Tankiso Mokhohlane, the NAC Coordinator, said the NAC is mandated to provide strategic leadership and governance, efficient and effective coordination and management of the national multi-sectoral and decentralised HIV and AIDS response towards ending AIDS in 2030.

He said despite Lesotho’s achievement towards the 90-90-90 in HIV response, she still has some challenges amongst children and adolescents.

What are the 90-90-90 goals?

The UNAIDS “90-90-90” strategy was a call to have 90 percent of all HIV-infected individuals diagnosed by 2020, 90 percent of whom would be on anti-retroviral therapy (ART) and 90 percent of whom would achieve sustained virologic suppression.

Reaching these targets by 2020 would reduce the HIV epidemic to a low-level endemic disease by 2030

“Numbers have declined but there are still new infections amongst adolescents. We are concerned because of the high prevalence,” he said.

Mokhohlane added that “HIV isn’t the Ministry of Health’s responsibility alone… all stakeholders have to join hands to prevent new infections”.

“We want to establish where we went wrong and how to collaborate as a way forward for each person to play their role for the protection of Basotho,” he said.

He said amongst adolescents and youths, there are more females infected than males.

Adolescents are children between the ages of ten and 19-years.

“We need to protect our youngsters.”

Lephia 2020 report shows that early sex debut, inter-generational relationships, sex work and sex exploitation, inadequate condom use and concurrent sexual partners are the main causes of new infections.

It further revealed that gender inequality, harmful cultural norms and practices, worsening poverty and unemployment are amongst the causes of new infections.

Mokhohlane noted that there is a high prevalence among women aged 15 to 44 at 29.4 percent, 71.9 percent among female sex workers and 32.9 percent among male sex workers.

He said according to statistics, 80 percent of new infections are recorded among young women aged 15 to 34 and the largest number of new infections, 29 percent, occur among women who had never married.

Uncircumcised men who never married contributed 26 percent of new infections, while 13.5 percent of new infections occurred among couples with a male partner of positive status.

Mokhohlane said new infections put the country at risk.

“We have to take responsibility and make it everyone’s business to prevent new infections.”

The NAC, through the support of the United Nations Agencies (UNFPA, UNAIDS and UNDP), has made noticeable progress towards fast-tracking implementation of the National HIV & AIDS Strategic Plan (NHASP) 2018-2023.

The NHASP suggests the development of the District Fast Track Plans that are responsive to the Lesotho National Decentralisation Policy of 2014.

As the first step of working on decentralisation of HIV services, District AIDS Committees (DACs) were resuscitated and provided with both financial and technical support to develop their respective District Fast Track Plans (DFTPs).

As Pre-exposure Prophylaxis roll out implementation of these DFTPs, three District AIDS Committees (Mohale’s Hoek, Quthing & Mokhotlong) were provided with capacity building and further implementation followed suit.

Additionally, three more districts were chosen according to challenges they are faced with.

Butha-Buthe, which has a development site with the Ha-Belo factory site will see an influx of people when they operationalise those factories and possibly affect its status as a district with the lowest HIV prevalence in the country.

Thaba-Tseka has been experiencing a worrisome rise in child marriages and lastly Mafeteng, which LePHIA 2020 report revealed that has the highest prevalence in the country.

DACs in the above mentioned districts were capacitated and now NAC is providing more support to these committees to implement their District Fast Track Plans focusing on HIV prevention interventions.

UNFPA HIV Programme Analyst, Thabo Lebaka, said the UNFPA’s approach to HIV is based around two strategies – prevention roadmap on how best they can ensure that HIV prevention still stays at the top of the agenda of the government.

They also have to ensure that policies relevant to HIV prevention, especially for young people, are made and executed.

He said the UNFPA also supports a comprehensive HIV prevention project called “Along the borders,” which focuses on preventing HIV transmission and improved access to Sexual and Reproductive Health and Rights information and services along Lesotho’s three porous borders of Maseru, Maputsoe and Mafeteng.

“These are the busiest borders which are deemed highly porous and catalytic to the transmission of new HIV infections, thus the project is targeting migrants, long distance truck drivers, youths and key populations along these borders,” Lebaka said.

