Lesotho

Christina and Sophie report from Maseru

Departing thoughts

August 7th, 2007 by Christina

It has been difficult accepting the fact that my time is over here because there are few times when I have left a foreign place feeling at home. It is true that I have missed my family and close friends, but I am leaving Lesotho feeling as if I have become acquainted with an incredible family at Baylor. The physicians, the staff, the patients, and the Basotho people I have come in contact with have been some of the most amazing individuals I have known, and I will never forget their hospitality and their welcoming spirits. I am forever grateful to the Beyond Traditional Borders program, BIPAI, our program directors and mentors who have created such an incredible opportunity and have allowed me to be part of such a wonderful mission.

I have been told by many who have worked in developing settings or in some sort of volunteer work that those who attempt to teach others or contribute to a problem in some way end up leaving having learned much more than they could have ever taught others or end up gaining much more than they could have been left behind as some sort of contribution. I have found this to be true and I have learned so much about the people, culture, health, education, challenges, and opportunities of Lesotho in such a short period of time. I have felt such a unique combination of emotions all packed into a series of encounters and experiences that seem to blend into one another like one of the beautiful tapestries woven in rural villages in Lesotho. It is as if all of life’s emotions can be packed into a single day’s work– happiness, frustration, empathy, anger, desperation, fulfillment… I could go on and on.

I am leaving Lesotho with a refreshed and renewed perspective on global health and the complexities that exist when working on problems of such magnitude. I will miss the daily challenge of working on any aspect of HIV/AIDS and the tough questions I asked that ended up consuming my thoughts and conversations late into the nights. I have seen for myself the tragic truth that many speak of… of the needless deaths that occur daily and the completely preventable illnesses that young and innocent children die from. I have seen the “accidents of latitude” that Bono and Sachs speak of when they talk about the unthinkable disparities that exist among those who have been born in the developed world and those who have been born in areas such as Sub-Saharan Africa. I have seen the struggling face of a baby who died of a simple case of diarrheal infection, and the face of her mother who thought her child was on her way to improvement. I have seen the determined faces of a medical team that went to great lengths to take a child to a South African hospital just to put a baby on a life-saving ventilator, a simple tool they lacked in Lesotho. I have felt the pang of injustice, not injustice I have personally faced, but injustice that I have felt through my close encounters with children, mothers, grandmothers, health professionals and people from all over the world working in Lesotho. I have seen things and felt emotions that have left a lasting impression, and I only hope that I have been able to contribute a fraction of the impact I have felt myself and that I have been able to leave just one child with a fraction of the knowledge I have collected during my time here.

In Greece…

August 7th, 2007 by Christina

I just uploaded the last entry on Lesotho from Crete, Greece. I have met my parents and brothers here, and we are visiting my grandparents in the town my mother was born in. It is absolutely beautiful here in such a different way than what I experienced in southern Africa, and I am glad to be with my family and sharing some of my experiences from the past two months. I have experienced such a dramatic change from the chilly mornings and frigid nights in Lesotho to the warm and sunny summer on the beach in Crete, and I am so thankful for the opportunity to spend the last weeks of summer with my family.

Fueling the Anti-Asian Outlook

August 7th, 2007 by Sophie

In Lesotho, there exists a strong anti-Chinese sentiment.  This is due mainly to the poor working conditions of the workers employed at the Chinese-run factories.  At first I thought the anti-asian sentiment was just due to racism and misunderstanding.  However, the more I learned about the unjust business practices of the Chinese, the more I commiserated with the Basotho.  From my understanding there are extremely poor working conditions in the factories.  For example, there are Basotho who are suffering from severe respiratory problems and even dying because the factory owners are not providing protective masks in work areas where there large amounts of sediment particles in the air.  I have heard stories of people regularly coughing up blood from working under these conditions.  Moreover, at one point the Chinese had built a factory, but instead of employing the factory with Basotho who desperately need jobs (Lesotho’s unemployment rate is over 50%), they employed Chinese prisoners.  Then, after the work was finished, the businessmen just left the prisoners in Lesotho.  I found it surprising that the Lesotho government doesn’t enforce regulations on working conditions like we do in the U.S.  From my understanding, there is no minimum wage, no cap on the amount of hours worked, no safety regulations for the workers, no vacations, etc.  I remember talking to a Basotho college student who had heard that in China, people never sleep, but they always work…  Maybe the Lesotho government is afraid to enforce fair working condition regulations because they think it might scare the Chinese businessmen from investing into Lesotho- and undoubtedly, these factories are helping out Lesotho’s economy, especially by providing Basotho with jobs.  But something has to be done to ensure that workers are treated fairly.

