Community clinic in limbo
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…as Govt and mine shift blame
By Matiisetso Mosala
Access to health care facilities for Seate Community council’s villages located within the vicinity of the world’s highest dollar per carat diamond mine—Letšeng diamond mine—is but a dream.
The villages’ under-development, lack of access to basic human needs make living conditions for villagers unbearable and extremely difficult.
Only sight of lights in the night in the area is from Letšeng mine that is confined within its compound 13 kilometers from Maloraneng, one of the villages within the Seate Community council.
Letšeng mine is located at the Letšeng-la-terai area and connected to the Khubelu river valley by a Patising stream that flows right from the mine into the river.
Just at the confluence of the Patising Stream and Khubelu river, you find Maloraneng nestled on the river bank and more villages like Ha Nthimolane, HA Masasane, Ha Moroke, Ha Seema and Matlakeng.
One thing that is common to visitors’ eyes about Letšeng’s neighbors is poverty, lack of basic services that include electricity and health facilities.
A small building that must serve the community as a health post is visible but does not serve anyone amid the high need for health service that forces villagers surrounding the area to seek medical care from a clinic located 41 kilometers away in the town of Mapholaneng or cross into the district of Botha-Bothe or seek help in Molika-liko.
The health post was built to serve the health needs of people in the area, but it has been nonoperational since its completion.
It used to house health professionals that would visit the health post once a month from Mokhotlong Hospital but ceased the operations over promised upgrades to the small hall that served as a health post.
The community was promised its health post would be upgraded to being a fully functional independent health clinic that villagers would visit any time of day and night.
But ‘Mamapholo Ntsike, a community health worker elected by villagers who coordinate health services delivery told MNN Centre for Investigative Journalism the health post-upgrade to a clinic was met with varying challenges.
She said the key challenge is the blame game played by the government and Letšeng mine over who should shoulder the costs of the upgrade of the health post into a clinic.
Letšeng mine’s Corporate Social Investment Manager Tšepo Hlojeng in an interview with MNN said despite having promised the communities near Maloraneng Health Post improved health care, the mine is still trying to fit the upgrade into its upcoming five-year implementation plan.
The Mokhotlong Hospital District Managing Officer who refused disclosure of her name said their hopes were pinned on Letšeng due to financial woes of the health ministry but the upgrade may take longer due to its projected high costs.
Ntsike said the two parties — government and Letšeng — have alternated so much on the works to have the health post operating as a clinic that she is certain the building may eventually collapse due to inactivity.
She said at one point, the area chief and councilor campaigned for the erection of the health post in another village and not upgrade the health post in Maloraneng.
“Things were finally taking shape and it seemed the health post would start operating but the area chief of Pae-lea-itlhatsoa Makhaphela Sekonyela and community Councilor ‘Mapakalitha Sibisa vehemently advocated that the clinic be uprooted and moved to Pae-lea-ithlatsoa.
“He even offered a new site for the clinic. It does not make sense why they wanted to build from scratch when there is already a structure waiting to be used,” said Ntsike.
Ntsike said many of the life of the people in the area are at the risk of being lost even over the most easiest to treat illnesses.
She recounts numerous occasions where people died on the long journey they have to take to get to the nearest clinic.
“Imagine having to go back home with a dead body on your back,” Ntsike said reminiscing ordeals suffered by her community members.
As a community health worker, she says she has had to accompany parents whose children were sick and carried on their backs trying to get to the clinic on foot because the only available taxi in the area had already left for the day.
She says “… and even when it is available, it costs us M140.00 per person to get to Mapholaneng and back”.
For Ntsike, while many have ample options for access to health services, people living in her area do not have the luxury of picking or choosing where to access their health services.
She told MNN that she has witnessed three kids die in one of the valleys on the way to the nearest clinic, mainly because they were taking too long to get them medical attention as they had to rest along the way due to the steep mound to the A1 main road.
She said they take up to eight hours to walk from the village to the clinic or may take 3 hours to get to the nearest place where they can access public transport to Mapholaneng.
When emergencies arise at odd hours, Ntsike said they are forced to seek overnight stay in stranger’s houses in order to make to the clinic early in morning.
