Twenty-six-year old Palesa Moholei has been forced to stop going to Queen ‘Mamohato Memorial Hospital (QMMH) because of the unavailability of compression/elastic socks which she needs for her condition.
Moholei was diagnosed with Lymphedema in 2016. This after she inexplicably had developed a swollen leg in 2015. However, the swelling went away just as quickly as it had come, so she did not think much of it.
Lymphedema is an abnormal swelling that develops when the lymphatic system is damaged or overwhelmed and can’t clear lymph fluid fast enough, causing it to build up.
Lymph is a thin, clear fluid that circulates through the lymphatic system removing waste, bacteria, and other substances from the body’s tissues. Edema is a build-up of excess fluid.
Lymphedema signs and symptoms include swelling of part or all of the arm or leg, including fingers or toes, a feeling of heaviness or tightness and restricted range of motion.
Moholei has been living with lymphedema for close to 10 years and has not received any help.
The mother of a six-year-old daughter explains that she survives by selling leafy vegetables on the side of the road at Ha Mantṥebo in Maseru.
She said she was given compression socks when she first went to QMMH for consultation when the hospital was it was still under the management of the Tshepong Consortium.
Her whole right leg is swollen.
“I used to receive those socks in the beginning, but encountered difficulties when the hospital ran out of stock in 2019; I have not been able to afford them since.
“This discontinuation of treatment likely contributed to my condition deteriorating, as I’m still am unable to buy those socks. In the meantime, my leg keeps swelling,” she explained.
Moholei currently lives with her daughter since the child’s father works in South Africa.
Eking out a living involves physically demanding work, such as selling vegetables by the roadside.
“This sometimes aggravates my condition, as it limits my movement when I need to move fast to sell my wares to passing motorists or passengers. Also, I cannot stand for long periods, as this causes blisters and pain in my enlarged leg.
“When my sick leg is not painful, I try to make ends meet by selling leafy vegetables by going house to house.
“I have made peace with this disease; I just need help to treat or manage it,” she said.
Moholei was advised not to have another child as this could prove detrimental to her general health. She had her child when the lymphedema was in its early stages.
And as a young impecunious mother with little familial support, managing her health while providing for her daughter is proving to be a real burden.
“I need access to affordable or subsidized healthcare, and ongoing support in managing my lymphedema,” Moholei indicated.
The Lesotho Medical, Dental and Pharmacy Council’s president, Dr Kopang Mohalenyane, told this publication that lymphedema indeed requires ongoing management, typically involving compression therapy among other treatments.
Mohalenyane who works at QMMH said it is in rare cases that they receive patients with lymphedema.
He noted that QMMH does not have compression socks anymore.
“Before the hospital was handed over to the government, it was able to stock up on the socks as it was money-oriented.
“This decision appears to be based on usage rates and cost considerations rather than urgent medical need.
“Anything that is hindered by the government shows that it is not a sense of urgency to them,” Mohalenyane said.
He points out that in cases where lymphedema progresses to a severe stage requiring surgical intervention (such as vein or lymph node surgery), the necessary skills and facilities are not available in Lesotho. Patients may need to travel to Johannesburg, South Africa, for such specialized care.
Mohalenyane advises patients with lymphedema not to expect adequate help at QMMH and suggests seeking assistance elsewhere, particularly in Johannesburg, for more advanced treatments.