To make things worse, the Chinese government is also not serving as a good example to the businessmen as is evident by their own business practices throughout Africa.  In a recent visit to the continent, President Hu of China had to cancel an excursion to Zambia’s copper-producing region because of the threat of demonstrations.  There too, China is highly unpopular due to poor working conditions and high mortality rates in its copper mines.  The Chinese government is also being criticized for selling weapons to the Sudanese government and fueling the Darfur genocide.  There are plenty of more cases of the Chinese government’s lack of consideration for humanitarian issues in the countries they are investing in in Africa….it’s simply shocking.  What apparently ‘protects’ China from censure on human rights is its sovereignty policy.  According to this policy, it is not any of China’s or any other country’s business how a government runs its affairs.  They seriously need to open their eyes. 

Things That Make Me Mad

August 3rd, 2007 by Sophie

Yesterday, a young boy at the clinic lay paralyzed while several of the doctors struggled to keep him alive.  His tiny body was on the examining table while beeping noises filled the room.  The young boy could no longer breathe on his own. There are no child ventilators in all of Lesotho.  Why?  None of the people we spoke to really knew for sure, but most speculated that this was due to a lack of organization of those who are in charge of inventory of medical supplies.  The physicians decided to take the child to Bloemfontain, which is the town with the nearest South African hospital.  I just thought about how this boy would have surely died if he was not in the care of the doctors at our clinic.  The staff at the government hospital seems too overstretched to have ever taken the care to send the child to Bloemfontain where a simple ventilator could be obtained to save this child’s life.

There is such needless dying and suffering in this country.  And when I hear that many are dying due to carelessness or disorganization - something inside me just burns with anger.  The country always runs out of CD4 reagents…As a result, I have heard it announced repeatedly throughout my stay here that there are no CD4 counts for the week, which is crucial for monitoring HIV patients and starting them on antiretroviral treatment.  In a country where 1/4th of the population has HIV, having CD4 counts available is a necessity.  Again, there are speculations that the CD4 reagents run out not because of a lack of funding, but instead because of people who are disorganized. 

Another thing that deeply angered and frustrated me today was seeing about 20 spotless Mercedes Benzs lined up at the airport along with several beautiful black Audis and about 20 shiny Toyota Camrys…  The government here pays for these cars for their highest government officials, while the lower down government officials all get Camrys (but not to worry, starting next year all the Camrys get upgraded to Lexus cars).  It is all so wasteful…  Especially now, after the government has declared Lesotho as being in a state of emergency.  Lesotho suffered from its worst drought in 30 years – many were expected to starve to death or die from malnutrition this year.  Why is the government paying for these fancy cars and not spending it on their people who are suffering and dying from a mere lack of food?

The 500,000 rand or so spent on each of these cars could also easily be invested to send more kids to school.  There is a lack of access to higher education for too many children of Lesotho because they cannot afford to pay for high school tuitions.

Furthermore, while Queen 2 (the local government hospital) is in shambles, a beautiful new ministry building is being built right next to it.  The conditions at Queen 2 are terrible – it is overcrowded, the staff is too few, the building is too old - there are even cockroaches crawling out of the children’s beds during the summer.  There is absolutely no excuse for not making the rebuilding of Queen 2 a priority.  People are dying needlessly due to the dreadful conditions of the place.  But yet, a beautiful new ministry building is being built …and the rebuilding of Queen 2 will continue to be put off while the government officials keep driving their sparkling cars….

Views of typical homes and stores in Lesotho:

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Conversations and Katse

July 30th, 2007 by Christina

Having spent almost all of my time in Maseru the past 7 weeks, I was ready to experience the drive to the mountainous regions and really get the meaning of the name Mountain Kingdom. Our friend, the clinic driver, was also excited about such a trip, and he drove us to Katse Dam, perhaps the largest engineering project in all of Lesotho. It was about a three and a half hour drive to the mountains, and we were also accompanied by another friend who is also a staff member at the clinic.

