‘I’m so proud Le­sotho now has a med­i­cal school’

Lesotho Times - - Big Interview -

Prime Min­is­ter Thomas Tha­bane of­fi­cially opened Queen El­iz­a­beth II Dis­trict Hos­pi­tal on Fri­day last week fol­low­ing the fa­cil­ity’s clo­sure in Septem­ber 2011.

In his ad­dress, Dr Tha­bane said Le­sotho needs all the hos­pi­tals it can have, and con­demned Queen II’S clo­sure by the pre­vi­ous gov­ern­ment led by Dr Pakalitha Mo­sisili.

Ex­plain­ing why the coun­try’s then na­tional re­fer­ral hos­pi­tal was be­ing closed after 100 years of ser­vice, the then gov­ern­ment cited its ex­tremely di­lap­i­dated state.

Mean­while, Health Min­is­ter, Dr Pinkie Manamolela also spoke at Fri­day’s open­ing cer­e­mony and re­vealed Le­sotho is now train­ing its own doc­tors. In this wide-rang­ing in­ter­view with Le­sotho Times (LT) re­porter, Lekhetho Nt­sukun­yane, min­is­ter manamolela gives more de­tails on the med­i­cal school and also what the fu­ture holds for the coun­try’s health­care sys­tem.

LT: IN YOUR AD­DRESS AT THE OF­FI­CIAL OPEN­ING OF QUEEN II DIS­TRICT HOS­PI­TAL ON FRI­DAY LAST WEEK, YOU GAVE AN OVER­VIEW OF THE COUN­TRY’S HEALTH­CARE SYS­TEM AND ALSO SAID LE­SOTHO NOW HAS A MED­I­CAL SCHOOL. COULD YOU PLEASE ELAB­O­RATE ON HOW THIS SCHOOL CAME ABOUT?

DR MANAMOLELA: Although it has not yet been of­fi­cially launched, the Le­sotho Med­i­cal School, which is the first of its kind in this coun­try, started op­er­a­tions on 1 Septem­ber 2014 with an enrolment of 40 stu­dents. Per­haps I should first start by in­di­cat­ing that the es­tab­lish­ment of this mile­stone project comes through an ar­range­ment be­tween Le­sotho and Zim­babwe.

In 2011, there was an agree­ment signed be­tween th­ese two coun­tries and un­der the ar­range­ment, Ba­sotho were to take up med­i­cal stud­ies at the Univer­sity of Zim­babwe (UZ).

The first batch of 40 Ba­sotho stu­dents was en­rolled in 2011, with the sec­ond, still com­pris­ing 40 stu­dents, be­ing en­rolled in 2012.

In 2013, there was a third batch although the num­ber had now been de­creased to 25 stu­dents. Of course, there were is­sues around this, with the UZ cit­ing lack of space and fa­cil­i­ties to en­roll the re­quired num­bers. I should ex­plain that it was fur­ther agreed that while Le­sotho con­tin­ued send­ing stu­dents to Zim­babwe, the coun­try should also start prepa­ra­tions to es­tab­lish its own med­i­cal school.

We are ex­pect­ing the first batch which went to the UZ in 2011, to come back after four years and do prac­ti­cals here un­der the su­per­vi­sion of the now-es­tab­lished Le­sotho Med­i­cal School.

Queen ’Mamo­hato Memo­rial Hos­pi­tal (which re­placed Queen II as the coun­try’s main re­fer­ral hos­pi­tal) will also as­sist be­cause of its good fa­cil­i­ties and ex­pe­ri­enced doc­tors. When the cur­rent coali­tion gov­ern­ment took over in 2012, we in­her­ited this good ini­tia­tive from the pre­vi­ous gov­ern­ment.

Be­ing the Min­is­ter of Health, I in­sisted that be­cause this was a good ar­range­ment highly ben­e­fi­cial to Ba­sotho, we should embrace it.

I al­ways main­tained that we should con­tinue with the good pro­grammes ini­ti­ated by the pre­vi­ous gov­ern­ment, while we let go of those that do not ben­e­fit our coun­try. LT: BUT WHERE IS THIS MED­I­CAL SCHOOL LO­CATED?

DR MANAMOLELA: The Le­sotho Med­i­cal School is cur­rently op­er­at­ing at the NHTC (Na­tional Health Train­ing Cen­tre) in Maseru. We chose NHTC over NUL (Na­tional Univer­sity of Le­sotho) for sev­eral rea­sons, but mainly sta­bil­ity and con­ve­nience.

