Tuberculosis (TB)

Open borders

MASERU BORDER POST, Lesotho – South Africa completely surrounds Lesotho, and the flow of people between the two countries almost never stops.

And that poses huge challenges in stopping the flow of drug-resistant TB as well. “One of the main problems here is that if someone gets TB in South Africa and then they move back to Lesotho, they don’t often continue treatment, meaning that TB develops into MDR-TB,’’ said Health and Social Welfare Minister Dr Mphu K. Ramatlapeng.

Palamang Lenkoe plays his cutout guitar outside the remote village of Sekhutlong, Lesotho.
WHO/Dominic Chavez
Palamang Lenkoe plays his cutout guitar outside the remote village of Sekhutlong, Lesotho. His mother, Matsepe Lenkoe, recovered from multidrug-resistant TB after a year of treatment.

She said that health ministers in the region have started to talk about ways to share information in TB control, but acknowledged, “we have not made much advancement so far. Until we do, if one country has a problem with TB, all the countries will have a problem.’’

Lesotho, meanwhile, has taken one small step on its own, hiring the country’s first two border officers to monitor environmental health issues.

But by late 2008, two months into the job, the officers said they had not stopped a single person on health grounds – and didn’t know how they would do so. “It’s not so practical,’’ said Bonang Ntsaole, 23, standing in an office shared with a customs officer who performs livestock checks.

Ntsaole said he and his assistant, Keneude Senoko, have no equipment to test for diseases, nor a laboratory to carry out the tests. They have asked for a nurse, mini clinic, vehicle, protective clothing, gloves, and masks. So far, they have none of them.

They also want to work in collaboration with South African border health officials. But those officials are based an hour away, and come to the border just twice a week. And they themselves work eight hours a day, five days a week. The border is open 24/7.

“People are just coming in and going out,’’ Ntsaole said, “and there’s nothing we can do about it.’’