He said they also support the NAC to create advocacy about HIV prevention around gatekeepers to reduce new infections.

The Mafeteng’s Ha-Makopela Chief, Ntsane Makopela, said the drivers of new infections are behavioural and socio-cultural as they still have a challenge with men reluctant to partake in voluntary male circumcision.

“Some only agree to do it if they get sick and are hospitalised,” Chief Makopela said.

He also said Basotho are not interested in HIV capacity building public gatherings if hosted by chiefs or village health workers.

“We do social messaging at every chance but they prefer new faces,” the chief said.

“With this collaboration, apart from being empowered, we will also know who to involve for a successful engagement with our communities,” he said.

Lihlong Tjokosela, the Ministry of Education’s Special Needs Unit director, said students in rural areas are left behind in information accessibility about HIV.

“It’s even worse for those living with disability as communication on its own is a barrier and they fail to access health services because there are no specialists in health facilities,” Tjokosela said.

“Their fundamental human rights are violated and it seems they live in their own world,” she said.

She said all key stakeholders in HIV should also offer services to hard-to-reach areas and not only focus on urban areas.

“People should be given information for them to make informed decisions,” she said.

Tjokosela said the education ministry has introduced life-skills based sexuality education subject in schools for children to know who they are.

“But it’s not compulsory in all grades and doesn’t have its own teachers,” she said.

“Some teachers even hate it because they aren’t well trained in it as it only offers it’s only short courses.”

She said the subject should be introduced from pre-school to Grade 12.

She said parents should also be capacitated because “some insult us when we encourage their children to use family planning, saying we teach them prostitution”.

“They are already sexually active,” Tjokosela said.

“Yearly after June, we have so many pregnant children and we need everyone on board to end this.”

’Mapule Motsopa

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Government is broke

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… Borrows M500m to pay salaries
MASERU – THE government is so broke that it had to borrow a staggering M500 million to pay civil servants’ salaries.
thepost can reveal that the money was borrowed through Treasury Bills from the local market this week.
The borrowing spree comes as the government is battling to pay salaries and suppliers due to a massive drop in tax revenues.
It comes as Prime Minister Moeketsi Majoro’s government is left with two weeks in office.
But those few days left on its tenure have not stopped the government from making plans to borrow more money from the local market.
Highly placed sources told this paper of plans to issue more Treasury Bills in the next two weeks to raise money to pay suppliers.
A source however said there is some reluctance from some technocrats in the Ministry of Finance who believe the government’s books and financial control systems are so shambolic that it doesn’t know exactly how much it owes the private sector.
The arrears fluctuate every day but this paper understands that the government owes between M800 million and M1 billion to the suppliers.
Although the government has been grappling with the financial crisis for the past few years the crunch began to bite this year.
Sources say this month has been particularly terrible for the government.
By last week, a source said, the government had only M150 million for salaries. The total public wage bill is around M600 million.
This explains why the government had to borrow half a billion this week through treasury bills issued by the Central Bank of Lesotho.
The money arrived in the government’s account yesterday afternoon according to sources privy to the transaction.
The government has options to pay the debt in three, six, nine or 12 months. But given its precarious financial position, the government is likely to opt for the 12 months.
This means the debt will be paid on September 21 next year at about 7.8 percent interest. That translates to an interest of M39 million which brings the amount to M539 million.
The latest borrowing pushes the government’s domestic debt to M4.3 billion.
The foreign debt is around M15.6 billion. Although the debt is moderate, the government might be forced to borrow more if revenues continue to drop.
That could spell disaster for the country.
As things stand the government has to cut expenditure or look for ways to generate more revenue.
But with the economy still smarting from the effects of the Covid-19 pandemic and companies shutting down, there doesn’t seem to be much wiggle room.
Donor fatigue and the drop in the Southern African Customs Union, once the anchor of Lesotho’s budget, have made things worse.
Cutting expenditure seems to be the only option but the government appears reluctant to bite the bullet.
Lesotho has consistently failed to implement the International Monetary Fund (IMF)’s recommendation to cut the wage bill.
Successive ministers have hinted at plans to retrench some government employees but have never implemented them because that has political implications.
There are signs that the chickens are eventually coming home to roost.
A few days ago Government Secretary Lerotholi Pheko issued a circular announcing a raft of measures to “contain expenditure and overdue payments for ministries, departments and agencies”.
Pheko said due to increasing expenditure pressures and a drop in revenue the government is implementing measures that will contain expenditure to levels that are aligned with available resources.
“The Ministry of Finance will continue to issue monthly warrants only for wages and salaries as well as essential and critical expenditures in line with the approved procurement and cash plans plus availability of funds,” Pheko said.
He ordered chief accounting officers to stop international travel, buying furniture, large maintenance, subsistence allowances, and hiring new staff.
Also, all vehicles other than VVIPS will not fuel more than once a week unless they are for essential services as authorised by the government.
All government vehicles other than for VVIPs and selected offices must be parked at their designated places by 5pm and shall be used only for authorised purposes, Pheko said.
Nkheli Liphoto

