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Fighting the cancer monster



MASERU – WHEN Rakosi Hlehlethe, 43, speaks his voice betrays little emotion. But bottled inside are feelings of anxiety and depression caused by having to deal with foot cancer.
He said the problem started in 2017 when his big toe became sore and swollen.

“While still monitoring it, my toenail fell off,” Hlehlethe recalled.

He said he limped his way to Malealea Clinic in Mafeteng and was encouraged to sterilise his toe.
He said it affected the next toenail which also fell off.

“An open wound made its way from my foot,” he said, adding that “it was a sore that would heal and resurface.”

His third toe broke in his sleep and he only realised it in the morning.
Eight months later, the pain became unbearable as another wound formed.

“I have been treating something I didn’t know for the past two years,” he said.

He said it was only in July 2021 when a doctor in Mafeteng Hospital confirmed he had cancer and referred him to Motebang Hospital in Leribe, which re-transferred him to Queen Elizabeth II Hospital in Maseru.

There, he was only scrubbed and advised to keep cleaning the wound.

“Unfortunately, it got rotten and stinky.”

He has one toe hanging on his feet.

“The pain on my foot is unbearable,” he said, breaking down.

He said his foot had worms just last month.

“I am not really sure what happened as I followed my routine of cleansing it after every three days,” he said.

Hlehlethe wishes for amputation as he was diagnosed late for cancer.
Another cancer patient, ’Majakote Lejaha-Letebele, 54, was diagnosed with breast cancer in April 2007 and since then she has visited many medical practitioners in search of a cure.

She saw a dimple like lump on her left breast and went to the Maloti Seventh-Day Adventist Hospital for a biopsy and got her results two weeks later.

“I had stage two breast cancer and I did mastectomy as advised by doctors citing it will prolong my life expectancy,” she said.

She said the tests confirmed she was pregnant, something she was unaware of. She also had five lymph nodes (litšoelesa) under her armpit.
She was referred to Queen ’Mamohato Memorial Hospital and was booked to Bloemfontein, in South Africa, six months later for treatment.

During her check-ups at the local hospitals, results never showed that the cancer was spreading and she completed her nine months of pregnancy. She started six chemotherapy sessions four months later after giving birth.

She said she would vomit and poop at the same time, lost her hair, her nails became darker, her skin was very dry and she was weak and forgetful and she lost too much weight.
Afterwards, she started a six-week radiotherapy which led to a five-year pills (tamoxifen) treatment.

At last, cancer was arrested.
However, that was not the case as during her sixth year, she went for a check-up with a painful hip.

“The pain got deeper by weeks and in 2016, I went for consultation suspecting cancer but I was misdiagnosed as the doctor said it was arthritis,” she said.

“I was injected and the relief only lasted five hours,” she said, recalling her return with a painful hip, again, a week later.

“The doctor still maintained that it was arthritis and I requested X-rays for confirmation. But he didn’t budge and I had to take the matter further with his manager.”

Lejaha-Letebele said she was transferred to Bloemfontein for treatment right away as an emergency after the doctors confirmed cancer on her hip and lungs.
She underwent radiotherapy to strengthen her bones. She was discharged without any cure, just hoping for divine intervention.

“The most painful part was coming home to wait for my death in 2016,” she said, praising God. “He heard my prayers and responded accordingly.”

She said she went to a doctor who practises homeopathy in Port Elizabeth who gave her a lot of medicines and she paid “a lot of money as I was told that cancer is irreversible”.

“I had to take a loan and I spent over half a million maloti trying to work on myself after the doctors did their part and concluded it was the end for me.”

“My medication is costly and I had to stop eating meat and fruits completely. I was so thin but after following the instructions, I slowly regained my weight,” she said, adding that she now eats meat in small portions balancing it with green vegetables.

She still takes painkillers but the pain is no longer as strong and she gains strength daily as the cancer is no longer spreading.
Lejaha-Letebele says the absence of a cancer facility is a major challenge for Basotho.

“During my time (at Mediclinic), I watched as many Basotho were sent back home daily due to delays by the government in making payments and the polite excuse given was they needed a blood transfusion,” she said.

“There were so many needless deaths which I believe could have been prevented if we had our own facility.” When a 53-year-old ’Mamosa Mosola bled after intercourse in October 2018, she didn’t think much of it, even less that it could be a sign of cancerShe was diagnosed with stage 3 cervical cancer, she was overwhelmed by the news, and the pain that followed was unimaginable.

“They were like birth pains,” she said.

