The clinic that never works

MASERU – A CLINIC in the constituency of Health Minister Nkaku Kabi in Qeme is one of the most unreliable and villagers are demanding action.
’Matumeliso Phakoe was elated in April this year when the government established a clinic in her Ha-Jimisi village.
She thought at last, a reliable health facility was finally close by and at a time when she was pregnant. But seven months on, the clinic has proved anything but.

Phakoe’s jubilation soon turned into despair when the clinic was closed down, albeit temporarily and she was forced to deliver at a hospital far from her home.
The clinic was opened again a few weeks later but then closed again, in what has become a disturbing cycle for Phakoe and other villagers who had dreamt of a reliable clinic in their area.
In October, the clinic closed for an entire month.
“Worst part, it was in the very same month that I was supposed to give birth,” said Phakoe. The clinic has been re-opened but villagers are not certain for how long.
The Health Ministry confirmed it had faced problems keeping the clinic running without disruption.
“Yes, there was a plethora of problems but we have now solved much of them,” said the ministry’s Director-General, Dr. ’Nyane Letsie. Dr Letsie said the problems “have been solved and now the nurses are helping the community in Ha-Jimisi”.

“Surely one would expect some problems when we are starting something new,” she said.
Ha-Jimisi is situated about 20 kilometres in the southern outskirts of Maseru, a rural area. Conditions are dire in the village. Water availability is a big challenge and there is no dedicated taxi route to the village.
Residents have to travel on foot to Mazenod Roman Catholic Mission Clinic about five kilometres away for medical services.

The decision by the government to establish a clinic in the area had come as a relief. Other villages surrounding Ha-Jimisi who travel longer distances to Mazenod would also benefit from a clinic nearby.
For pregnant women such as Phakoe, the government-run clinic in Ha-Jimisi was God-sent given that the Mazenod clinic does not offer family planning services in line with the Roman Catholic doctrine.
When the clinic closed, women from the area had little choice but to walk to other clinics either at Matukeng Health Center, about 15 kilometres away or to the one based in Mazenod.

Phakoe said her mother, who struggles to make ends meet, had to hire a vehicle to take her to St. Joseph’s Hospital, another Roman Catholic Hospital in Roma at night, after severely painful contractions indicated she was due. Fed up with the unreliable service provided by the new clinic, Ha-Jimisi residents last week went to the clinic to demand answers from nurses on the intermittent closures.
They were told this was due to geographical features and lack of water.

“I do understand their challenge regarding water and I used to bring my own water as expected,” Phakoe said.
She said the village chief held a public meeting and asked residents to contribute some money for the generator, which helps in pumping water.
However, more needs to be done to ensure that the clinic provides an uninterrupted service, she said.
“It is very saddening that the only nearest clinic is unreliable,” Phakoe said.

“Illness doesn’t have timetable, it can attack any of us at anytime and some people will not even make it to the hospital as it is far away,” she said.
Another resident, Molefi Machotola, said the situation is grave for elderly people who have no money to pay for transport to hospital.
“Whoever is responsible to ensure that the clinic’s operations become reliable should think of the elderly ones who are no longer able to walk long distances,” Machotola said.
He added: “It hurts to see some of my neighbours sitting there (at the clinic) the whole day, hopeful that it will be opened and very unfortunately it often doesn’t.”

’Maleshoboro Khoeli, another villager, said sometimes the clinic is open but won’t have medication in stock.
Villagers usually have to walk for hours to get to the nearest health center to get prescribed drugs, she said.
“It is a major barrier to getting health care when I need it,” Khoeli said.

Another villager, ’Makhulu Khemisi, said lack of medication, especially for children, should be addressed urgently.
“I remember my grandchild was given oral dehydration solution with the explanation that there were no syrups,” Khemisi said.
She said although she opts to go to Mazenod at times, she always finds a huge queue after walking a long distance.
“Even when I go to collect my treatment pills, I always get home late,” she said.

Chief Koali Makhobalo of Ha-Jimisi says the problems that lead to the intermittent closure of the clinic go beyond geographical issues.
He says he was informed that the main reason was because the government owes rent to the landlord.
The chief recalled a case when the land owner wanted to use grinders to mow down the gates and fences, angry that he was still not yet paid rent.
“I worked hard with the crime prevention committee to stop him,” the chief said.

Three nurses left the clinic after the incident and the chief said he was told that this was because the health personnel felt their lives were in danger.
The chief said some of the nurses told him that they were uncomfortable continuing to work at the clinic.
He also pointed to political wrangling within the ruling All Basotho Convention (ABC) party as a factor in pulling the clinic’s development backwards.
“We would very much like our clinic to be comfortable for people offering us services,” he said.

The landlord, Thulo Qhotsokoane, confirmed the rent dispute. He said although he does not want the clinic to be closed, he is unhappy that the government is failing to pay him on time.
“The bottom line is that they still haven’t paid us. It’s been over a year now,” Qhotsokoane said, adding that talks with the government to resolve the issue are underway.
The government rented the land from October last year but only started operating on it in April this year.

Dr. ‘Nyane Letsie, the Health Ministry’s Director-General, said the government and the landlord were working on a lasting solution.
“The only problem we are still working on is our agreement with the landlord,” she said, adding that delays in signing the contract had also affected operations.
“One of the big issues was how much rental should be paid in light of the fact that this is in the rural areas and it has to differ with buildings in towns,” she said.
On services offered by staff at the clinic, Dr. Letsie admitted that the clinic started without its own staff and “we had to borrow nurses from other clinics”.

“It was facing closure. It is true. But now it will be continually opened because its own nurses have been recruited,” she said.
She also admitted that there was a problem of water scarcity “but now we have borehole water and the problem is no more”.
“The local school is benefiting from the same borehole water. We cannot prevent school children from drinking the water,” said Dr. Letsie.
She said the nurses on site “have colossal work of training rural voluntary health workers, which shows that they are serious with their job at the clinic”.
“Now even patients from Ha-Abia in Maseru and Mazenod go to this clinic, especially those who need family planning services because the church-owned clinic in Mazenod does not provide such services.”

‘Mapule Motsopa