Driving just an hour outside of Maseru, the terrain began to change and the snow-covered mountains became part of the backdrop as we drove through tiny villages of Basotho hut homes. It was amazing to see the dry terrain transforming into bright white peaks and frosted roadsides. As we approached the dam, the mountain ranges seemed to roll out into a body of water, and I had never seen such a contrast of snow and mountains surrounding large bodies of water.

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The dam was quite an engineering project, and we learned it was jointly funded by the UK, South Africa, Italy, France and Germany. Basotho were largely involved in its construction and in the maintenance, but there was a contract signed with South Africa that guarantees all of the water for South African purchase and use. There are huge tunnels running to parts of South Africa that commonly experience droughts, and water is Lesotho’s most significant export. While it is true that the dam provides many economic benefits to Lesotho, it is difficult to experience such a work of engineering brilliance that is primarily benefiting South African farmers and people. When Lesotho is about to declare a state of emergency because the country is experiencing the worst drought in 30, not a liter of this vast reservoir of water goes to local farming areas desperate for irrigation, and there is no sign that any terms of the treaty will end any time soon.

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Despite some frustrations with the economics of the situation, we met some very nice people along the way, and our tour guide offered his front yard for the barbeque or brai that we planned to have while in Katse. We met some of his friends who work in the area and are in charge of running the compensation programs for local villagers who were displaced because of the project. It was interesting to hear some of his efforts to encourage local people in the rural areas to accept money instead of grain and begin investing in their own businesses and ventures to make the profit sustainable. It seems easy, though, give a person some money to start with and they could go off and start a small shop or tourist attraction, but he said most of the people have never gone to school and struggle with financial concepts and are reluctant to even deposit the money into a bank. Playing the part of a tourist for a moment, I encouraged him to find an interested villager and start a ferry boat service in the waterways of the dam… something I would have liked to do while in Katse.

The barbeque was a great time and the meat was delicious. Perhaps it was the crisp weather, the good company, the pleasant atmosphere, the cook, or a combination of these things that made the meat some of the best I have tasted.

On the ride back, the sun was setting on the mountains and they looked almost velvety and smooth. Driving home and listening to a change in the nonchalant tone of the conversation going on in Sesotho, I felt comfortable enough to ask the Basotho who were with us what their boisterous conversation was all about. It led to an interesting discussion on the quality of life in Lesotho vs. South Africa, crime rates, the extent to which luxuries are a sign of success in one’s life, the work environment in Lesotho, attitudes on food assistance programs, HIV testing, and sexual prevention of HIV around Lesotho. It was good to hear the challenges and frustrations working people here face, and to listen to the realities of societal pressures and the fundamental desire of people to achieve the very best in their lives. As outsiders, I am sure our opinions were not well-informed and quite amateur, but it was enlightening to hear local perspectives.

Velvety mountains:

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Changing environments from rural Katse to urban Maseru even made us think about the simple lives of the villagers who choose to handle grain instead of money. We all decided that knowing nothing other than that type of life would be much less stressful and hectic, maybe even more enjoyable at times. But knowing more and growing up in the surroundings we were raised in make it impossible to imagine a life without schedules, applications, time constraints, obligations, and pressures. It is up to each of us to find happiness in our lives and achieve a healthy balance that allows us to maximize our lives and prioritize what matters most.

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Missing Our SOS Kids Already….

July 27th, 2007 by Sophie

I am in love….with a little girl named Lisemelo.  She is the most beautiful and sweetest little girl I have ever met in my life.  Every time we walk by her home at the SOS orphanage, she is always waiting on the side of the road for us because she knows by now the times that we usually walk by everyday.  She just stands there and smiles at you so sweetly.  Then, when you run up to her to give her a hug, she opens her arms so wide for you to pick her up (she is a tiny 2-year old).  I wanted to cry today though…instead of walking back to the clinic from the SOS Village today, Christina and I were picked up.  As we drove by little Lisemelo’s home, she was standing out on the street and she could see us in the car as we approached.  I waved to her and her face looked so sad when she realized that there would be no hugs today.  I looked out the back car window after we had passed and I could see her walking up closer to the street and looking after our car.  I was so sad….oh goodness, what do I do?  I am so in love with little Lisemelo! 

