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The burden of cancer



MASERU – WHEN ’Mathabang Serabele died two weeks ago, few paid attention to the cause of her death: breast cancer.
Instead, all eyes were on her socio-economic circumstances that saw her being nursed by her nine-year-old grandchild too young to shoulder the responsibility of looking after the ailing grandmother as well as siblings and cousins who included two toddlers.

For the police, attention was the criminal element as the law enforcers vigorously hunted down Serabele’s daughters who abandoned their children on her doorstep to search for employment in South Africa. Teachers at a school where some of the children attended were more worried by the effects of the situation on the children’s academic progress. As for the village social worker, poverty that was affecting the family and the plight of the children were her main concern.

Scant attention was paid to the breast cancer that slowly ate away Serabele – a situation that highlights the plight of people enduring breast cancer.
Instead of investing in its own infrastructure to fight breast cancer, the country is spending huge sums of money paying South African medical institutions that take in many patients referred from Lesotho.

It is not clear whether Serabele, who lived in a poor and hard to reach rural area of Liotlong in Mosalemane constituency, was one of the many Basotho patients whose cancer illnesses are treated in Bloemfontein, South Africa. It is also not clear whether she was transferred to Lesotho’s only referral hospital, Queen ’Mamohato Memorial Hospital at any given time for onward referral to Bloemfontein.

The grandchildren, whom the Ministry of Social Development says it is taking to a children’s home, are too young to know some of the details.
Serabele’s two daughters were away in South Africa during her illness.

What is known, however, is that Serabele died of a much feared condition on which Lesotho spends a lot of money to fight.
Lesotho paid M110 million last year alone to South African hospitals for treatment of cancer patients who are being transferred there, according to Health Ministry Principal Secretary Monaphathi Maraka.

“We first have to register cancer so that it can be a noticeable disease like any other disease,” Maraka says. He says global research shows that eight million people will die of cancer infection worldwide, “so we have to work very hard to prevent it”. “So in fighting this disease, the Health Ministry is preparing to build a clinic to treat cancer near Queen ’Mamohato Memorial Hospital which will enable patients to get treatment near home and get quick services,” he says.

Dr Mosilinyane Letsie, the Disease Control Director in the Ministry of Health, says most of cancer patients are referred to South Africa for treatment at the moment. “The results of this are inequitable access to services, late stage representations and poor treatment outcome that lead to significant number of cancer patients dying and a huge financial burden to the government of Lesotho,” Letsie says.

“So we want to prevent all this and help Basotho to get better services than being transferred to South Africa,” she says. The Director General-Health Services, Dr ‘Nyane Letsie says about 1 300 Basotho are referred to South Africa for cancer treatment every year. Letsie says if there was a cancer facility in the country that would save the country a lot of money.

Letsie says all health centres in the country should provide screening services for cancer to scale up the fight against the disease.
Dr Letsie says the initiative helps in diagnosing the disease at an early stage. The recent statistics by Health Grove reveals that for men, the deadliness of breast cancer in Lesotho peaks at age 80 plus. It kills men at the lowest rate at ages 20-24.

Women are killed at the highest rate from breast cancer in Lesotho at age 80 plus. It is least deadly to women between the ages 15 and 19.

At 139.7 deaths per 100 000 women in 2013, the peak mortality rate for women was higher than that of men, which was 10.1 per 100 000 men.
The statistics for cervical cancer by HPV Information Centre, whose report was published in July last year, shows that about 312 new cervical cancer cases are diagnosed annually in Lesotho (estimations for 2012).

It notes that cervical cancer ranks as the leading cause of female cancer in Lesotho. It states that cervical cancer is the second most common female cancer in women aged 15 to 44 years in Lesotho. Prime Minister Motsoahae Thabane, speaking at the commemoration of World Cancer Day on February 5, urged Basotho to join hands in the fight against cancer as it is dangerous and kills.

Thabane says cancer should be prevented at all cost. He urges men to be faithful to their sexual partners and avoid engaging in extra-marital affairs for their own health “because such affairs are risk factors to contracting prostate cancer”.

There is no cancer registry in Lesotho. However, a biomedical scientist Sejojo Phaaroe says in a 2007 report 13.5 percent of men had prostate cancer.
Phaaroe, who is also the National Cancer Programme Coordinator, told people attending Cancer Day commemorations that the cancer burden in Lesotho calls for a global response.

February 5 is the World Cancer Day and is commemorated annually. A breast cancer survivor, ‘Mampiti Mpiti, says she was diagnosed in 2010.
She urges both men and women to have routine check-ups, also urging those with cancer not to lose hope.