Ntsike said health workers used to visit the health post once every month, which was not enough but was helpful as it provided inclusive services of check-ups, provision of medication and injections, dental care, family planning and others.
“Even then we yearned for daily services but it was better than now because the last time they were consistently coming here was in 2019.
“Even this past year when we were faced with deadly flu and Covid-19 they did not come,” Ntsike told MNN.
Seate Council’s Clerical Assistant Masoabi Tšoeu blamed lack of services to inadequate financing for Councils development plans setting back many rural development initiatives.
She said “Seate community council is the biggest council in area it covers in the country, however it is one of those allocated the most limited budget yet has to meet the needs of 20 Electoral Divisions (EDs)”.
Tšoeu said many of the community councils in Lesotho are constrained financially; however she has also observed that council budgets are not allocated equally and often budget allocation overlook needs.
Tšoeu claimed the ministry of health had promised to provide nurses for the health post in Maloraneng but could not afford them accommodation hence progress was halted.
In 2019, the community called out to Letšeng mine for assistance and seeing the apparent need, it agreed to upgrade the Health Post into a clinic and would add the nurses’ quarters and extend the building to include maternal waiting wards.
“When the diamond mine offered help we gladly stepped back because there was nothing we could do,” said Tšoeu indicating that Maloraneng has not been budgeted for even in the 2020/2021 financial year.
She said for the current financial year the council was given just over M100, 000 and had to prioritize more urgent needs in other areas.
Area Chief of Pae-lea-itlhatsoa Molapo Kotela – a stand—in for Chief Sekonyela denied allegations they had personal intentions where the clinic must be constructed.
He said it was only because the land where the health post is located is too small for the upgrades needed.
“This was after the owner of the plot where the health post is located could not afford the necessary upgrades and its owner demanded compensation for his land which ministry of health said it could not afford to pay hence an alternative location,” Kotela said.
Kotela said the community argued that the delivery of medication and accessing the clinic would be a challenge owing to two collapsed bridges connecting Maloraneng and Pae-lea-itlhatsoa.
But Kotela said on the other hand “there is already a structure here; it only makes sense that the ministry compensates the plot owner of the land here instead of starting from scratch elsewhere where people will be inconvenienced”.
Hlojeng told MNN clinic location became an issue because the community and the council differed on where it should be situated.
“…when the squabbles erupted, it was agreed that the upgrades be postponed to the 2020 financial year, but then Covid-19 happened and all resources had to be committed to fighting the pandemic,” Hlojeng said.
Now, Hlojeng said the Letšeng mine has conclusively decided that responsibility of ensuring that the health post is upgraded and operational lies with the ministry of health and will only “assist where possible”.
Hlojeng blamed Letšeng’s change of heart on the Covid-19 pandemic’s negative impact on the mine’s business.
He said Covid-19 has put pressure on both their financial position as well as on their medical team, therefore the mine had to mobilize resources and prioritize its people.
He argued that the mine has not been able to do some things for the Maloraneng and others communities nearby because their mining agreement government obliges them to develop the country and not just the Maloraneng area or the Mokhotlong district.
The MNN however has it under good authority that Letšeng Diamond’s Corporate Social Investment is only stretched between two districts of Mokhotlong and Thaba-Tseka.
Transformation Resource Center’s Tšitso Kapa said while the government ought to make developments in communities, adding mines also owe such host communities developments.
Kapa said it is important for mine host communities to have a clear understanding and differentiation of developments to expect from mining companies and those that are the government’s responsibility.
“It is unfortunate however that these projects take the responsibility towards communities as optional and do not understand the need to invest in these communities”.
He said it was even more unfortunate that the government often drops its responsibility of service delivery to the people, especially where development projects are hosted.
Hape Lematla, one of the villagers in Maloraneng said it is only making sense now why they are always taken from pillar to post by the government and the mine in their area whenever developments need to happen.
He said “we have been tossed around so much that we no longer know what to ask for, from whom, what we deserve as communities hosting the mine and sometimes we feel like we are asking for too much because promises made to us are never fulfilled”.