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PublicationsInternational Activity Report 2006/2007LesothoMSF in Lesotho, 2006/2007Field Staff: 13 Reason for Intervention:
Recent update: All articles on Lesotho » With 23.2 percent of its adult population infected with HIV, Lesotho has the third highest HIV prevalence in the world after Swaziland and Botswana. Approximately 23,000 people die of AIDS-related causes each year. Tuberculosis (TB) is the leading cause of death among people with HIV /AID S in Lesotho, more than 90 percent of TB patients are co-infected with HIV. After 18 months in the country, MSF has provided anti-retroviral therapy (ART) for approximately 1,500 people in Scott Hospital Health Service Area, a rural health district with one hospital and 14 primary care clinics that serve a population of 220,000, 35,000 of whom are estimated to have HIV/AIDS. MSF works with hospital management and staff to provide comprehensive care including HIV counseling and testing (13,323 tested by June 2007), prevention of mother-to-child transmission, and management of opportunistic infections and co-infections, particularly TB. The program achieved these results within a short timeframe by training and empowering nurses; ensuring weekly visits to each clinic from MSF mobile medical teams that provide direct clinical care as well as in-service training, support, and mentorship; creating new cadres of community health workers (most of whom are living with HIV/AIDS and are enrolled in the program) to take on HIV counseling and testing, ART preparation, and other clinic support tasks to reduce the workload for nurses; strengthening laboratory and pharmacy capacity at the district hospital; and promoting openness about HIV and community involvement in service delivery. A shortage of healthcare workers threatens further scale-up of activities and makes clinical challenges more daunting, particularly the diagnosis and treatment of TB, including drug-resistant TB. There are fewer than 100 doctors in the entire country, most from other African countries and often awaiting certification in South Africa, where they can get higher paying jobs. In June 2007, over half the professional nursing posts were vacant in the 14 clinics supported by MSF and 30 percent of professional nursing posts at the district hospital were vacant. MSF made an exceptional decision to advocate at national and international levels for health staff. Adequate staff is necessary to expand and improve the quality of HIV-TB care and treatment for the thousands of people in need. MSF has worked in Lesotho since 2006. |
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