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Health delivery system in intensive care unit

by Lesotho Times
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MASERU — I am not a public health expert and I do not have a thorough knowledge of health management systems.

But as a layman I can say with conviction that Lesotho’s health delivery system is in the intensive care unit.

The country’s health care system has been in that state for years now.

In my humble opinion something needs to be done to prevent the situation from reaching crisis levels.

Lesotho has experienced massive brain drain in the health sector for years.

Hundreds of nurses and doctors emigrate from the country in search of better paying jobs elsewhere every year.

We have lost doctors and nurses mainly to South Africa chiefly because of the low salaries they are paid here.

The shortage of skilled human resources has led to poor quality of services in the health sector.

According to the World Health Organisation (WHO), in 2006 in the United States there were 1 147 health care providers for every 100 000 people.

In Lesotho, where life expectancy is at 35 years there were only 68 health care providers for every 100 000 Basotho.

The shortage of critical staff is hitting hard the country’s efforts to contain the Aids crisis.

Many HIV positive individuals in Lesotho die prematurely.

There are just not enough nurses and trained individuals to administer anti-retroviral drugs to patients, according to French aid group, Medicins Sans Frontieres.

There are an estimated 89 doctors servicing a population of 1.8 million people in Lesotho.

This generally means we cannot solely rely on medical doctors to provide ARVs as is the policy in countries such as South Africa.

What this means is that Aids treatment in Lesotho is nurse-driven.

But here lies the problem.

The majority of our nurses in Lesotho are disgruntled as a result of poor pay and bad working conditions.

The public sector continues to lose trained nurses to the private sector.

Thousands of nurses have emigrated to South Africa and the United Kingdom for better pay.

Media reports say in the Scott Health Service Area, we lost about 25 nurses last year alone.

At least 54 percent of professional nursing posts are said to be vacant in most primary health clinics.

A recent study said one nurse is looking after at least 100 patients in a single ward.

Nurse assistants, who are trained for two years to perform some duties normally reserved for doctors, are also over stretched.

Under normal circumstances, the nurse assistants are expected to see at least 24 patients a day.

The reality on the ground means that they are now forced to see up to 100 patients a day.

Doctors who are in private practice are said to be inaccessible to the most vulnerable sectors of society.

The result is that medical care that is being provided to Basotho has become seriously compromised.

We need to act soon as a country to reverse the problems in the health sector.

The government must drastically improve the salaries and working conditions for health personnel to stem the brain drain.

The Aids crisis is a national emergency.

We need to act soon to mitigate its impact on communities.

We need to invest more resources for the training of nurses and other health care staff.

We need to come up with creative mechanisms to retain and motivate nurses and doctors in our public health institutions.

The scores of Basotho granted scholarships to study medicine at foreign universities must be encouraged to come back home.

We need our sons and daughters to return.

We cannot afford to lose our health professionals to other neighbouring countries because we have failed to pay them well.

This is a national crisis.

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Lesotho’s widely read newspaper, published every Thursday and distributed throughout the country and in some parts of South Africa. 

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