Thooe Ramolibeli

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Mahao, PS in big fight



PRIME Minister Sam Matekane this week summoned the Basotho Action Party (BAP) executive committee in a bid to defuse simmering tensions within the party.
This comes amid fears that Professor Nqosa Mahao’s fallout with his principal secretary at the Ministry of Energy, Tankiso Phapano, could threaten the unity in the BAP and the government’s stability.

thepost can reveal that Mahao has hinted that he would resign if Matekane doesn’t fire or reassign Phapano.

But there are strong indications that Mahao doesn’t enjoy the backing of his executive committee and MPs in his fight with Phapano.

Inside sources this week told thepost that some members of the BAP’s executive committee and MPs are openly siding with Phapano and have been secretly lobbying Matekane to reshuffle Mahao from the Ministry of Energy to Sports.

A source said Mahao is aware of these manoeuvres, including a clandestine meeting in Maputsoe, and has said he would rather resign than be the subject of a humiliating reshuffle instigated by people he leads.

The source of the bad blood between Mahao and Phapano is not clear but it is understood that they have disagreed over tenders and the ministry’s direction.

The source said Matekane was first briefed of the running battles at the ministry some three weeks ago just as matters were coming to a head.

It is the second briefing which revealed a complete breakdown in the relationship that triggered Matekane’s meeting with the BAP’s executive committee and MPs on Monday.

Three people who were in that meeting said Matekane told the BAP officials to deal with the crisis before it affected the ministry and threatened the coalition government’s stability.

The BAP’s executive committee, including MPs and Mahao, then had a marathon meeting to discuss ways to make peace between Mahao and Phapano.

A source who was in that meeting said “it was clear to Mahao that the majority of the committee and the MPs were on Phapano’s side”.

“Mahao quickly realised that he did not have the backing of the majority and took a conciliatory approach. It was clear that the committee would rather have him resign than get Phapano removed from the ministry,” the source said.

“In the past Mahao had flatly refused to reconcile with Phapano because of seniority. But this time he appeared to be open to a meeting to discuss reconciliation.”

Both Mahao and Phapano told thepost last night that their relationship was still cordial. ‘“We are still in good books with Phapano until further notice,” Mahao said.

“However, we cannot predict the future.”

Mahao denied ever discussing Phapano’s dismissal or transfer with Matekane.

Phapano also insisted that he was working well with Mahao.

“We are still on good terms,” Phapano said, adding that the allegation that they were fighting was “baseless”.

The fallout between Mahao and Phapano has been quick and spectacular.

The two had been almost inseparable months before Mahao agreed to join the coalition government.

Phapano would use his car to drive Mahao around. They would attend party meetings together. Some party insiders saw Phapano as Mahao’s right-hand man and adviser.

Mahao allegedly strongly pushed for Phapano to be appointed as his principal secretary when he became energy minister.

But sources said Mahao started having second thoughts days after recommending Phapano and tried to get his appointment reversed but it was too late.

A source says within weeks Mahao was telling cabinet colleagues that Phapano had captured the ministry and he was unable to function as the minister.

“He started pushing to oust Phapano within days because they were already clashing. It’s been war from the first days,” said the source.

Staff Reporter

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How chicken import ban hit vendors



MALESHOANE Pakela used to work at small backyard chicken farms where she was paid with chicken heads, necks, legs, and offals that she would roast and sell to factory workers at the Thetsane Industrial Area.

Her job was to clean and pack chicken.
The profit wasn’t much but just enough for the 37-year-old widow to feed and keep her four children in school.

“It also covered her monthly rental of M150 for a room in Ha-Tsolo Sekoting.

Her life was however shattered last October when the government imposed a ban on chicken imports from South Africa following an outbreak of bird flu.
Without day-old chicks the farms quickly shut down, cutting Pakela’s supply of heads, necks, legs, and offals.
Within a few days, her family was starving.

Pakela had been struggling even for months before the ban. The closure of the factories and retrenchments of thousands of workers has severely hit her sales. She was behind on her rent and could barely feed her children.

The partial lifting of the chicken ban has not helped Pakela because her former employers still cannot import day-old chicks or live birds.
Pakela and a family were kicked out of their rented room in November when their arrears were about M1 000.
She has found another room nearby.

A ‘Good Samaritan’ has allowed her to use a room for free until she can afford the rent. But Pakela says she still feels obliged to pay something because she understands that things are hard for everyone.

“Here the rent is still M150 but the landlord accepts every amount that I give her,” Pakela says.
There are days when her children go to bed hungry.

“I have told them (children) that if I have nothing they should accept (the status).”

She now survives on handouts from neighbours and other well-wishers. Pakela’s poverty is apparent.

Barefoot and holding her small child in a seshoeshoe dress, Pakela says her two children usually go to school without eating.
The other child has dropped out of school because she doesn’t have shoes.

