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MSF brings hope to Aids patients

by Lesotho Times

MASERU — In 2006, 44-year-old Lekhokoho Kokome was on the verge of despair.

Two years earlier Kokome had been diagnosed with HIV, the virus that causes Aids.

His health was fast deteriorating.

But just when he was losing all hope, an international medical and humanitarian agency, Medecins Sans Frontieres (MSF), arrived.

MSF set base in Morija, an impoverished town 40 kilometres south of the capital Maseru.

There, they began running an ambitious project, Selibeng Sa Tšepo (Well-spring of hope), to fight Aids.

The agency was working closely with the Ministry of Health and Social Welfare.

Kokome says he was “lucky” because MSF arrived when he was just about to start his anti-retroviral treatment (ART) after his CD4 count deteriorated.

He says before the arrival of MSF, people would struggle to adhere to the strict ART regimen.

The nearest health centre, Senkatana Clinic, is some 40km away in the capital Maseru.

The long distance meant people could not afford to go and collect their monthly supply of ARVs.

ARV drugs require strict adherence with the tablets being taken at regular times every day.

Failure to adhere to this treatment schedule builds resistance with devastating consequences for HIV-positive patients.

“Only a few people were able to collect their medication from Maseru. Many would not afford to raise money for bus fare.

“But all that was soon forgotten when MSF brought services closer to the people.

“We have never run out of ARVs in our clinics. As a result more lives have been saved,” says Kokome who has virtually recovered and now works as a lay counsellor at Ha-Mofoka Clinic.

Lay counsellors are ordinary community members who are trained to provide health education, care and support.

Kokome says he now feels competent enough to deal with HIV and Aids issues, thanks to the training he received from MSF.

The Selibeng Sa Tšepo project has indeed brought real hope to Basotho who are ravaged by Aids.

After four years of hard work, the MSF will in June hand over the project to the Ministry of Health and Social Welfare.

The MSF can indeed look back at their achievements over the past four years with satisfaction.

MSF medical director for South Africa and Lesotho, Dr Eric Goemare, is proud of the relief agency’s achievements over the years.

“We were the first in Lesotho to achieve full decentralisation of HIV care and treatment throughout an entire Scott Hospital Health Service Area,” Dr Goemare said.

The Scott Hospital Health Service Area covers at least 14 health centres and five village health posts in the Morija area.

Before the arrival of MSF in Morija, there was no ART programme that was going on at the 14 service area clinics.

Only about 5 500 people out of the 35 000 who needed treatment in Morija were on ARV treatment.

Besides, these people had to travel to Maseru to collect their drugs at Senkatana Clinic, the only clinic in Lesotho that was providing ART services then.

Lesotho has one of the world’s worst HIV infection rates.

Nearly a quarter of the country’s 1.8 million people are said to be living with the virus, according to United Nations figures.

With their arrival, MSF boosted the HIV fight in Morija.

Slowly ART services were introduced in all 14 service clinics with the arrival of MSF.

And before long, villagers infected with HIV were able to access ART services.

The Scott Hospital Health Service Area is a rural health zone straddling Maseru and Mafeteng districts.

The area services a population of about 200 000 people and has historically been managed by the Christian Health Association of Lesotho (CHAL).

At least 35 000 people in the catchment area are living with HIV.

A survey carried out by MSF showed that a total of 55 254 people tested for HIV in the Scott Hospital area since January 2006.

Of these, 14 830 people were enrolled for HIV care at Scott Hospital and its service clinics.

Fifty-seven percent were non-pregnant women, 29 percent were men, nine percent were pregnant women and five percent were children under the age of 15.

The summary said Lesotho is still facing a huge challenge of TB-HIV co-infections.

“The people of Lesotho have the odds stacked heavily against their survival due to the high rate of HIV-TB co-infection.

“Each year approximately 18 000 people die due to Aids-related complications, including TB as well as Multi-Drug Resistant TB (MDR-TB),” the summary says.

It says that the HIV-TB co-infection rate for Lesotho stands at an alarming 90 percent.

The burden of the HIV and Aids epidemic is the leading cause of death in the Basotho society, says the summary.

In addition the challenge of identifying and treating MDR-TB is an ever emerging threat in a country with limited access to diagnosis for MDR.

“In 2007, 200 cases of MDR-TB people were treated and it was expected that this already high figure would rise to 380 in 2010.

“With an HIV co-infection rate of 90 percent this dual epidemic spells ‘double trouble’ and is a huge challenge for an already overstretched healthcare system.”

‘Macecilia Leche is an assistant counselling co-ordinator with MSF.

Leche says she has seen all the good things MSF has done for Lesotho over the past four years.

She says when MSF arrived at Scott Hospital she had already been working at the clinic as a voluntary peer educator on HIV for two years.

She says even though she liked what she did before the arrival of MSF, it was a bit frustrating because people were not too keen to talk about HIV issues.

She says many people were dying of the disease in large numbers every week.

She says it was only after the arrival of MSF that people began to open up on the subject of HIV and Aids.

There was a surge as people became freer to talk about issues of discrimination and stigma.

Leche was among the 38 people that were trained by MSF as lay counsellors in the Scott Hospital catchment area.

MSF also trained about 20 health care practitioners to enhance the almost non-existent human resource base at the clinics.

After the training, Leche says they were equipped with enough skills they needed to bring health services to the people.

“We did campaigns where we asked people to come for HIV counselling and testing. Those who were infected were put on ART.

“They got better and so more people came forward,” she says.

She commends MSF for bringing hope to the people of Lesotho.

“MSF has brought back life and hope to Basotho,” Leche says.

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