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Facing an unseen enemy

by Lesotho Times
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THABA-TSEKA — His hair is fluffy and his lips are blistered. He leans heavily on his walking stick for support.
His clothes — a pair of yellow track-pants and a blue jersey which he covers with a tattered grey blanket — hang onto his skeletal frame.
The young man, Thabo Motlohi from Ha-Makunyapane Village in Thaba-Tseka, is barely 30 but his youthful demeanour has diminished.
His body is fast being ravaged by Aids, his mother ‘Mathabo says.
“He is very ill. He has had to give up work in KwaZulu-Natal, South Africa, because he could no longer work.
“His bosses sent him home to recover,” ‘Mathabo says of her eldest son.
Ever since Thabo came back sick from South Africa his mother has had sleepless nights.
She has to wash him, feed him and make sure he takes his medications.
Of these three chores ‘Mathabo’s says feeding him has been the biggest challenge.
They did not harvest enough last year and ‘Mathabo is already struggling to feed her family of 12.
The situation is now worse because Thabo required a special diet because he is on medication.
“He needs a special diet for him to recover but where am I to get it? We don’t have anything,” ‘Mathabo says
‘Mathabo laments that there are no clinics nearby to attend to the sick and that it poses a great challenge to her family and neighboring families with HIV positive members because they have to walk long distances to get them to clinics or hospitals.
“If it were not for the unconditional devotion of caregivers in the village, ‘Mathabo says, we would be wandering in the wilderness.
“Support groups play an important role because they help us carry the burden of caring for our HIV positive family members. It is not an easy task to carry on with life when death is imminent in the family,” she says as she tries to hold back her tears.
According to the 2004 Lesotho Demographic and Health Survey, Thaba-Tseka’s HIV prevalence rate, at 18.2 percent, is significantly lower than the national average of 23.5 percent.
Only Mokhotlong district has a lower prevalence rate at 17.7 percent.
HIV prevalence is highest in Leribe (29.7 percent) and Maseru (25.5 percent).
Yet even with that seemingly lower prevalence rate, Thaba-Tseka has been ravaged by the disease.
It has almost wiped the entire productive population of some villages, leaving the elderly to fend for young orphans.  
It has its fair share of the 180 000 HIV and Aids orphans in Lesotho.
Many families here are either headed by a child or a grandparent who in most cases is too old and too weak to work.
What makes the impact of HIV and Aids dire for districts like Thaba-Tseka is the lack of health facilities.
Most villages are kilometres away from Thaba-Tseka’s only health centre, Paray Hospital.
To get there they walk for hours and in some extreme cases they spend days on the road to the hospital.
The sick have to endure these long and torturous journeys to the hospital.
Poverty amplifies the impact of the disease on the district.
Thaba-Tseka is one of the poorest districts in the country.
For years their harvests have been bad, forcing families to scrounge for food or wait for aid which rarely comes.
Families therefore find it difficult to provide their sick with nutritious food, a very important requirement especially for those on treatment.
“He is already on ARVs but I cannot afford the special diet required by patients for full recovery. The government does not supply HIV patients with food packages on a regular basis. He has to make do with porridge and pap to keep his strength up,”  ‘Mathabo says.
Most of the families here are part of Lesotho’s more than 1.8 million people who depend on agriculture for survival.
Occasionally though, their sons and husbands working in the mines send them money.
Thaba-Tseka is one of the major suppliers of labour for South Africa’s illegal mines.
But villagers say this is a double-edged sword.
They say the miners do send the money but when they do come they bring with them the disease.
The accusation that they bring the disease has not been proven and probably won’t be but the villagers believe that it does have an impact.
Five houses from Motlohi’s home lives ‘Mapuseletso Sello, a caregiver in the village of no more than 120 residents.
She has been a caregiver for the past 20 years during which she has developed a deep understanding of HIV and Aids.
Sello, 54, says despite the extensive workshops she and fellow caregivers conduct for villagers regarding HIV and Aids, the rate of infection keeps escalating.
“The rate of infection keeps escalating despite the workshops we hold to teach people about Aids,” Sello says adding that women who already know they are HIV-positive still fall pregnant but fail to attend clinic check-ups.
“It is shocking to find young women who know their HIV status abandoning clinic sessions and opting to give birth at home for fear of being discovered by their friends and families.”
Sello blames migrant workers for amplifying the rate of infection in the village.
“When they get to South Africa, both men and women live on the fast lane and forget about the principle of using condoms when engaging in sex. They bring the disease back home with them and infect their partners,” she says.
“We have tried to urge them to use condoms. But our children refuse to use condoms. They say they prefer flesh-to-flesh because it gives them more satisfaction.”
She however believes that most of the people are fast-tracked to death because of poverty.
With the right diet, Sello says, most of those that are dying would have lived longer.
“Many people who could have recovered have died because of poverty,” Sello says.
“It is difficult to be on ARVs without a healthy diet. We are also faced with the challenge of contaminated water. People on ARVs need to drink lots of clean water with their medication but the water is just not clean enough and their health is badly affected.”
She echoes ‘Mathabo’s sentiments regarding the lack of health facilities in the village.
“We rely on the clinic in Malingoneng in the neighbouring Mokhotlong district for health services or the Paray Mission Hospital in town,” she says.
Paray is about 30km from Ha-Makunyapane village.
“Sometimes patients die on the way because we don’t have transport. Some people have died at the Senqu River banks because the river was flooded, stopping people and cars from crossing to the other side,” Sello says.
‘Maseabata Sontaha, a midwife at the Paray Mission Hospital, says the HIV prevalence rate in Thaba-Tseka “keeps rising especially among pregnant women”.
“Although women are gradually learning about  Prevention of Mother-to-Child Transmission, some still continue to give birth at home and that puts their babies at risk,” Sontaha says.
“And as a result of poverty, HIV-positive women end up breast-feeding their babies thus risking their children even more.”
An assistant administrator at the hospital, Imelda Keletsane, says the institution is battling to cope with the increasing number of people with Aids-related illnesses. 
“We are not coping, especially since standardised fees were introduced. We are the only hospital in Thaba-Tseka with a bed capacity but we lack basic equipment and our beds are old and shaky,” Keletsane says.
The hospital does not have basic medicine to meet the demand that has surged due to HIV, she says.
She alleges that the situation is particularly worse this year because the government has reduced the budget to the hospital.
“The cut in budget has frustrated the hospital immensely and led to workers not being paid. It has actually affected all church hospitals of which Paray is one. If the budget issue is not sorted out immediately we might be forced to close,” she adds.
“Even the ambulances we use are a donation. If this hospital were to close down, Thaba-Tseka is in big trouble. I urge the government to make a plan fast because at the rate we are going it won’t be long before we shut down.”

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