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The call of duty

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MASERU – Growing up in Mokema, Ha-Lebakae, Dr Mahali Ntšasa always wanted to do something challenging and medicine seemed a natural choice.

“It is an honourable profession, it deals directly with human life. And I wanted to impact people personally,” she said.
“Also, it was a smart choice for sustainability. I am happy I chose it. I love my job. I would never want to do any of their job.”

She holds a Bachelor of Medicine and Bachelor of Surgery (MBChB) from the Walter Sisulu University, Eastern Cape, South Africa.

Initially, she didn’t want to return home after her graduating as the only lifestyle she could imagine was that of being in South Africa as a medical doctor.

“It was disappointing to learn that I had to come back home and after our arrival we didn’t have enough people training us as interns at Queen ’Mamohato Memorial Hospital (QMMH) as specialists were inadequate.”

“My management of patients was quite narrowed because I didn’t have enough investigations to support the diagnosis I could make,” she recalled.

In more advanced countries, medical personnel have plenty of resources at their disposal.

She said this continues to be a challenge because at the district level, one is expected to be independent but at the same time there is a need for mentorship which isn’t possible as there is a national shortage of doctors.

“We are very few to support one another and some wards just have one doctor. It’s not supposed to be like that, we need to be consulting each other but we are very few and burdened with a lot of work.

“It’s quite a challenge to work as a doctor in Lesotho because our health system is also burdened with a lot of challenges. It’s not the easiest of jobs,” said the 34-year-old who is in her eighth month as the Mafeteng District Medical Officer (DMO).

After her internship at QMMH, she worked at Motebang hospital for two years before transferring to Ntšekhe hospital, in Mohales Hoek for a year and then joining Mafeteng government hospital as the Medical Superintendent when Covid-19 became a crisis.

Dr Ntšasa didn’t have a smooth upbringing as she grew up an orphan who lost her parents as well as her grandmother who was her guardian at the time in three consecutive years.

“I come from very humble beginnings,” she said.

As the seventh child, she and her siblings were raised by their aunt and uncles.

“But I grew up in different houses from my uncle, aunt and my elder sisters when they got married. A lot of people contributed to raising me.”

As a top student, she got a scholarship that paid her fees throughout high school.

“I only struggled with uniforms and cosmetics but food wasn’t a problem since I stayed in boarding school.”

She says she became a top student throughout her lower education; primary, secondary and high school.

“I have always been book smart,” she says.

However, things quickly changed when she got to the National University of Lesotho where she was studying for a Bachelor of Science degree.

“I didn’t do well. I was quite depressed because I wanted to go to Machabeng College for IB. I was sure from Form D that I wanted to study medicine. But I wasn’t allowed to switch to Machabeng after attending the PESP programme at NUL for three months. So I stayed and I almost failed.”

She said she was then restricted to a single major in physical geography, quite different from what she wanted.

“But because God has never forsaken me, I was admitted into MBChB.”

She completed her medical degree in six years.

“My life has been amazing ever since, financially speaking,” she says, laughing.

Dr Ntšasa said her main motive was to get an education and work for her bread.

She said she joined the hospital in the middle of the chaos caused by the pandemic.

Her biggest challenge was to ensure teamwork amongst doctors and all the clinical staff.

“My reception was quite good as I was a Mosotho and the language was not a barrier.”

One challenge, she said, was that it was her first time in high office.

“Even though I had leadership qualities growing up as I was chosen to be a leader from class monitor, head prefect and the president of Lesotho Medical Students Association. But still it was nothing compared to this,” she said.

“It was a big adjustment for me to deal with issues such as assets, finances, people’s management and having to deal with other people even though I was the youngest in the room outside medicine,” she said.

She said occupying the office was a challenge as the hospital was transitioning to have a quarantine facility.

“It was busy and we had a lot of problems with oxygen challenges which led to needless deaths as people succumbed to Covid-19.

“Having to deal with all that at once, including getting used to my new role in a district I didn’t know anyone was a bit challenging. Fortunately I got all the help I needed from other role players in this fight and we did well.”

Dr Nts’asa says infrastructure is the biggest challenge facing the Lesotho’s health system.

“The hospitals have become so small for the population we are serving – all the buildings are too small to accommodate everyone.”

She says equipment is another problem as there are no CT scans and IMR machines and people have to go to private clinics that charge over M4 000.

“Not everyone can afford that amount and it’s unfortunate as we live in a country with a lot of people suffering from hypertension. It’s very difficult,” she lamented.

Also, Intensive Care Unit (ICU) services are a challenge as they are only available at Queen Mamohato Memorial hospital and the capacity is small with just 10 beds.

“Fortunately, the ministry is working on introducing nationwide critical cares at Mafeteng, Motebang and Berea as we now have oxygen plants at those places and clinicians, nurses and doctors are being trained.”

She says human resources are another problem.

“We don’t have doctors but it’s said the establishment list is full so doctors can’t be hired. We are short staffed.”

She said the hospital is only left with four Basotho doctors as the contracts of foreign doctors haven’t been renewed. Of the four, one was attending a workshop and the other was off after working for 36 hours.

