From Wales to Lesotho: A Life-Changing Global Health Journey 🌍
Hi all, we are Dr Jenna Crosbie and Dr Rachel Price, both GP trainees in Wales. We’ve been lucky enough to have recently visited Lesotho as part of an 8-week HEIW Global Health Volunteer Programme in association with Dolen Cymru. This is a new programme started this year, and we were the first volunteers to take part. It was entirely self-funded, and we were given freedom to organise our time and efforts whilst out there; we tried to see as many different healthcare settings/projects and different aspects of the country as we could. Overall, it was a fantastic experience.
We spent most of our time in Hlotse, Leribe, based at Motebang Government Hospital. We attended the doctor’s morning meetings, the wards (mainly Paediatrics, Neonatal, Maternity, and Casualty) and the outpatient department (mainly Medical, Surgical, Paediatrics, and Gynaecological clinics). The staff there faced challenges we could never have anticipated, and it was amazing to get to know them and see cases with them. Staff asked us to update the hospital admission proformas for adults, children and neonates. We reviewed documentation guidelines and observed the use of pre-existing proformas, identified helpful/unhelpful features as well as communication gaps, and presented at the doctor’s meetings to gather staff feedback and show our ideas. Following this, we created all three proformas, which were presented, revised, piloted and are now being rolled out in the hospital. We left the soft-copy files with local staff, and they plan to update and adapt them as they wish over time.
The Lesotho-Boston Health Alliance is an organisation based at Motebang hospital that runs a post-graduate medical speciality training programme in Family Medicine. They also organise outpatient clinics for chronic disease (e.g. diabetes, hypertension, epilepsy, and chronic mental health conditions) in their Centre of Excellence. We were lucky to join in with some chronic disease clinics and post-graduate teachings about HIV, TB, mental health and family dynamics. We enjoyed discussing the similarities and differences when practicing and training in family medicine in Lesotho as compared to Wales. We also went out on outreach visits to a factory manufacturing jeans and to a school/care home for children with disabilities. We helped with basic health checks for staff and children (BP, BMI) and treatments like deworming and health education.
We spent a week shadowing at Senkatana Oncology Clinic in Maseru. This is the only oncology clinic in the country, and it was common to see patients with very advanced disease and late presentations/diagnoses. They have a small team of doctors, nurses, counsellors, pharmacists and a passionate dietician (in Lesotho, many people grow their own food, so the dietician has a degree in agricultural studies and also gives gardening and farming advice). There is a lab within the clinic where they can make up and give certain chemotherapy regimes. Despite these services, many patients are required to travel to South Africa to receive cancer treatment, so passport applications and bureaucracy form part of clinic life. We could see the impact that recent cuts to foreign aid were having on local people, particularly with regard to large-scale loss of employment and disruption of healthcare services (e.g. HIV prevention work and cervical cancer screening).
Through the links provided by Dolen Cymru, we were able to visit some inspiring projects, including HOLO in Morija, Najojo’s project in TY, and cerebral palsy home visits (and support groups/APT chair provision) with physiotherapist Jan Jeffrey. It was incredible to see the impact these projects are having on patients and the wider community. We were lucky to meet the Palliative Care Works team, who were giving palliative care training courses in Maseru. They had lots of insights from decades of experience working to set up and support palliative care services in many different countries. We visited the site where the new Starlight Hospice is currently being built, and met the inspirational project organiser, Dr Paul Myres and palliative care nurse Tobello. We helped create some documents and leaflets needed for the new hospice. We also met schoolteachers and pupils from Wales and Lesotho and heard lots about their experiences through Dolen Cymru.
On the weekends, we attended museums, cultural sites and natural wonders to build our understanding of history and culture in Lesotho. We also attended the Dolen Cymru St David’s Day event in Maseru. The power of the link between Lesotho and Wales felt surreal at times, particularly when some school children in Hlotse passed us in the street and shouted “Shwmae” instead of “Hello”! Socialising with new friends we made in Lesotho was great fun, and we are so grateful for the welcome we received everywhere we went. Thank you to HEIW and Dolen for facilitating this life-changing experience. We’ve learned so much and we look forward to staying involved in the future.
