A guest post from one of TTL's current volunteers, Kat Stott...
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In a previous post, Julie
described the immense challenges faced by the people of Lesotho in terms of the
scale of this devastating HIV epidemic, compounded by alarmingly low numbers of
healthcare professionals per population and often seemingly impossible access
to care.
I thought I'd add a bit of
detail about the reality of the conditions at Mokhotlong District Hospital for
patients and staff, and the commendable way in which that reality is addressed
in order to provide the best possible care for residents of the district,
including the children at TTL.
I'm a doctor from the UK and
am really grateful to TTL for the opportunity to volunteer with them for a
while here in Mokhotlong. I've been dividing my time between TTL and the
hospital, both of which experiences have been eye-opening and educational.
The hospital is staffed by
five doctors from the Democratic Republic of Congo. It provides medical care
for anyone who makes it to the front door - be their needs medical, surgical,
obstetric, pediatric, psychological or traumatic. The outpatient department is
a small building, housing four consultation rooms and a waiting room full of
patients that overflow onto the driveway from around 8am each day, until everyone
has been seen. The inpatient wards are basic but provide safety and relative
comfort during patients' stay. There are two operating rooms, and one room that
constitutes the emergency room - this is sufficient because most emergency
cases are unable to make it to the hospital to seek urgent care. The doctors
work a rotational on-call system, which entails taking turns to be the
emergency doctor for all hospital
departments including the labour ward, operating rooms and casualty, for seven
days in a row, 24 hours per day. This makes my work schedule from the UK seem
like a breeze – I work a maximum of four nights on-call in a row, sleep during
the day after each shift, and am only on-call for one department or specialty
at any one time.
Even basic resources at the hospital are scarce, with no hot running water,
overused bedclothes often with large holes in them, and staff shortages across
all professions. This week has been a particularly difficult one, with the xray
machine- the only imaging modality in the hospital- out of order, and two very
commonly required medications now out of stock in the entire country.
The nature of illness encountered here is very different to that which I
have seen in the UK, mainly in terms of the burden of HIV and TB, and also the
late stage at which patients present to services. This is due to a number of
factors, some of which are mentioned above; in addition there is generally a
relatively limited level of health awareness, reluctance to seek care due to
financial implications in terms of direct cost of services and opportunity
costs, and often cultural barriers to health-seeking behavior.
Despite these challenges, the hospital staff work without complaint to
provide the best service they can for the many patients in need. Emphasis is placed not only on the management
of illness in its acute phase, but also on health education and follow-up to ensure
clinical improvement. For the children here at TTL, the hospital offers a
safety net and a vital role in their treatment and development. I hope the
admirable attitude of the doctors, nurses and other staff there is maintained
and that the relationship between the hospital and TTL continues to strengthen,
to promote the best possible care for Mokhotlong’s vulnerable children for
years to come.
-Kat
-Kat
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| The Mokhotlong Government Hospital |
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| Construction at the hospital in the TB ward |
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| One of TTL's babies, Tsepang, admitted at hospital for a high fever |
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| Tsepang back in the safe-home and on the road to recovery |
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