“It was just horrible and this halted the outreach programme. We can no longer do that because we don’t have enough doctors and it’s not just a case in Mafeteng but it is a countrywide concern. Without doctors, the hospital might be just a clinic yet this was supposed to be a regional hospital. It should really be stocked with doctors and specialists.”

She said upgrading oneself is a challenge and people are forced to study in their own time at their own expense.

“Study is not happening at the rate that it should be. The country lacks specialists. It’s just a mess as to why role players don’t push for Basotho to pursue their studies and specialise so that the people can get quality health services and this can only when there are specialists in all relevant fields.”

She says “it’s easy” to overcome these challenges: extend hospitals, hire doctors, send doctors to school, buy the needed equipment and pay people what they are worth.

“I really don’t think it’s difficult to address these challenges…we just have people who don’t want to deal with them.”

She says she would like to specialise in internal medicine but “my leadership qualities overshadowed everything I was doing clinically and I was needed.”

She says since she is now into administration, she plans to take “the office route” by studying public health, business administration or health care management.

“But since I am a clinician at heart, I still believe that if an opportunity comes to specialise in internal medicine I will happily grab it. I would be the happiest person if that happened.”

“However, I also realise that our ministry is lacking in several departments. It would be wise for me to further my studies so that if an opportunity to work at the ministry’s headquarters presents itself, I will have the right qualifications.”

“Most of our bosses in the country are old and the problem is our youths are now more interested in entrepreneurship than holding positions in offices for the betterment of Lesotho,” she says.

She says for her, saving just one life was a milestone as it is something she prayed for when she was still at medical school.

“The more lives I save, the more grateful I become and the more I want to save. If I had to change to clinical practice I would happily do but I am also happy that I have been afforded a chance to be in a big office at my age. I feel honored and privileged and it only means I can go higher from here.

She says she has a supportive environment at home as she is married to a doctor as well.

“It’s very nice to have someone understanding and supportive whether clinically or administratively. It indeed makes the journey quite easy.”

’Mapule Motsopa

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Dead on arrival

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My sister delivered a stillborn baby when she was on her way to the clinic,” ’Matemoho Letšela, 23, barely holding back tears.

Letšela says her sister, whose name she withheld, suffered birth-pangs when she was alone at home in Khonofaneng village in Mokhotlong.

She was then rushed down the slopes of a mountain by some passers-by on foot, striding on the slopes of a rocky mountain, crossing deep gorges as she sought to get to the Molika-Liko Health Centre some eight kilometres away.

When she arrived at the clinic, the baby was declared dead on arrival.

Welcome to Mokhotlong, Lesotho’s mountainous region known worldwide for its big and clean diamonds where the people do not have basic services.

Letšela said her sister collapsed when she was on her way to the clinic and was only seen by some passers-by.

By the time passers-by saw her, it was already too late for her and her baby.

She was eight months pregnant. 

“She was still far from the clinic and away from the villages,” Letšela says.

“She had no one to help her until she lost her baby. She was helpless the whole day until it was too late for her to survive,” she says.

 “She had already lost a lot of blood and could not make it to the hospital.”

Letšela shared her sister’s story with thepost during a tour conducted by the China International Development Cooperation Agency (CIDCA) and the United Nations Population Fund (UNFPA) to assess the impact of their assistance in Mokhotlong and Quthing districts a fortnight ago.

Letsela pleaded with the government to provide services in Mokhotlong’s hard-to-reach areas to avoid unnecessary deaths like her sister’s.

“My sister was eight months pregnant so the long walking distance might have been the cause of her early delivery and ultimate death,” she says.

She says there are still some villages in her area that are way far from where she stays, villages like Lichecheng where a patient must travel early in the morning, sleep on the way and reach the clinic the following day.

Cars cannot reach those remote areas, she says.

At Letšela’s area, they only have one bus that travels from home to town at 9am and will be back late at 8pm.

Even though they would love to always catch a ride whenever they are going to the clinic, sometimes they just do not have the money.

Letšela is three months pregnant now and says she cannot wait to reach 37 weeks so she can go and stay at the accommodation facilities provided by the clinic.

 “That is the advice from our midwives and I am willing to take that offer,” she says.

“I don’t want what happened to my sister to happen to me.”

When thepost met Letšela at the clinic last week, she had left her place at around 4am walking alone to the clinic and arrived after 10am.

Relebohile Tšepe

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Doctor tampers with corpse

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THE Mokhotlong Government Hospital has agreed to pay M200 000 as compensation to the husband of a deceased patient after a doctor unlawfully tampered with the corpse.

There is a deed of settlement between the hospital and Jacob Palime, the deceased woman’s husband.

Jacob Palime rushed to the High Court in Tšifa-li-Mali last year after the hospital failed to explain why the doctor had tampered with his wife’s corpse at a private mortuary behind his back.

His wife’s body had been taken to the Lesotho Funeral Services.
Palime lives in Phahameng in Mokhotlong.

In his court papers, Palime was demanding M500 000 in compensation from the hospital “for unlawful invasion, intrusion and interference with” his rituals and rights over his dead wife.