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We’ll gang up against RFP, says Rapapa

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MASERU – Lesotho’s biggest political parties have hatched a grand plan to throttle the Revolution for Prosperity (RFP) led by Sam Matekane.
The plot was revealed by the All Basotho Convention (ABC) chairman Sam Rapapa at an election rally held in Mashai constituency last Friday.
He said even if the RFP makes it into parliament, they will make sure that it would not be part of the next government.
The plan, Rapapa said, is to “keep the RFP leader Sam Matekane at least as the leader of opposition, with no party to cobble up a coalition government”.
He said Matekane’s “dream of becoming a government alone is practically impossible because” the ABC, the Movement for Economic Change (MEC), the Democratic Congress (DC), and the Basotho Action Party (BAP) “will gang up to sabotage him”.
Rapapa spoke as he appealed to ABC members not to join the RFP which he said will not form a government or be in the next coalition government.
“These big parties will gang up against him (Matekane) and he will not be part of the government,” he said.
Rapapa wondered out loud why anyone would therefore want to leave the ABC to join the RFP.
“We will do everything to stop Matekane from getting into the government,” Rapapa said.
He urged Basotho to analyse critically which parties are likely to form the next government so they vote wisely on October 7.
“Both ABC and DC are likely to form a coalition government,” Rapapa said.
He said although he would in the past viciously attack the DC, he had since toned down after the two parties formed a coalition government in 2020.
In a lighthearted moment, Rapapa compared the political landscape in Lesotho to that of a child who runs away from his home to a neighbour’s house because the head of that house has arrived home with stolen wors.
Rapapa said people who are claiming they are leaving the ABC because it is engulfed in conflicts are lying.
Instead, he said the conflicts are in the RFP which has been battling numerous court battles as party members fight to represent the party in the general election.
“There is no peace in Moruo,” Rapapa said. “There is a fight that is going on in the RFP.”
Moruo, which means wealth, is the RFP’s slogan.
Rapapa urged the members to either vote for the DC or the ABC as there is peace and direction in those parties.
After the election, Rapapa said they will tell Maketane to stand in the corner with his people and a few constituencies.
He said Matekane is going to lead the opposition because they had discussed amongst themselves that he is a businessman and he should go back to business.
“We gave you a job to build roads, (but) you leave them with potholes and join politics,” Rapapa said.
He said Matekane is likely to only qualify as an MP and not a Prime Minister.
The ABC secretary general, Lebohang Hlaele, however distanced himself from Rapapa’s statement this week.
He said the party is busy campaigning to win next month’s election to form the next government and has not yet pronounced itself on any coalition deals.
“We have not planned to do anything about Matekane as the ABC National Executive Committee,” Hlaele said.
The ABC leader Nkaku Kabi told another rally in Thaba-Bosiu that “it is still premature as to which parties we would align ourselves with after the election”.
He said there are some parties that had been approaching the ABC to discuss coalition possibilities but they have not sat down to decide to cobble up any coalition agreements with any of them.
“Our committee has never met any party to discuss the formation of a coalition government after the election,” Kabi said.
Kabi said the matter should not trigger any ruckus in the party.
Nkheli Liphoto

