COVID-19 to worsen other health problems

MATHATISI SEBUSI

MASERU – The surge in confirmed COVID-19 cases will render Lesotho incapable of withstanding anticipated effects, while worsening other already existing health challenges, the United Nations (UN) has said. This is contained in the COVID-19 Situation Update Report from the office of the Resident Co-ordinator in Lesotho, Salvator Niyonzima, in collaboration with humanitarian partners, issued on July 13, 2020. To respond effectively to the COVID-19 pandemic, Lesotho needs to strengthen her health systems in planning and co-ordination, surveillance and investigation, screening of travellers, laboratory investigation, infection prevention and control and in case management, while ensuring continuity of other priority public health interventions.

The report further states that the country already has challenges of inadequate medical staff to support the increased demand due to the COVID-19 pandemic, including inadequate isolation units, intensive care units, infection control materials, medicines, and medical supplies across the country. “In addition, the national lockdown has impacted on community-based outreach services for health and HIV services that have been halted, thereby further increasing health demands, especially among adolescents and young people.

HIV prevalence is high in Lesotho with the highest incidence being among adolescents and young people, estimated at an average of 38 percent for both males and females aged between 15 and 24. “Due to the COVID-19 crisis, this population group is exposed to high-risk behaviour which may lead to early and unwanted pregnancies and child marriage as a result of the lockdown measures in place,” reads the report. The report further notes that the risk of contracting HIV and unplanned pregnancies is heightened by the absence of supportive services and educational programmes as these have not been considered critical due to the urgent need to address COVID-19. It observes that this threatens to escalate teenage pregnancy prevalence which has increased from 88.16 births per 1 000 girls to 93 between 2010 and 2017.

“Global Modelling based on Sub-Saharan Africa (Stover et al) shows that if continuity of HIV services, including preventive community outreach and ART services are interrupted during the COVID-19 pandemic, HIV deaths are likely to double or triple in 2020. “This is especially concerning for adolescents and young people in Lesotho – who have the poorest HIV outcomes in the country and face multiple overlapping risks,” reads the report. It further notes that persons with disabilities (particularly girls and women) are at heightened risk of exposure to COVID-19 because of their limited access to information on prevention measures, structural stigma and discrimination, barriers to accessing health services, and difficulties in accessing Water Sanitation and Health (WASH) project facilities.

The UN, therefore, urges an urgent need for Lesotho to ensure that the immediate and the recovery phases of the response to COVID-19 are fully inclusive of the rights of persons with disabilities, tackling their access to information, healthcare services, education, social protection, and to civic participation. The report also touched on the migration crisis in Lesotho brought about by COVID-19, noting a large number of vulnerable Basotho living in South Africa are in need of food, shelter, and medical attention.

“The IOM has partnered with the medical professional diaspora in South Africa exploring the tele-medicine for the COVID-19 related cases in Lesotho. “In order to respond to the COVID-19 pandemic in Lesotho, IOM has also identified the hot spots with community crossings in 10 districts, and is currently developing IEC material for risk communication targeting migrants, key populations and passengers at border,” it noted.

The report notes that the government of Lesotho and UN a have also put aside a COVID-19 response budget to the tune of US$ 48.5 million (about M800 million) and US$24 million respectively. “United Nations in Lesotho and its partner organisations have developed a COVID-19 response plan, particularly focusing on Health, WASH, Food Security, Protection, Education and Nutrition which is currently ongoing in all 10 districts. “The World Health Organisation (WHO) supported the government with the development of COVID-19 Case Management Guidelines as well as assistance with the development of the National COVID-19 plan.

To build the capacity of health personnel, WHO conducted various training programmes on case management, COVID-19 risk communication and community management. “WHO also provided PPEs and other delivery packs in selected health facilities to reduce the spread of the COVID-19,” reads the report. “Being a member of the National Technical Working Group, UNAIDS is providing technical guidance to Ministry of Health’ on how to set up the system and guidance for surveillance of COVID-19 cases, suspected cases, and contact tracing.

“The group has designed the system and tools for tracking individuals who have been screened (in facilities and border posts); in quarantine (self and government-sponsored facilities); suspected cases (with symptoms) and contact tracing for suspected cases (while waiting for lab results). “Also, the UNAIDS has partnered with the National Institute for Communicable Diseases (NICD) in South Africa for support with the modeling tools they are using as these will be more relevant for Lesotho,” the report.

The report further articulates that the declaration of a national emergency on the 18th of March 2020 and closing of all schools (including ECD centres) affected approximately 511,000 learners. It notes that most learners are in rural areas and on average 4.3 percent of the learners affected by the closure have a disability, therefore, school closures and lockdowns have disrupted children’s routine and social support systems.

“Children and families who are already vulnerable to socio-economic exclusion are particularly vulnerable to protection risks including increased risks of sexual exploitation, need for mental health and psychosocial support, neglect, child abuse, and domestic violence. “The population of Lesotho is mostly rural, and many families rely on herding cattle and farming for their survival and/or income. The participation of boys in education, particularly in rural mountain areas is the lowest of any group.

It is expected that this negative trend may be exacerbated by COVID-19 given the higher opportunity cost of going to school following the economic shock as a result of the crisis. With support from UNICEF, the Ministry of Education and Training (MOET) has implemented continuity of learning programmes through radio and television since April 2020. UNICEF has also supported the Ministry of Education with the development of COVID-19 communication materials for learners,” said the report.