He informed the court that his wife died in September 2020 at Mokhotlong Hospital.

“All requisite documentation pertaining to her release to Lesotho Funeral Services were effected and ultimately the deceased was accordingly transferred to the mortuary,” Palime said.

The court heard that Palime’s family was subsequently informed about the wife’s death.

The family however learnt that one doctor, acting in his professional capacity, went to the mortuary the next day and tampered with the corpse.

The doctor subsequently conducted certain tests on the corpse without the knowledge of family members.

Palime said their attempts to get an explanation from the hospital as to the purpose of the tests and the name of the doctor had failed to yield results.

“It remained questionable and therefore incomprehensible as to what actually was the purpose or rationale behind conducting such anonymous and secret tests,” he said.

Palime told the court that the whole thing left him “in an unsettled state of mind for a long time”.

He said his family, which has its traditions and culture rooted in the respect for their departed loved ones, regards and considers Mokhotlong Hospital’s conduct as an unlawful invasion, intrusion and interference with his rituals and rights over his deceased spouse.

“This is more-so because the hospital had all the opportunity to have conducted any or such alleged tests immediately upon demise of the deceased while still within its area of jurisdiction and not after her release to the mortuary,” he said.

Palime said despite incessant demands, the hospital has failed, refused, ignored and neglected to cooperate with him “to amicably solve this unwarranted state of affairs”.

Palime told the court that there were no claims against the Lesotho Funeral Service as they had cooperated and compensated him for wrongly allowing the doctor to perform tests on the corpse without knowledge or presence of one of the family members.

’Malimpho Majoro

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Villagers whipped as police seize guns

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Dozens of villagers in Ha-Rammeleke in Khubelu, Mokhotlong, were on Monday night rounded up and beaten with sticks and whips by the police during an operation to seize illegal guns.

The villagers told thepost that they heard one man crying out for help saying his wife was sick. And when they rushed to his house, they found the police waiting for them.

The police had stormed the man’s house and ordered him to “cry for help” to lure men from the village.

The men and women were then frog-marched outside the village where the police assaulted the men with sticks, whips, and kicked them.

One man said when he arrived at the house, he found other villagers who were now surrounded by armed police.

“At first I thought they were soldiers but later picked up that they were SOU (Special Operations Unit) members,” he said.

He said they were subjected to severe torture.

“They beat us with sticks at the same time demanding guns from us,” he said.

The police and soldiers also raided other nearby villages in Khubelu area but in Ha-Rammeleke villagers say they identified only police from the Special Operations Unit (SOU).

Several villagers who spoke to thepost asked for anonymity for fear of retribution.

This was the second time within a month that the security forces have raided the villages in search of illegal guns after a spate of gory murders in the areas.

The murders are perpetrated by famo music gangs who are fighting over illegal gold mining in South Africa.

The first raid was on Wednesday preceding Good Friday.

Villagers say a group of armed soldiers stormed the place in the wee hours collecting almost every one to the chief’s place.

“We were woken-up by young soldiers who drove us to the chief’s place,” one resident of Ha-Rammeleke said.

When they arrived at the chief’s home all hell broke loose.

A woman told thepost that they were split into two groups of women and men.

Later, women were further split into two groups of the elderly and younger ones.

She said the security officers assaulted the men while ordering the elderly women to ululate.

Young women were ordered to run around the place like they were exercising.

She said the men were pushed into a small hut where they were subjected to further torture.

A man who was among the victims said the army said they should produce the guns and help them identify the illegal miners.

He said this happened after one man in their village was fatally shot by five unknown men in broad daylight.

He said the men who killed the fellow villager had their faces covered with balaclavas and they could not see who they were.

 

The villagers chased them but they could not get close to them because they were armed with guns.

“We were armed with stones while those men were armed with guns,” he said.

“They fired a volley of bullets at us and we retreated,” he said.

The murdered man was later collected by the police.

The army spokesman, Lieutenant Colonel Sakeng Lekola, confirmed that soldiers stormed Khubelu area in response to the rampant lawlessness of unlicensed guns.

Lt Col Lekola said their presence in the area followed two incidents of shootings where one man was fatally shot and a child sustained serious gunshot wounds.

“There were reports everywhere, even on the radios, that things were out of hand in Khubelu,” he said.

He said in just a day they managed to collect six guns that were in wrong hands together with more than 100 rounds (bullets) in an operation dubbed Deuteronomy 17.

These bullets included 23 rounds of Galil rifle.

Lt Col Lekola maintained that their operation was successful because they managed to collect guns from wrong hands.

He said they are doing this in line with the African Union principle of ‘silencing the guns’.

He said it is an undeniable fact that statistics of people killed with guns is disturbing.

“We appeal to these people to produce these unlicensed guns,” Lt Col Lekola said.

Lt Col Lekola said they could not just watch Basotho helplessly as they suffered.

He said some people are seen just flaunting their guns.

“They fear no one,” he said.

Police spokesman, Senior Superintendent Kabelo Halahala, said he was aware of the operation in Mokhotlong but did not have further details.

Majara Molupe

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