Her children took her to Makoanyane Military Hospital where she was admitted for two weeks, but that was just the start of her journey managing a disease that is affecting many Basotho women.
She was referred to Queen Elizabeth II Hospital before being taken to Queen ’Mamohato Memorial Hospital where cancer was confirmed.

For survivors such as Mosola, the hope is that the government deals with the challenge as a matter of urgency so that other women do not have to go through the pain she suffered.
The pain made her feel like death was knocking on her door.

“I couldn’t walk anymore and had to use a wheelchair,” said Mosola, adding: “I could see death getting nearer and nearer.”
She was referred back to Queen Elizabeth II Hospital in December and was told to seek further treatment in Bloemfontein, South Africa.

But the doctors were on leave and would only be available in January.

“I lost all hope,” she said.

A ray of light filtered when she learnt of a visit to Lesotho by some Indian doctors, who eventually attended to her.
Mosola later sought for treatment in India in February 2019, where she underwent chemotherapy sessions for six weeks.

Afterwards, she said she underwent two radiation sessions.
She urged Basotho to go for cancer screening before it’s too late.

“The pain I suffered, I wouldn’t wish it on anyone.”
‘Malisela Tšilane sobs as she narrates how her 63-year-old mother succumbed to cancer in 2015.

She said she had a lump which looked like a boil under her armpit.
She went to Queen ’Mamohato Memorial Hospital and got treated as an outpatient following numerous check-ups and given different antibiotics for the same thing.

“Doctors were negligent as they kept prescribing different pills without running tests even though the cancer had spread to her breasts and her situation worsened with time.”
She said she changed doctors to a privately owned health centre.

“Worse, she was misdiagnosed with mastitis there,” Tšilane said.
She said she returned to Queen ’Mamohato Memorial Hospital but “unfortunately we didn’t see a doctor as we were given an appointment for a biopsy which was to be done in three months”.

She said the biopsy was finally done and it confirmed she had breast cancer, hence her referral to Bloemfontein.

“In the meantime, her problem was escalating as her breast was shrinking and itchy and when she scratched, the cancer wound appeared and she was hurting,” she said.

“But because they didn’t care, she was given antibiotics until forever.”

It took six more months before she could get a six-week chemotherapy treatment.

“Unfortunately, she died after her fifth chemo, we were least expecting it as she looked better with lesser pain,” she said, adding: “I don’t think she would have died had she been diagnosed and treated much earlier.”

These cases are just the tip of the iceberg as many Basotho continue to suffer.
Speaking at a press conference recently, the Health Services Director General, Dr ’Nyane Letsie, said cancer is now a major cause of morbidity and mortality in Lesotho.

She said it is the fifth cause of death among adult men and second among female adults, saying cervical cancer is among the highest in women, followed by breast cancer and prostate cancer in men.

She said the country continues to refer cancer patients to Bloemfontein for care and treatment. However, the costs remain high for testing and treatment.
She said the government spends between M150 000 and M200 000 per patient from diagnoses, treatment and rehabilitation.

“The government solely pays for this,” Dr Letsie said.

“Also, despite all this, the mortality rate among our patients who are already under care is significantly high,” she said.

“We lose more than half of them and this is really shocking.”

Dr Letsie, therefore, said to ‘close the care gap’ in Lesotho, there is a need for infrastructure, skilled human resources for the management of cancer as well as drugs and supplies.
She added that plans are underway for the construction of a cancer hospital in the country.

“Despite the delay of construction of a cancer hospital, we are glad to note that at least now the processes have begun and I am sure that the ministry in charge will soon announce the processes to ensure that construction continues.”

She announced that Queen ’Mamohato Memorial Hospital has a cancer unit designed to provide cancer services since 2010 and “we began to deploy staff to ensure that chemotherapy is provided”.
She said four operation theatres are also being maintained and the new Queen II Hospital will provide a fully equipped chemotherapy unit.

She said the first Mosotho oncologist has resumed duty and has already conducted a baseline assessment.

“It is an honour as most services that were not given will be given. And now that we have the oncologist, soon we will not have to refer many patients but those in critical conditions.”

She added that medical physicists, radiotherapists, doctor and nurses oncologists and cytologists amongst others have been trained.

“There is light because most cancer services will be provided in the country although those who will need referral will still go to Bloemfontein.”

“The death rate will decline as we will be able to diagnose them sooner,” she said.

Meanwhile, she said the country spends M12 million per month on cancer patients.

’Mapule Motsopa

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