Tšepong brings critical surgical procedure to Lesotho



…saves government thousands of maloti in the process

Pascalinah Kabi

A total of 44 Basotho patients in dire need of hip and knee replacements have benefitted from Queen ‘Mamohato Memorial Hospital (QMMH)’s initiative to bring orthopaedic surgeons into the country.

Tšepong, as QMMH is popularly known, decided on the initiative after realising Basotho continued to suffer because they could not afford the operations done in South Africa—the nearest country where the service was available—due to financial constraints.

The surgeons had their first operation in February 2015 at Tšepong and have since successfully worked on 44 patients.

Bringing the specialists into the country is part of the hospital’s efforts to reduce the number of Basotho patients it refers to South Africa. It costs government more than M150 000 for each patient who is referred to South African hospitals for the replacements.

QMMH public relations officer, Dr Limpho Seeiso told the Lesotho Times the initiative further helps develop skills among Basotho.

Dr Seeiso also said patients are required to prove they are fit for the operation which takes up to two hours to perform. The surgery, she added, takes place in two theatres supported by two surgical teams each.

“The teams of six comprise a visiting orthopaedic surgeon, senior surgeon and an assisting surgeon from QMMH, an anaesthesiologist, a scrub nurse and a floor nurse. During the five sessions in the first year, a total of 46 operations were performed on 44 patients,” Dr Seeiso said.

She further noted a patient may need more than one joint replacement depending on individual clinical conditions.

“Patients in need of these interventions have had progressively increasing joint pain, reduced ability to walk or perform daily activities.  The outcome of the surgical intervention brings almost immediate relief from pain and recovery of mobility.

“There is a wide range of indications for hip and knee replacement surgery. These are principally grouped into conditions such as osteoarthritis, post-trauma and those of a congenital in nature,” she said.

Dr Seeiso added the average age of patients undergoing hip replacement is 65 years, but added there is no age restriction regarding the operation.

She however, said a number of factors are taken into consideration when selecting patients for the procedures.

“Younger candidates should have achieved total bone maturity or reached the end of bone growth while the elder candidates should be healthy enough to undergo surgery with no signs of advanced osteoporosis or mineral loss to their bones,” Dr Seeiso said.

“Patients should also be of normal weight to optimise the outcome of the surgery and minimise the risk of post-operative complications.”

On the issue of saving costs by bringing services closer to home, Dr Seeiso said: “Patients operated on at QMMH pay highly subsidized fees resulting in minimal out-of-pocket costs. This is just one of the examples where the Lesotho healthcare system offers sophisticated treatment to patients that most citizens would otherwise not be able to afford.

“The costs of waiting for the surgery and other costs associated with hospital admissions in South Africa are also dramatically reduced when the operations are performed locally.”

A patient’s social support system is also enhanced as family and friends can easily visit their patients at QMMH, a luxury most families do not afford when their loved ones are hospitalised in South Africa, Dr Seeiso said.

“Performing the treatment locally is not only beneficial to the patients but also to the local staff as well. Surgeons and the support teams at QMMH have the benefit of learning and sharing skills with the visiting surgeons.

“At first, there were very few patients on the waiting list but with improved diagnostic skill and the servive spread by word of mouth, demand for the interventions is increasing,” she said.

Dr Seeiso however said challenges associated with offering this service ranged from logistics such as flight delays due to weather conditions and customs clearing.

“In its fifth year of operation, Queen ‘Mamohato Memorial Hospital remains committed to offering the best treatment solutions for patients,” she added.

Queen “Mamohato Memorial Hospital opened its doors to patients on 1 October 2011, replacing Queen Elizabeth II Hospital as the country’s referral hospital.  The 425 bed-hospital also functions as the nation’s major clinical teaching site for healthcare professionals. The state-of-the-art hospital offers a wide range of services and prides itself in being the leader in professional and skills development of healthcare personnel in the country.

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