I love all of our SOS kids.  They are so funny.  I caught a recording of them doing a dance-off of sorts in front of the camera today.  I was filming while Christina was trying to teach the kids a hip-hop dance that they are learning as part of their Immunology Skit which they will be performing next week.  Their awesome personalities shined through so well in this recording.  I wish that there was some way to post it up on the blog.  As I filmed, all of the kids (from ages 4 all the way up to 16) were laughing and jumping in front of the camera showing off their best moves.  They kept pushing each other aside to hog the camera view, but were laughing as they tried to steal the spotlight from each other.  It is one of the funniest and cutest things I have ever seen.  I love our SOS kids…I don’t know what I’m going to do without them.

Me and Lisemelo:

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Christina teaching the SOS kids a dance:

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Group Adherence Counseling Module Debut

July 23rd, 2007 by Sophie

Last Friday, Christina and I presented the antiretroviral therapy group adherence counseling module that we have been developing to the social workers at the clinic.  This was a huge project for us since we are completely revamping how adherence counseling is done at the clinic.  Our preparations consisted of assessing what is said in the current adherence counseling sessions, how the current counseling falls short, the greatest challenges faced with poorly-adherent patients, and assessing successful group adherence counseling sessions here in Lesotho.  There were many concerns in that the current counseling module was not effective enough since there is poor adherence among many patients.  The patients do not seem to truly understand how their ARVs work or even the names of them.  Therefore, our goal was to make adherence counseling much more educational in teaching the concepts of drug resistance, how ART works, and the importance of strict drug adherence.  The doctors and social workers all seemed very supportive of doing this.

 

We made a powerpoint presentation to accompany our new module in order to have visual aids during the group counseling session to help the social workers explain different concepts that are generally difficult for patients to understand (i.e., drug resistance).  The social workers seemed to like the visuals on the powerpoint presentation.  We even made some simple animations to illustrate drug resistance and HIV replication.

 

We are scheduling patients this week for the new group adherence counseling session and will be piloting the new program next week.

Reach Out and Read Volunteer Group

July 23rd, 2007 by Christina

I still remember walking into the waiting room at the Baylor clinic here on my first day in Lesotho. Seeing the dozens of children and mothers sitting solemnly in the waiting area with emotionless looks on their faces made me wonder what could be done about the depressing situation of the waiting room. After all, they should not spend the entire day in this state. After reading to patients on my own the first few weeks and introducing coloring book activities with word searches and other activities, I realized that despite the benefits of being able to offer my own storytime with the children while I am here, there would be no one to continue reading and volunteering once I am gone.

After some conversations with the staff and management here, we decided to build on the Reach Out and Read program here and create a volunteer process whereby youth and adults could participate in increasing family literacy and brightening the waiting room environment. The Reach Out and Read program in the U.S. and here in Lesotho focuses on increases family literacy and children’s interest in reading by having pediatricians hand out books at periodic check-ups and encourage parents to read to their children as a part of the developmental process.

Having worked with the youth at SOS, we introduced the idea of volunteering to the students and teachers there and received and overwhelmingly enthusiastic response. I was quite surprised at the spirit of volunteerism the students presented and there was a line at least 30 students long waiting to sign-up just to receive the application!

We trained the first group last week and have been pleased at their first performance reading with the children on one of the busiest days at the clinic. Now we want to make sure this program lasts and encourage the students to volunteer on a periodic basis.

I was also surprised to learn that there are almost no children’s books written in Sesotho. This poses a problem for any literacy initiatives and it is difficult to import books and translate them into Sesotho because of customs fees and other barriers. The Reach Out and Read program in Lesotho had the wonderful idea of starting a story-writing competition in which Basotho people of all ages were encouraged to submit children’s stories they have written. There was a judging panel that selected the best stories and there are cash prizes and the chance to be published for the winning authors! Apparently there were 288 entries from school children, adults, and people from all walks of life. It will be exciting to see what the outcome of the competition is and what types of children’s books can finally be published in Lesotho. That is another interesting part of the initiative… local artists and publishers will finally get a chance to participate in the publishing of these books, and this will open up the possibility of working on a new market and industry in Lesotho

Below are pictures of our volunteers!
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Keyhole Gardens: A Sustainable Aid Solution

July 23rd, 2007 by Sophie

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We went to Mafetang district, considered to be the poorest of all the districts in Lesotho, with M’e Mamra, who is the our clinic’s nutritionist.  The malnutrition ward in Mafetang happened to be empty when we went (which was a good thing).  What we did see on our drive though, were beautiful stone gardens that were filled with green vegetables.  This was astonishing since Lesotho had a horrible drought this year and has just declared a state of emergency as a result.   An Onhono (grandmother) proudly showed us around her beautiful garden.  She said that she had enough food for her family of 5, and even was able to sell some left-overs.

