29th January 2018
Today I started the placement proper. I met Manyanye at the Dolen Cymru/Lesotho-Wales Link office and started to plan how to get to meet the people I needed to see. Lesotho is a country where they like to do things properly – in some ways. Most professionals will not speak to you unless you have spoken to their superiors and got their permission. So the first task was to speak to Mme Lethema, the Director of Mental Health for Lesotho. In order to get her number to achieve this Manyanye phoned her husband to get her number. She answered Manyanye’s call and although I have no idea what the discussion entailed as it was in Sethoto she agreed to see me that afternoon. This was a bit of a surprise as if you tried to organise a similar meeting in Wales you would be lucky to get an appointment in the next month. Its not what you know, it seems.
The meeting was at the Department of Health in Maseru. Once we had tracked Mme Lehema down and introduced ourselves to each other she kindly started to explain the mental health system in Lesotho. For many people the first port of call when there is a problem is to visit the traditional healer/diviner and the chief. Before I left Wales I was informed by a very erudite gentleman that traditionally the Basotho has two allegiances. The first is to their local community and the second is to their “clan”. Only if this approach does not bring results will the individual and their family seek help from “western” medicine and even then they will continue with traditional treatments alongside the western ones. As a result the government run health system has to take tis into account.
The mental health system has four levels and starts with the Village Health Worker, a volunteer with some training who supports their local village. When the problem is beyond their competencies, the person is referred to the local clinic, which is staffed by general nurses. These in turn feed district hospitals which have a broader range of staff including a Community Psychiatric Nurse (CPN). District hospitals have local observation units for people mental health issues in which there are 6 beds for men and 6 for women. There are 10 district hospital in Lesotho making 120 “community” beds and then there are another 120 beds in the Mohlomi Psychiatric Hospital. These are divided into forensic unit, older adults unit and two adult wards.
There is much more to learn about this system and I hope and expect to learn more as the weeks go by.
Really enjoying this blog, interesting to see how other health systems function.
Amazing and informing Owen – keep writing as much as you can!