And like I said, the first batch of 40 stu­dents was en­rolled this year. This, I should em­pha­sise, is a dif­fer­ent batch al­to­gether from the three groups we sent to Zim­babwe.

How­ever, the first group we sent to Zim­babwe in 2011 will un­der­take part of its stud­ies at the Le­sotho Med­i­cal School for six months, be­gin­ning this year. After the six months, the group will go back to Harare to com­plete their fifth and sixth aca­demic years be­fore they grad­u­ate. Peo­ple should trust this ar­range­ment and support the pro­gramme; it has proved to be very fruit­ful in other de­vel­op­ing and even de­vel­oped coun­tries.

LT: WHO ARE THE LEC­TUR­ERS AT THE MED­I­CAL SCHOOL, AND DO YOU HAVE AD­E­QUATE RE­SOURCES FOR THIS VERY DE­MAND­ING PRO­GRAMME?

DR MANAMOLELA: The is­sue of lec­tur­ers is a chal­lenge that is still be­ing ad­dressed. We have been mo­bil­is­ing lec­tur­ers from other coun­tries, with more em­pha­sis on South Africa as our im­me­di­ate neigh­bour.

But you see, the prob­lem is we have many Ba­sotho doc­tors and in­tel­lec­tu­als work­ing abroad, who left this coun­try be­cause of lack of support from gov­ern­ment.

There was lack of po­lit­i­cal will in the pre­vi­ous gov­ern­ments to re­tain Ba­sotho doc­tors and in­tel­lec­tu­als. When I came into of­fice on 27 June 2012, I com­mit­ted my­self to bring­ing back all Ba­sotho doc­tors from all over the world.

Be­lieve me when I say some­times I spend sleep­less nights think­ing about how best I can con­vince our doc­tors to come back. I make sure that on each and ev­ery trip I take out of the coun­try, I make it a point to lure Ba­sotho doc­tors and nurses, back to Le­sotho. But what do I prom­ise them? That is the mil­lion­dol­lar ques­tion and a big chal­lenge for me.

But through the grace of God, I have man­aged to bring back about 12 of our doc­tors.

It’s sur­pris­ing be­cause I didn’t prom­ise them bet­ter wages and didn’t talk about ben­e­fits, which of course, are bet­ter than ours out there. I just con­vinced them of how im­por­tant it is for them to come back and prac­tice in their own coun­try, some­thing no­body did in the past gov­ern­ment be­cause there was no po­lit­i­cal will to do so.

All they needed was for the gov­ern­ment to show a lit­tle support. Now, com­ing to your ques­tion, the Le­sotho Med­i­cal School cur­rently has a few lec­tur­ers who are work­ing part­time. They are med­i­cal doc­tors run­ning their own busi­nesses, while oth­ers are em­ployed by gov­ern­ment. How­ever, the hu­man re­source struc­ture, like I said, is not yet com­plete, although we have al­ready filled po­si­tions of Dean of Stu­dents and his deputy, which are cru­cial in any in­sti­tu­tion of higher learn­ing.

We are get­ting there be­cause re­cently, I was in­formed that there were new ap­pli­ca­tions from some Ba­sotho doc­tors who are prac­tic­ing in South Africa, who would want to come back.

What re­mains another mam­moth chal­lenge is the is­sue of ac­com­mo­da­tion for the lec­tur­ers. You see, be­cause they come from afar, we need to make good prepa­ra­tions for their stay as they come on a part-time ba­sis. We also need more build­ings; a li­brary to be ex­act. But all those is­sues are be­ing ad­dressed.

LT: WHAT CAN WE EX­PECT OUT OF THIS PRO­GRAMME? I MEAN, ARE WE GO­ING TO HAVE SPE­CIAL­IST DOC­TORS OUT OF THIS INI­TIA­TIVE?

DR MANAMOLELA: We are not go­ing to have spe­cial­ists yet un­til hope­fully, we re­alise our dream in 2016. You see, we have a vi­sion that by 2016, we should start en­rolling Ba­sotho for a post-grad­u­ate med­i­cal de­gree where will now have spe­cial­ist doc­tors.

And while we are do­ing this, we are also mak­ing sure we have a good re­ten­tion strat­egy be­cause if we don’t, there won’t be any rea­son why we should be con­tin­u­ing with this highly ex­pen­sive pro­gramme.

This is a very se­ri­ous pro­gramme not only sup­ported by the gov­ern­ment of Le­sotho but also many other for­eign in­sti­tu­tions and non­govern­men­tal or­gan­i­sa­tions.

