Poverty, distance block access to health care

’MAPALO NKHELOANE

QACHA’S NEK – Long distances from health facilities and budget constraints are some of the main reasons why people living in the most remote areas of Qacha’s Nek are unable to access basic health care services.

But the two main health centres in the district – the Qacha’s Nek Government Hospital and the Machabeng Hospital – are working tirelessly to ensure that the general population in the district receives the essential health care it requires.

During the commemoration of the African Vaccination Week held in Qacha’s Nek last week the importance of promoting the use of vaccines to protect children under five years of age against diseases was highlighted.

The annual event held under the theme ‘Protected Together, Vaccines Work’ was organised by the World Health Organisation (WHO) in partnership with the Christian Health Association of Lesotho (CHAL), through the Tebellong and Machabeng hospitals.

According to WHO, immunisation saves millions of lives every year and is widely recognised as one of the world’s most successful and cost-effective health interventions.

Diseases that children were immunised against include: measles and rubella, polio, tetanus, and diphtheria.

Vaccinations not only protect children from the deadly diseases mentioned but they also keep other children safe by eliminating or greatly reducing dangerous diseases that used to spread from child to child.

The three health partners spread their services to the villages of Ha Kali, Ha Tlhaku, Moeling, Ha Moleleki and Ha Semethe which are all located a considerable distance away from the health centres.

As part of the celebration, the partners also sensitised the villagers about the importance of childhood vaccination and the negative effects of failure to vaccinate children accordingly.

This was achieved through brief health education sessions which strongly emphasised the need for childhood vaccinations.

CHAL is a voluntary organisation of six-member churches: Anglican Church in Lesotho, Assemblies of God, Church of the Bible Covenant, Roman Catholic Church, Lesotho Evangelical Church in South Africa, and Seventh Day Adventist Church of South Africa.

CHAL currently provides about 40% of health care in Lesotho and is a key partner of the government of Lesotho. The eight-member churches body owns eight local hospitals, Tebellong Hospital included.

CHAL aims at providing (not for profit) equitable, quality and sustainable health care services to Basotho, especially those living in rural and semi-urban areas.

The Tebellong Hospital, as one of the contributing partners, is situated in the remote mountainous area of Qacha’s Nek in the south-eastern part of Lesotho.

Although its services are in highly demand, the health centre is however difficult to access as it is located across the Senqu River and can only be reached by boat.

During the rainy season, especially when the Senqu River is in flood, it becomes risky to cross the river and at times lives are lost.

It normally costs M10 for one to be ferried across the river by boat, but the fare increases to M50 when the river is in flood due to the heightened risk entailed.

Executive director of CHAL, Lebohang Mothae, says it is only fair to commend Tebellong Hospital staff for risking their lives to serve Basotho who need health services.

Mothae says the hospital’s geographical location is a huge public threat, adding it therefore takes guts for someone to ride on the boat to reach the hospital.

Stereotypal men, especially those who live in rural areas, are usually reluctant to take their children to health facilities because they perceive it as women’s responsibility.

But 49-year-old Kheuoe Thatho of Ha Tlhoro does not have a problem taking his two young daughters to the clinic in Ha Kali for vaccination.

The health centre is located approximately two hours away from Thatho’s home village on foot.

“I work in Cape Town and I am hardly at home to be with my family. Walking for two hours to get here in this cold gave me a better opportunity to spend time with my girls. Luckily enough, they also love spending time with me.

“Being a father is a precious gift that God gave to man, so putting my fatherhood to good use was the least I could do because not all of us get the opportunity to be called ‘dad’. Assuming it is a mother’s duty alone to take care of one’s children is poor thinking. It is imperative for all fathers out there to start acting like real fathers and take their children’s health seriously.”

The area chief of Ha Tlhaku, Chief Mpiti Letsie, expressed his profound gratitude to the three partners for bringing essential health services to their doorstep.

“No amount of words can express my gratitude, especially because we are in dire need of a health centre in this area.

“Life is the most precious gift of all and it comes once in a lifetime. It is therefore very important to look after one’s health. I sincerely hope the visit happens again in the near future,” Letsie said.

The nearest health centre from Quthing is in Mphaki and the Christ the King from Qacha’s Nek both located over 50km away from Ha Tlhaku.

Letsie says one of the major challenges his subjects face is being waylaid by thugs on their way to and from health centres.

“Owing to the long distances to the centres, they have to wake up early to get there on time. Women are the worst hit because besides getting robbed on the way, some also get raped.

“They cannot use vehicles as most of them are less privileged and can therefore not afford bus or taxi fares. I should, however, commend village health workers for dedicating their time to offer health services; they really do an amazing job.

“The event is well attended partly because of the good word the village health workers spread,” he also said.

He is hopeful that the government, through the ministry of public works, will construct roads in the area as that is another reason that hinders service delivery.

Limakatsa Lipholo, a nurse from Machabeng Hospital, says the greatest challenge they encounter in their line of work is with parents who do not take children for vaccination at all or according to the set schedules.

“They also have a habit of stopping children from taking albendazole pills and Vitamin A with the mistaken assumption that they are not as vital as vaccine syringes.

Albendazole is an anti-worm medication that prevents newly hatched insect larvae (worms) from growing or multiplying in one’s body.

It is used to treat certain infections caused by worms such as pork tapeworm and dog tapeworm.

Vitamin A is important for normal vision and the immune system. It also helps the heart, lungs, and other organs to work properly. Failure for targeted children to get the pills therefore poses a threat of suffering from diseases the two pills prevent.

“It is really sad that most of these parents opt to bring their children to hospital when the child has started to battle with a disease and it is almost too late.

“What is also sad is that even though some of these things are due to parents being negligent, most of them claim that they fail to properly take their children for vaccines because getting to health centres is a hassle as the distance they travel is too long,” Lipholo says.

This year’s edition of the African Vaccination Week was special in that besides immunisation, health services such as HIV testing, oral health, hypertension and family planning services were offered.

CHAL’s deputy executive director, Paseka Ramashamole, told Public Eye that it is because during the commemoration of the event last year attendants showed that they needed other health services as well, so they figured it was imperative to offer them this time around.

Ramashamole agrees that both the financial state and distance make it almost impossible for people to access health services at the centres.

“Another major problem arises when patients have to go for check-ups. Most are forced to default because they do not have the money required and the long distance is also disheartening,” he further shows.