You are unlikely to catch any dangerous diseases in Lesotho’s clean mountain air. Because the country is at such a high altitude, there are very few insects and no mosquitoes – hence no malaria. You are most at risk from the weather and being caught without sufficient clothing and equipment. When it rains it pours and you can get seriously wet and cold very quickly, so make sure you are properly equipped regardless of the time of year.
While Lesotho’s healthcare system has made enviable progress over the years, challenges such as widespread poverty and the HIV/AIDS epidemic are severely hampering its efforts to achieve the United Nation’s health-related Millennium Development Goals (MDGs).
Lesotho, in conjunction with its international partners such as the Global Fund and the World Bank, pharmaceutical companies, Boston University and Baylor College of Medicine, and the Clinton Foundation, is scaling up the fight against this pandemic. This is evidenced by a number of milestones in 2005, including strengthening the HIV/AIDS policy environment through the UN-supported ‘Three Ones Process’ and the launch of the first national network of People Living with HIV/AIDS (PLHA) in May of that year.
Lesotho’s health infrastructure is divided into 18 Health Service Areas (HSAs), each served by a hospital. The central hospital in each district services a number of village health centres that are staffed by nurses or nurse practitioners and community healthcare workers. Village health centres are responsible for providing child immunisation, antenatal and postnatal care, family planning consultations and basic curative services.
Nine of the 18 HSA hospitals are run by faith- based organisations that are part of the Christian Health Association of Lesotho (CHAL). The Christian Health Association of Lesotho (CHAL), active mostly in rural areas, runs close to 50 percent of primary healthcare centres and some hospitals, while the rest are managed by NGOs and the private sector. Lesotho’s premier hospitals are Queen Elizabeth II Hospital, the national referral hospital in Maseru, and Maseru Private Hospital in Thetsane.
Close to 80 percent of the population is within a two—hour walk of a health facility.
Another component is the Community Health Worker system. Over 5 000 village health workers and 1 400 traditional birth attendants provide primary health care in approximately 300 health centres and community—owned village health posts.
The Lesotho Planned Parenthood Association is also active in promoting family planning through local clinics and promoting community-based distribution services. The Lesotho Flying Doctor Services provides emergency medical service, particularly in hard to reach mountainous areas. Traditional healers are informally included in Lesotho’s health system.
Other important sectors include the SOS Children’s Village Association of Lesotho, that provides permanent care and housing for orphaned, abandoned and destitute children, Lesotho Save the Children, an organisation that advocates for improvement in children’s rights and assistance for disabled children, and the Lesotho Society of Mentally Handicapped Persons, that advocates for and protects the rights of individuals with developmental and intellectual disabilities.
Subsidised health services are provided at all levels of society in Lesotho. The government also provides free treatment of tuberculosis, leprosy, childhood diseases for which immunisation exists, malnutrition, antenatal and post-natal care services and subvention of referrals made to South African institutions in special cases.
The rise in HIV infection since the early in 1990s (a mere 4 percent in 1993) has prompted the country to treat the epidemic as a national crisis that has the potential to reverse the progress made in human development over the past three decades and continues to threaten the productive sector of the economy, public service delivery and social development. Substantial investment is needed in both prevention and treatment, the first to halt the spread of the virus, and second to improve the lives of those who have it and buffer the negative investment effect.
In October 2003 a semi-autonomous national commission on HIV/AIDS was established to replace the previous structure, the Lesotho AIDS programming Coordinating Authority. The new National AIDS Commission and Secretariat, which became operational in 2005, has further accelerated the ongoing drive to scale up the response to the pandemic.In support of a multi-sectoral response, HIV/AIDS prevention and mitigation activities involved all ministries in efforts to provide care and counseling support to those affected by HIV/AIDS.
In addition, Lesotho is in step with the SADC HIV/AIDS strategic Framework and Programme of Action 2003-2007, that calls for a focus on access to care, testing and treatment and prevention education. The secretariat of the global Fund-supported national network of People Living with HIV/AIDS became functional in September 2005.
In 2005, the Government of Lesotho received UN agencies’ joint support for furthering the “Three Ones Process”. This includes ensuring that the newly established National AIDS Commission and its Secretariat are fully functional, supporting the development and implementation of the National Strategic Plan for HIV/AIDS (2006-2010), and assisting in the development and implementation of the National Monitoring and Evaluation Framework for HIV/AIDS.
The availability of low cost anti-retroviral treatment (ART) means that HIV is no longer a death sentence, which mitigates many of the negative investment effects of HIV and AIDS. The Lesotho government is presently increasing access to ART among pregnant women.
Donors such as the WHO have provided technical and financial support towards initiatives to deal with HIV/AIDS. Furthermore, the Global Fund awarded Lesotho US$34 million for HIV/AIDS and tuberculosis to be disbursed over 5 years. The Clinton Foundation’s among others, proving clinical mentors, lab support, pediatric drugs, supply chain management expertise as well as assisting in the day to day running of clinics.