And to men­tion but a few, we have the UZ and Colom­bia Univer­sity sup­port­ing us in terms of pro­vid­ing the cur­ricu­lum. We have or­gan­i­sa­tions such as WHO (World Health Or­gan­i­sa­tion), Ro­tary Club and ICAP (In­ter­na­tional Cen­tre for AIDS Care and Treat­ment Pro­grammes) also sup­port­ing us.

You see, the is­sue of es­tab­lish­ing a med­i­cal school in Le­sotho, although only be­ing im­ple­mented this year, comes a long way.

Ac­cord­ing to the records, it was ini­ti­ated in 1974, but failed to ma­te­ri­alise un­til now. Some­where in 1978, the records show it was re­sus­ci­tated but still failed to ma­te­ri­alise.

I was re­cently hav­ing a con­ver­sa­tion with the Prime Min­is­ter (Thomas Tha­bane), who spoke of how, dur­ing the ear­li­est gov­ern­ments, they had fought for the es­tab­lish­ment of the school but in vain. I should con­sider my­self lucky that Le­sotho has re­alised this mile­stone pro­gramme dur­ing my ten­ure. I also worked tire­lessly to make sure the school is es­tab­lished de­spite the slim chances that this was fea­si­ble, which is why I am so proud that we now have our own med­i­cal school.

LT: WHAT ARE THE RE­QUIRE­MENTS FOR AD­MIS­SION INTO THE PRO­GRAMME?

DR MANAMOLELA: I am not quite part of the ad­mis­sions panel, but I no­ticed most of the stu­dents hold BSC (Bach­e­lor of Sci­ence) de­grees while oth­ers have Nurs­ing qual­i­fi­ca­tions and B. Tech (Bach­e­lor of Tech­nol­ogy) de­grees. I should also men­tion that the pro­gramme is not only pi­loted by the Min­istry of Health on be­half of the gov­ern­ment of Le­sotho, but also the Min­istry of Ed­u­ca­tion and Train­ing, and the Min­istry of De­vel­op­ment Plan­ning.

LT: WITH THE RE­CENT RE­OPEN­ING OF QUEEN EL­IZ­A­BETH II DIS­TRICT HOS­PI­TAL, WHAT CAN WE EX­PECT IN RELATION TO THE PRO­GRAMME?

DR MANAMOLELA: The re­open­ing of Queen II sim­ply means our grad­u­ates are go­ing to be de­ployed at the hos­pi­tal and else­where in the re­mote ar­eas of our coun­try. We still have ar­eas where it re­mains dif­fi­cult for pa­tients to ac­cess a doc­tor — the clos­est treat­ment they can get is through a nurse.

In other coun­tries, the ra­tio is one doc­tor to 500 pa­tients, while in Le­sotho, it is one doc­tor serv­ing 20 000 pa­tients. The worst thing is that almost all the med­i­cal doc­tors serv­ing in Le­sotho are for­eign­ers. Ac­tu­ally, we have eight Ba­sotho doc­tors in Maseru, two in Berea, two in Leribe, two in Mafeteng, two in Mo­hale’s Hoek, one in Butha-buthe, one in Mokhot­long, one in Qacha’s Nek and one in Quthing.

All in all, we only have about 20 Ba­sotho doc­tors serv­ing in pub­lic health cen­ters through­out the coun­try. The rest, who con­sti­tute the larger per­cent­age, are for­eign­ers. You should re­mem­ber that out of the 20 Ba­sotho doc­tors that we have, I have per­son­ally brought 12 back into the coun­try since 2012, which means the sit­u­a­tion was worse be­fore then.

I should also talk about the Le­sotho Bos­ton Health Al­liance (LEBOHA), which is a post-grad­u­ate med­i­cal study pro­gramme in­tro­duced in Le­sotho by the Bos­ton Med­i­cal School in 2003. Through this pro­gramme, Ba­sotho med­i­cal doc­tors were sup­posed to take part-time stud­ies to be­come spe­cial­ists. Three med­i­cal in­sti­tu­tions should have been es­tab­lished in the South, North and Cen­tral re­gions of the coun­try, but the pre­vi­ous gov­ern­ment was not keen to im­ple­ment that good pro­gramme.

As we speak, only two doc­tors were pro­duced through that pro­gramme through the only ex­ist­ing in­sti­tu­tion in the North­ern re­gion, at Ma­luti Hos­pi­tal. I re­cently sought cap­i­tal for new ap­pli­cants from Global Fund to as­sist eight lo­cal doc­tors to un­der­take the pro­gramme as I am try­ing to re­sus­ci­tate it.

Health Min­is­ter Pinkie Manamolela

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