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Lesotho

Acute shortage of ENT specialists

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By Neo Kolane

The government is reportedly facing a severe shortage of Ear, Nose and Throat (ENT) specialists which has in some instances led to misdiagnosis of patients, disability, and death.

Health professionals this week put the blame squarely on the ministry of health, which they accused of delays in appointing specialists or renewing contracts of those employed by the government.

So grim is the situation that the government only has two ENT specialists, according to the Lesotho Medical, Dental and Pharmacy Council.

The council’s president, Dr Kopang Mohalenyane, said Lesotho currently has only two registered ENT specialists, based at Queen ‘Mamohato Memorial Hospital (QMMH).

Mohalenyane, who is also a medical officer at QMMH, noted that this shortage inevitably results in poor health services.

He also indicated that with the two specialists based at QMMH, patients in the districts are only attended to by general practitioners.

To make matters worse, such medical officers cannot perform surgical interventions on patients if the need arises, Mohalenyane pointed out.

He said some of the patients are forced to go to QMMH where they are greeted by long queues.

He further indicated that most ENT patients do not seek medical attention unless their condition gets worse, like having difficulties in breathing or when they are unable to swallow food.

“It means when they eventually go to hospital, they need undivided attention but due to long queues, they are booked and given a much later date, sometimes months away. This obviously becomes a burden to them,” he said.

Mohalenyane also pointed out that the plight of patients was not improving because the government does not have a clear plan to help or encourage Basotho doctors to further their studies or specialise in areas such as ENT.

The fact that Lesotho does not have a medical school does not help matters.

“Some doctors remain general practitioners while others choose to study online but this is not very effective because there is no interaction with patients. Besides, they’ll not be considered as specialists,” Mohalenyane said.

Demonstrating the magnitude of the shortage of specialists, he pointed out that some patients had lost their lives at government hospitals while waiting to get medical attention.

Others are misdiagnosed due to lack of expertise in the districts.

“All this leads to a poor health outcome,” Mohalenyane showed.

ENT doctors, also known as head and neck surgeons, focus on a number of medical specialties and various sub-specialties including paediatrics, oncology, sinus disease, and surgery. Other ENT disorders include hearing loss, vertigo, acid reflux, as well as cancers of the ear and nose.

An audiologist at Queen Elizabeth II Hospital in Maseru told theReporter in an interview this week that they were currently not helping ENT patients because there are no specialists.

The audiologist, Mpolokeng Thakaso, said they used to receive between 40 and 70 ENT patients per day some years ago and these would be attended to by one specialist, who has since left the hospital because his contract was not renewed by the government.

Currently, the hospital does not have any ENT specialist, she pointed out.

Thakaso said a specialist from Bangladesh, Dr Shaheen Sarwar, was using his own equipment since he arrived in the country in 2019.

“Now he is currently at his home here in Maseru because his contract has not been renewed by the government despite promises to do so since May this year,” she noted.

“Right now, we are stranded. We have been waiting to be assisted by the government for almost seven months but nothing has materialised yet in terms of getting specialists.

“When we ask, we are told that the Public Service Commission has not processed his contract (Sarwar). The question is if the matter is essential, why is Sarwar not told to continue with his work while waiting for his paper work to be processed, just like it is the case with other specialists?” Thakaso quizzed.

Thakaso also said the shortage of ENT specialists has far reaching negative effects on the health of patients.

She cited that when a patient has cysts in the ear that are not treated in time, their ear drum might be damaged and this will affect their hearing. This can even lead to death if the cyst drips back into the ear drum.

Thakaso further recalled an incident where a patient with a swollen neck died at Queen II because there was no specialist to assist him.

“When it comes to ENT, the ministry of health does not seem to show interest,” she said.

Efforts to get a comment from health minister Selibe Mochoboroane on Wednesday this week during the official unveiling of an oxygen hub at Mafeteng Hospital were not successful.

Yesterday (Thurs) his mobile phone rang unanswered several times when this publication called him.

The director of health services, ‘Nyane Letsie, earlier this week said she was not the responsible official to comment on the matter.

She referred this publication to the ministry’s public relations officer, Tumisang Mokoai, who promised to forward our questions to the relevant authorities. However, there was no feedback yesterday by the time of going for printing.

A patient who is experiencing ear pain, Tiisetso Melao, said she is having trouble hearing and sometimes her ears feel congested.

Melao said sometimes she hears buzzing sounds and becomes dizzy; she also has a yellowish discharge from her ears.

She said she went to Queen II on Monday this week and was told there were no ENT specialists.

She therefore, could not proceed to QMMH since she did not have a referral from this hospital.

“Queen II staff dismissed me saying my ear problem was not major. They couldn’t even give me a referral letter to take to QMMH,” Melao claimed.

Investigations by theReporter have also revealed that Motebang hospital in the Leribe district does not have ENT specialists either.

Sources at the hospital said patients are attended to by general practitioners.

They said foreign doctors who left after their contracts expired and were not renewed by the government have not been replaced.

“It has been three to four years now since we have not had any ENT specialists,” a source said.

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