Day 105, Wednesday 13th November, Maseru, Lesotho

At the Lesotho Wellness Centre, we started with a meeting at 10am to discuss the day’s plans. Madame Doreen had been instrumental in arranging my visit to Maseru:
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The president was out of town and so she and the Secretary General worked hard over the space of an hour to arrange meetings and visits to fill my day and fulfil my objectives.
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Should we do a day trip tomorrow to some very remote, mountainous areas?

We jumped in the car and headed to the Mission Aviation Fellowship, based at the military airport, to seek some advice on airstrips.
Qacha’s Nek and Nkau it would be, with a very early departure time of 6am!

From there, it was North to Berea District Hospital:
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Sister Leleka gratefully received 2 blood pressure monitors and a midwifery pack:
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and then showed us to the maternity block where we met the on-duty Basotho midwives and the Congolese doctor:
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The maternity team’s challenges at present were numerous. Staffing was a huge problem, with 3 midwives covering the unit from 7am until 5pm and then only one until the night shift started at 8pm. And if there was an emergency? No extra pair of hands.

There had been no oxytocin medication for the past month meaning patients requiring augmentation in labour needed to be referred to other hospitals with long journey times and also that ergometrine was being used for the third stage (delivery of the placenta) – until that ran out too. There were no abdominal swabs meaning that no caesarean sections could be performed in the otherwise well-equipped theatre:
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Patients requiring caesareans had to be transferred elsewhere too.

I found the neonatal intensive care unit; here the equipment was present but the functionality not. The staff I met didn’t know how to use the incubators and even if they had done then they would have been unable to staff the area:
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What a shame! Premature babies and babies with difficulties at birth had little chance of survival here.

From Berea we drove the short distance to the General Practice of Dr Molise, the President of the Lesotho Medical Association. His clinic was in the high street of Berea, next door to the huge Chinese supermarket that had recently sprung up and where we grabbed a drink on the way. Dr Molise kindly spared some time between patients to see us. He was Lesotho born and South African trained, and one of only a handful of doctors of Basotho Nationality working in the country. Many of his colleagues were from Zimbabwe and the DRC. I was interested and astounded to hear that there were not many speciality doctors in the country, with no Psychiatrist and no Obstetrician/Gynaecologist for a population of 2 million people. Local doctors do undergo speciality training but don’t often come home on completion, preferring to stay in their country of training. And of 280 registered doctors, only 40 belonged to the medical association. Not such a cohesive group, but nevertheless the association was working with the nurses association to increase multidisciplinary, collaborative working. Medical students were also now being trained in Lesotho, with the help of the University of Harare in Zimbabwe for clinical placements in the final years.

And so we hit the road again:
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We were headed to the Roma School of Nursing and Midwifery to visit the student midwives and tutors there! Our journey was about 90 minutes back South towards Maseru and then East through the beautiful sweeping shallow valleys of the Basotho lowlands, and where most of the country’s population live.

We sped past the President of the Nurses Association who was heading back into town after a visit to Swaziland; luckily we spotted each other, reversed, and had a chat and photo session by the edge of the road:
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The midwifery school gave us an energising welcome, despite the fact we were running late and they had been waiting a good couple of hours to receive us:
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I told them all about Flight For Every Mother and we discussed, in particular, the urban-rural divide of healthcare workers in Lesotho, unskilled home deliveries and the clinical aspect of the second stage (pushing phase) of labour. There was definitely some motivation going on in that session!

The Secretary General and I stopped for chicken and beer before heading back to (a different) Motel where Ross was waiting and where we slept early in anticipation of our very early flight in the morning!

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