By ‘Majirata Latela
Parliamentary social cluster committee chairperson Moshoeshoe Fako has vowed to clamp down on nurses at rural clinics, with an indifferent and sloppy attitude to their work, which puts the health of the communities in jeopardy.
Fako said this during a face-off between the ministry of health and representatives of the community of Kuebunyane in the remote Hloahloeng constituency, which had laid a complaint with the committee. The community was complaining that nurses at Kuebunyane clinic are dedicated to their work and were not treating them with respect and dignity.
The complaint emanated from a March 16 2022 incident, of a heavily pregnant woman who went into labour and delivered her baby on the way to Qacha’s Nek Hospital after allegedly being turned away by the nurse in charge of the Kuebunyane clinic. hospital turned her away to go to deliver at Qacha’s Nek Hospital saying she was to give her first born.
Recounting the events of the day, Tlali Rakoetlane, the father of the young woman who delivered on her way to hospital, said in the morning hours of the fateful day, he and his two daughters-in-law accompanied his daughter together to the clinic after she showed signs of going into labour. It was his daughter’s scheduled delivery date as written in the clinic booklet.
Upon arrival at Kuebunyane clinic, he said, Nurse Julia Madhiri rudely turned them away, telling them to go (on horseback) and wait for an ambulance at Ha Ntoane, which would then ferry them to the hospital at Qacha’s Nek, a four hours’ walk away.
“Julia was inexplicably rude and foul-mouthed. She kept pestering and shouting at my daughter to leave even when she had vacated the clinic. We had to borrow horses and head to Ha Ntoane.
“Two hours into our journey, my daughter went into labour and gave birth right there and then. The pain of watching my child deliver on the roadside was unimaginable. We sought the help of around that place. We received help and had no choice but to go back to Julia’s clinic.
“Upon our arrival, the nurse just examined the baby and proclaimed that it was fine and the mother had no birth-related complications. The nurse gave my daughter contraceptive pills and sent us away. I was very furious. I may not be a doctor, but I could see that my daughter was never going to make it to the ambulance because she said the labour pains were intensifying,” Ramakoetlane said.
In her defence, Julia said when the patient checked in, she examined her and determined that she could safely get to the hospital. She said settled for the ambulance because Lesotho Flying Doctors helicopter had run out of fuel.
She added that, in line with Lesotho’s maternal health practices, expectant mothers do not deliver at the clinic but they deliver at the hospital where there is enough equipment and a doctor.
“What happened with the lady is that she was given the date of delivery by us at Kuebunyane clinic but before we could give her a transfer letter to the hospital, her mother-in-law took her to Hloahloeng clinic. Unfortunately, Hloahloeng clinic also turned her away, telling her to get a referral letter from the clinic where she attended pre-natal care.
“Usually what pregnant women do in these rural areas, is that when they are being transferred to the hospital, they do not go, they wait until they feel the labour pains. Sometimes when they get to the clinic, we are forced to help them deliver even if they are delivering first-borns because we realise, they won’t make it to the hospital either because there is no helicopter to help them or the head of the baby is already near the perineum.
“Even though the policy does not allow it, we sometimes find ourselves having to help first time mothers with their delivery. But we do that after exhausting all options to get the pregnant lady to the hospital. On the other hand, some expectant mothers do not abide by the instructions citing lack of money,” Madhiri said.
She added that the mothers wait until they experience complications.
She said she believed that the young mother would safely arrive at the clinic to deliver. However, she commented that the pregnant lady had precipitate labour which is hard to tell when examining the patient.
Precipitate labour is very quick and short, and the baby is born less than three hours after the start of contractions.
Fako expressed disbelief at the incident and asked why Madhiri did not help the patient deliver “because it was her day of delivery and there was no helicopter to transfer the patient to hospital.”
He said overall the conduct of nurses in remote rural clinics is unacceptable and should be addressed to save the lives of Basotho.
“These nurses in rural clinics are out of order. They are out of order and yet they are there to treat our parents and offer them good health services, but their conduct is simply unacceptable. I have been to Kuebunyane and I have engaged with the communities there.
“There is no way that the community of Ha Ntoane could be lying when it complains about the same thing. The community there also complains about Nurse Julia’s conduct. If we don’t call her to order over her behaviour then we would not be doing justice to the Basotho nation.
“Julia should be reprimanded so that she respects the Basotho that she is supposed to serve. I went there during the Covid-19 and observed a lot of malpractices. I even compiled a report on the conditions I found there. I saw the disdain with which those communities are treated by the clinic,” he charged.
In addition, he slammed rural nurses for behaving like demigods with power over the people.
“They don’t want to work with the already functioning village health workers. I will soon submit a report to the health ministry illustrating the complaints about the nurses at Kuebunyane clinic.”
Kuebunyane Clinic was further accused by the Ntoane community that it does not open on time. It was explained that the clinic opens around 9 O’clock, starts attending to patients around 11’Oclock and closes around 1600hours.
Meanwhile, the minister of health, Semano Sekatle acknowledged cognizance of the conduct of some nurses in rural clinics, describing it as an unfair practice to the people seeking services.
Sekatle said the ministry has learned that such clinics only open three days a week. He ordered Madhiri to stop the practice if that is what she does at Kuebunyane clinic.
