LPPA Programmes Director ‘Makatleho Mphana
THE Lesotho Planned Parenthood Association (LPPA) is one of the oldest and pioneering non-profit organisations providing a wide array of sexual and reproductive health services including family planning, management of sexually-transmitted infections (STIs), cancer screening as well as provision of normal and emergency contraceptives.
With most of its services catering for issues affecting women, LPPA Programmes Director ‘Makatleho Mphana gives insight on some of the challenges facing Basotho women in an interview with Lesotho Times (LT) reporter Pascalinah Kabi.
LT: As one of the pioneering organisations in advancing women’s issues in the health sector, what activities have you lined-up to commemorate African Women’s Month?
Mphana: It is the norm for LPPA to commemorate African Women’s Month every August by offering cervical and breast cancer screenings free of charge at our centres, and this is year is no different.
You will appreciate that cervical and breast cancers are some of the dangerous diseases claiming the lives of Basotho women. We are doing our part by giving these services to women as part of African Women’s Month celebrations.
Added to that, this year we are going to Tša Le Moleka Community Council in Butha-Buthe. Our discussions will be highlighting challenges women in the area face, especially issues of gender-based violence (GBV).
The event will see the area chiefs making certain commitments as we would want to see them actively advocating for women, especially in helping them to freely access family planning services.
LPPA believes with the support of area chiefs as village gatekeepers, it would be easy for families to support women and young girls when seeking and accessing family planning services.
We also appreciate that as gatekeepers, chiefs are best placed to know the problems women face every day and are also in a good position to offer possible solutions to the same problems, hence we are seeking their buy-in into this programme.
LT: As we celebrate African Women’s Month, what are some of the challenges Basotho women face that prevent them from reaching their potential economically and politically?
Mphana: We live in a country where there are no clinics in hard-to-reach areas, and many women end up walking long distances from home to the nearest health centre.
In some instances, you will find the same hard-to-reach clinics lacking basic medical equipment, resulting in women and girls losing their lives.
The shortage of medical equipment also frustrates some clinical personnel to the extent of having negative attitudes towards patients.
We also have high maternal and child mortalities in this country, but the most disturbing reality is the high number of women dying while attempting to abort.
This is despite the LPPA and Ministry of Health’s efforts to provide family planning services to women and girls. In a lot of cases, women opt for backstreet abortions which are very dangerous.
Women are also victims of GBV. In cases where they would have taken a decision not to have more children, women are sometimes pressured into conceiving by their husbands and in-laws demanding a male child. At times, they give in to this pressure and ultimately lose their lives or that of the child while giving birth.
Women are also not safe, both in the streets and in their homes, because they can become victims of rape by strangers and people they know. The worst case scenario is being raped by a husband.
As for girls, they face the risk of either being raped, abducted or being forced to drop out of school for a future with a man they might never love.
LT: What’s the impact of poverty on women and girl children, given that Lesotho is a least developed country?
Mphana: Poverty affects women and girls the most. And in most cases they end up engaging in activities such as selling their bodies to rich men so they can take care of their families. Unfortunately, in most cases, the sex is unprotected and women end up contracting STIs, HIV and unplanned pregnancies. On the issue of HIV, it is important for us to understand that while both men and women are victims of the pandemic, women are the most affected because they endure sexual abuse that may result in them being infected. We have situations where women are accused of infecting their partners, leading to divorce and again, women are forced to look after children on their own. Women also bear the brunt of these divorces and in-laws see them as enemies. We also have issues of girl children having no choice but to nurse their bed-ridden parents with full blown AIDS. When parents die, these girl-children are forced to parent their siblings and drop-out of school to look for employment. In most cases, the next available job is sex work – becoming victims of crime, HIV and teenage pregnancy.
LT: What has LPPA done to assist women in addressing these problems?
Mphana: We have provided family planning services to women, their husbands, mothers-in-law, chiefs and churches. When we first came into operation between 1967-1970, we witnessed a situation where the church, mothers-in-law, chiefs and men were all scared because they thought we were going to strip them of their powers to decide over when, why and how many children a woman should have. After winning this first round, we were then faced with a situation where 80 percent of women did not have access to family planning services despite their knowledge and understanding. We then moved to ensuring that women have access to family planning services.
Working together with the Ministry of Health, we have established clinics and health facilities across the country and also conduct community-based distribution campaigns where we visit hard-to-reach places at least three times a month. It is absolutely unacceptable that women and children are still dying during birth or pregnancy, and this is why we are doing everything in our powers to ensure safe delivery. LPPA nurses are well trained and their attitudes towards patients always in check as we offer pre- and post-antenatal care services in Maseru and Mafeteng.
Despite the family planning services, we also distribute condoms, offer test and treat services as well as Voluntary Medical Male Circumcision. We also have youth-oriented services at Thakaneng Youth Centre. While our youth seek our services in good numbers, it is disturbing that in most cases they seek STIs and abortion services.
Because we are well aware that sex workers also require our services, we are also offering them services at favourable times because health services are offered during the day when sex workers are resting.
In all our centres, we have introduced a GBV screening tool which facilitates treatment immediately if required while some are referred to hospitals and churches. As an organisation, we also have a policy on sexual harassment to protect staff members, clients and volunteers against GBV.
LT: What is LPPA’s advice to women in engaging their children in discussions about sexuality?
Mphana: The Ministry of Health used to have a Parent Education Programme empowering parents with skills to discuss sexuality issues with their children. This was introduced after realising that despite the cultural taboos, many mothers are now working and do not have time to discuss sexuality issues with their children. The world is now shifting to Comprehensive Sexuality Education (CSE). CSE will help us deal with challenges facing teenagers. Parents need to understand CSE, we are not saying children must have a right to have sex. We are teaching them about physical changes in their bodies and that they must be prepared. This will help them not to jump into having sex when they experience these changes. Chiefs and politicians must also understand and appreciate that CSE is the answer to our problems. We believe that if well implemented, CSE will help our children lead responsible lives and we can achieve the 90-90-90 targets by 2030, ushering in a HIV-free generation.
LT: What’s your advice to women as they celebrate African Women’s Month?
Mphana: Have self-esteem and believe that you are all beautiful in your own right. God did not make a mistake when He created you. You do not need to prove to the world that you are tall when you are not, accept who you are and never attempt to change yourself for others, because the world needs to accept you just the way you are. However, you need to show the world that you can lead a good life despite your looks, figure or economic state of affairs.