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Stunning details of how Matela died

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 MASERU – A witness has revealed shocking details of how ’Mahlompho Matela died.
Lekhooa Monaleli told the court that ’Mahlompho told her that she had been strangled.
Monaleli was testifying this week in the trial of Qamo Matela who is accused of the murder of his wife ’Mahlompho.
Monaleli was friends with the couple.
He was testifying before High Court judge, Justice Tšeliso Mokoko, last Thursday.
Monaleli said he went to the couple’s home after Qamo Matela had told him that his wife was not feeling well and he needed help to take her to hospital.
Monaleli said he found ’Mahlompho and Qamo on the bathroom floor. He said ’Mahlompho was sitting between Qamo’s thighs while their children were in the lounge.
Monaleli said Mahlompho looked “tired and helpless”.
“I helped the accused to lift (his wife) and carried her to the car,” Monaleli said.
He said Qamo had thrust a spoon into ‘Mahlompho’s mouth to stop her from biting her tongue.
“I noticed that something might have happened to the deceased (‘Mahlompho) apart from her being ill,” he said.
“What I picked from the deceased was that her eyes showed that she had been assaulted.”
“I kept quiet because this hit me hard,” Monaleli said.
They drove to Willies Hospital in Khubetsoana.
At the hospital, Qamo left them in the car as he went to fetch a wheelchair for ‘Mahlompho.
Monaleli said this gave him a chance to ask ’Mahlompho what happened.
Monaleli said ’Mahlompho told him that Qamo had assaulted and strangled her.
“I asked the deceased why she did not call for help when what happened. The response was that the accused was strangling her.”
Monaleli said ’Mahlompho told him that Qamo had strangled him for a long time.
The court heard that later on the same day, after helping the couple to the hospital and back, Monaleli sent Qamo a voice note on WhatsApp telling him that he had ruined his day.
Monaleli said he later went to the couple’s house with his wife but they could not see ’Mahlompho because they were told that she was still asleep after taking her medication.
Monaleli said seeing that his friend’s family needed help, he arranged for them to see a psychologist.
The crown’s second witness Rorisang Mofolo, ’Mahlompho’s sister, said she received a call on September 4 last year from Qamo telling her that ’Mahlompho had fainted four times.
Mofolo said Qamo told her that he suspect ’Mahlompho might have a heart problem but she was now feeling better after giving her some sugar.
“He also told me that they were waiting for a car to take them to Willies Hospital,” Mofolo said.
“After our conversation with the accused (Qamo) I called my nurse friend to ask about the temperature change issue, she said it might be Covid-19 so the deceased should get tested,” she said.
She said every time she tried to call ’Mahlompho the phone would be picked by Qamo who would speak on her behalf.
Mofolo said during a video call with ’Mahlompho, in Qamo’s absence, she noticed that she had bruises on her face.
She said ’Mahlompho told her she had fainted three times.
Mofolo said she was relieved after Qamo gave him the impression that ’Mahlompho was recovering but was shocked when Monaleli called and insisted that she goes to see her sister.
She said in their telephone conversation ’Mahlompho said she was “trapped in a hell of a marriage…this man is a psycho”.
Mofolo said ’Mahlompho told her that at one point Qamo had helped her pack her belongings and that of the children so they could leave but suddenly changed his mind and said she would not leave with the children.
She testified that ’Mahlompho said Qamo started assaulting and choking her, saying she refused to give his mother M20 yet she had M30 000 in her bank account.
Mofolo said ’Mahlompho was later taken to  Maseru hospital which quickly referred her to Bloemfontein where she died a few days later.
She said when a nurse at the Bloemfontein hospital called her to break the news of ’Mahlompho’s death she advised her to go to the police to open a murder case.
She reported the case at the Mabote police station.
She said when she arrived at the couple’s house she found Qamo crying in the bedroom.
Mofolo said Qamo said: “I am very sorry, please promise me that you will be there for me and the kids and that we will plan the funeral together”.
Mofolo said she did not reply but she went out.
Tholoana Lesenya

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