’Mako Lepolesa, 44, who has been running a chesanyama (meat grill) at the Maseru West Industrial Estate since 2018. The father of three says his clients are mainly taxi drivers and factory workers.

Chicken was her main product until last October when the ban was imposed. It wasn’t long before his business started wobbling.

“I thought it would be just a short-lived problem (chicken import ban) but it passed on this year,” he says, adding that it might take months for his business to recover.
Moshe Ramashamole, 42, who also owns a chesanyama in the Maseru West Industrial Estate, tried to remain in business by sourcing chicken from local farmers.

It was a stopgap measure that however lasted a few weeks because the farmers also ran out of stock. He resorted to bad chicken but they were double the price of a full chicken before the ban.
Yet Ramashamole thought he could make it work by increasing the price of his plate from M35 to M55. The customers however resisted the new price and Ramashamole had to take the losses.

The poultry ban did not affect street vendors like Pakela alone.
Former Minister of Communications, Khotso Letsatsi, is one of those poultry farmers struggling following the chicken ban.

He ventured into poultry in January last year. It was an audacious venture that included a M100 000 investment in a shelter and other equipment.
He started with a batch of 300 chicks and had reached 1 000 by the time the ban was imposed.

“The business was lucrative,” Letsatsi says.

“I had to employ two people permanently to assist me on a full-time basis,” he says.

When it was time to slaughter the chickens, Letsatsi says he had to employ seven casual labourers.
Since the ban was imposed he had released all his workers.

“I do not know where they are now. Maybe they are starving,” he says of the workers he released.

Letsatsi doesn’t know how he will revive his business.
The Director of Marketing in the Ministry of Agriculture and Food Security (MAFS), Lekhooe Makhate, says the ban has been devastating to farmers and businesses.

“Some big businesses are going to declare less tax to the government because there was no business,” Makhate says.

He says Lesotho spends M2.1 billion on the importation of chicken and its products from South Africa every year.
But that amount usually soars to M4 billion depending on the market forces of demand and supply.

Makhate says the M2.1 billion goes to South Africa where the chicken and its products are imported.

At the height of the scarcity of chickens in the country, Makhate says people were supposed to make initiatives to travel to villages to search for chickens.

“There is not enough production of chickens in the country,” he says.
“Economically speaking we rely on South Africa. We have to be self-reliant.”

Majara Molupe

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Letseng fends off threat to sue



LETŠENG Diamond says it is under no obligation to advertise jobs for Basotho to provide certain services “where it has the capacity to undertake the same services”.
Letšeng Diamond boss, Motooane Thinyane, was responding to a threat to sue by a little-known political party called Yearn for Economic Sustainability (YES).

Matekane’s company, the Matekane Mining Investment Company (MMIC), had been providing blasting, haulage and drilling services at Letšeng mine since 2005.
The deal with the MMIC was terminated in December last year with the mining company saying it was improper because Matekane had now become a politician.

Letšeng Diamonds announced that it had reached an agreement with the MMIC to acquire its mining equipment at the mine and offered employment to its current employees in line with operational requirements.

“This will enable Letšeng to continue with its mining activities,” the company said in its statement.

This infuriated opposition parties that argued that the mine should have called interested Basotho companies to bid for the contract, saying it is provided for in the Minerals Act of 2005.

The leader of Yearn for Economic Sustainability (YES), Molefi Ntšonyana, wrote the mine last week threatening to sue for allegedly failing to follow section 11 of the Act.
Ntšonyana argued that the Act “does not grant the Letšeng Diamond 100 percent to mine with its good own equipment” but it should engage Basotho companies like it did with the MMIC.

Ntšonyana said Letšeng Diamond and the MMIC made the agreement to acquire the MMIC equipment so that the mine could continue with its mining activities “without any advertisement to seek qualified Basotho to provide such services”.

Ntšonyana said the agreement unilaterally denied Basotho a chance to tender for such services and ignored the fact that the government of Lesotho on behalf of Basotho own 30 percent in the Letšeng Diamond.

“It is advisable to reconsider your decision,” Ntšonyana said, adding that they would also write to the mining board requesting the resolution they made regarding this matter of insourcing mining activities.

He said the company should adhere to section 11 of the Mines and Minerals Act of 2005 and within 14 working days the matter should be reconsidered, “failing which we will have no choice but to drag the company to the courts of law”.

In his response, Thinyane said Ntšonyana must “revisit the section in question in full for its correct interpretation”.

“Letšeng Diamond is under no obligation to advertise to seek qualified Basotho to provide services where it is willing and has the capacity to undertake the same services,” Thinyane said.

He said the decision relating to the agreement referred to has been through the necessary governance structures and is therefore procedural.
Thinyane said Letšeng is a corporate citizen that is fully compliant with the laws of Lesotho.

Majara Molupe

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