M’e Mamra seemed to strongly believe that there was less malnutrition in Mafetang than Maseru due to these gardens. Lesotho is also the perfect place to implement these sort of gardens since the landscape is generally very dry.

A British NGO known as Stock Aid is responsible for teaching the villagers of Mafetang this agricultural technique.  They have also taught the people to make simple devices to solve the problem of having no running water and also how to build clay stoves in their homes and chimneys for these stoves.

So far, the gardens have only popped up in 1 or 2 districts.  But the gardens will hopefully spread to other regions as well.  The gardens would probably also work in urban areas such as Maseru since they only take up a small space.

Poster in the malnutrition ward.

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Onhono showing off her garden:

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Runner Water Contraption:

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 Clay Stove with Chimney:

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But they also had an electric stove:

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From Highlands to Green Lands

July 20th, 2007 by Sophie

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Cape Town is probably the most beautiful city I have ever seen in my life.  The most breathtaking sight for me was the Cape of Good Hope, which is supposed to be the south-western most point of Africa (almost the southern-most point) and also where the Indian and Atlantic Oceans meet.  We hiked up the mountain to be rewarded with one of the most spectacular and incredibly serene sights I have ever seen.  It was one of those things where you feel like you can’t fully appreciate the beauty in front of you because it is too much for your eyes to handle.  I could have stayed up at the top of the mountain for hours and have been completely content.blog-web.jpgblog-2.jpg

We also went to the top of the majestic Table Mountain.  The view from up top was nothing short of amazing as well.  However, we got scared at the end of our visit since the call for the last cable car down for the day was blaring (via loud tornado sirens) while we were still very far away from the departure point.  The sun was setting and it would have been dangerous to hike down the rocky mountain in the dark.  So we bolted across the top of the mountain to the departure point and I tried to take a few pictures while I was running.  Thankfully, we made it in time to take the cable car down the mountain.   It was quite an experience, but I  laughed and smiled as we ran all the way back to the cable-car station. blog-table-run.jpg

The trip was inspiring as well.  On the plane ride to Cape Town, I sat next to a woman named Tracy who is a schoolteacher in Belhar, which is considered to be one of the worse neighborhoods in Cape Town.  She described that the area is crime-ravaged and that many of her students don’t have food to eat.  She also told me of how the use of crystal methamphetamines was tearing many lives apart.  She had her students do a school project on the harmful effects of crystal meth, and it is so easily accessible in Belhar that some of the children even taped bags of it to their posterboards.  She had a visible passion for helping her students.  I have been thinking of possibly teaching for some time in underprivileged areas. Tracy truly inspired me towards this endeavor.

Slums of Capetown:

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Tracy is also of mixed racial descent and has a rich family history.  Her grandmother was a British missionary who had come to South Africa and fell in love with the chief of a local South African tribe (Tracy’s grandfather).  When her grandfather’s family found out that he was determined to marry a white woman, they disowned him, and he was forced to give up his role as chief.  The couple then moved down to Cape Town, where they were unable to be seen in public together.  Some of their children were dark-skinned, while others were light-skinned.  The mother could not be seen in public with her darker children and the father could not be seen with the lighter ones.  The story was heartbreaking, but I was in awe of Tracy’s faith and hope for the future of South Africa.  She was encouraged by the movement towards equality in the U.S. and at how far the
U.S. has come in resolving issues of prejudice. 

Our visit to Robben Island was another moving part of our trip.  It was very emotional to tour the island and hear the stories of all the political prisoners who sacrificed so much to fight injustice.  It is mind-boggling to know that apartheid just recently ended in South Africa– it’s like a fresh wound in their history.  I was in awe of Nelson Mandela, Desmond Tutu and other post-apartheid leaders’ commitment to reconciliation between the white and black communities of South Africa.  I found the story of Nelson Mandela to be almost like a fairy-tale.  It brought me to tears when I first heard about his life and imprisonment and then saw footage of him rejoicing with dancing and laughter after finding out he won his first presidential election. 

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Limestone quarry where Mandela and many other political prisoners were forced to do hard labor cutting stones.  It was also a space to impart knowledge, such as reading, writing, and math skills.  Mandela preached a message of reconciliation to the other prisoners here.blog-robben.jpg