State-run clinics run out of drugs

MASERU – MANY state-owned and community health centres countrywide have run out of drugs, resulting in patients being forced to buy prescribed medicines from expensive private pharmacies.

Some health officials have blamed the supplier of drugs, the National Drug Service Organisation (NDSO), for delaying distribution of medicines to clinics. The Ministry of Health spokesperson, ’Mamolise Falatsa, was not available for comment.

NDSO Public Relations Officer, Bokang Ntsoeu said the institution delivers medicines to clinics on a weekly basis to the North, South, Central and Highland regions.

“Orders are dealt with within five working days but when there is a crisis of any illness, an emergency request is made and we have never received such from any facilities.

“We were all surprised to learn about that,” she said.

She said the NDSO made deliveries to the central region “without any problems” this week for those that made requisitions on time.

“It’s not true that we delay deliveries when everything is done properly,” she said, revealing that on Tuesday, a driver returned with Domiciliary Clinic drugs with the explanation that employees said they had already knocked off and there was no one to take delivery of the drugs.

The lack of some drugs in the clinics has frustrated patients, some of whom are too poor to afford medicines from private pharmacies.

This became evident in the case of the Maseru City Council (MCC)’s two health centres that have run out of flu medications.

Thamae and Khubetsoana Clinics ran out of drugs from August to early September, forcing their chemists to direct patients to private establishments in the city. This happened at a time when there was a high prevalence of flu in Maseru.

The Principal Health Inspector at the MCC’s Thamae Clinic, ’Maseitshiro Khooe, said they have since placed orders but have not received the drugs.

“The challenge is communication with our supplier as often it’s back and forth (thereby) delaying delivery,” Khooe said.

“At first, I thought it was monetary issues but that one I ruled out after approaching our finance department,” she said, refusing to reveal the supplier.

However, thepost has established through the Health Ministry that the supplier of drugs in all health facilities in the country is the NDSO.

The NDSO was established as a non-profit organisation in 1979 to procure, store, and distribute quality medicines and medical commodities for health institutions in Lesotho.

The health institutions include government hospitals and health centres, Christian Health Association of Lesotho (CHAL) facilities and private clinics and pharmacies.

She said they end up sharing “the little we have” with a sister clinic in Khubetsoana.

She said they cannot ask their other partners to share their drug stock “because they too are running low”.

“We crossed fingers hoping that we don’t run out of essential drugs (for those with chronic illnesses) before receiving our consignment,” she said.

“Limited competition or serving a lot of clinics overwhelms the supplier as other clinics complain about experiencing similar problems.

“We then become victims as the market seems monopolised. I am not really sure what the reason behind the delay is,” said Khooe.

She said the clinics record about 80 patients, children and adults, suffering from flu weekly.

She said the number of flu patients has doubled in Khubetsoana.

However, she said their analysis revealed that this is not linked to Covid-19 as many people had earlier suspected.

“It does not sit well with us that we don’t give full services… it is beyond us and our clientele should bear with us because we want to provide quality service.”

’Maselloane Mofosi (names changed at request) who brought her two-year-old son to Thamae Clinic when thepost visited the clinic on Monday last week said the child had been suffering from flu for two weeks.

“It is the second time I brought him back here because during the first visit there was no medication,” Mofosi said.

“We were only given a prescription and they recommended that I buy the medicines from a private chemist,” she said.

“I didn’t buy any of the four recommended drugs because I am broke so I came back again hoping drugs were now available. I am disappointed to learn they still don’t have them,” said the patient.

Asked why she did not go to other clinics, she said apart from Thamae being nearer to her, health workers there are “friendly”.

Another patient, Neo Sello, said he had been battling with flu for a week before visiting the health facility.

He too was prescribed medication to buy from a private chemist.

“I am disappointed because I already paid to get services. I wouldn’t have wasted my M20 if I knew there was no medication,” Sello said, adding: “I will buy the drugs from a private chemist because I don’t have any other choice.”

Sello suggested that the clinic puts up a memo that informs flu patients of the drug shortages “so that people don’t waste their time and money paying for half services”.

Health services are paid for at the MCC clinics as opposed to other government and CHAL-owned health institutions countrywide.

The CHAL spokesperson, Lebohang Liphapang, said shortage of medication is a general problem faced by their health facilities.

“It has been a challenge for years. It’s a general problem deriving from subvention (delay),” Liphapang said.

She said the major challenge is that the government gives CHAL the same amount of subvention money even though medication is getting expensive due to inflation.

“We can’t afford the medication and if we still get the same amount, there is no way that it will cater for all the needs of the facility’s operations. Operations and drugs are already a challenge,” she said.

“If any medical equipment breaks down, servicing it will be a problem because we don’t have that included in our budget,” she said.

She said at some of their clinics that have run out of flu drugs, officials employ different strategies depending on work for the clinic.

“Some prescribe medication for patients to buy them at a private pharmacy while others who don’t have enough drugs will give out any of the available drugs.”

Liphapang said they signed a Memorandum of Understanding (MoU) which determines their operation with the Health Ministry more than a decade ago.

“It expired a long time ago and this is hindering the smooth operations of facilities. By right it was supposed to be reviewed each and every three years to improve the partnership,” she said.

“The biggest challenge is that the government delays its review because it knows that the review will have financial implications on it.”

The NDSO does not receive funding directly from the government and must recover all its costs through a handling (mark-up) fee system.

Sales of drugs and other medical equipment are ideally the sole source of revenue and income that must cover the NDSO’s total expenditures.

An official at the NDSO who chose to remain anonymous as she was not authorised to comment said health facilities, especially government-owned, do not receive timely information about their budget situation.

As a result, they fail to submit corresponding health supplies purchase orders to the NDSO.

The official blamed health centres for poor inventory management, lack of knowledge about their budgets and failure to follow procurement procedures for the scarce drug stock.

’Mapule Motsopa