Let me back-track and explain the purpose of our trip to Lesotho. Bear with me because this will take time.
On a map, Lesotho looks like a small dot in the middle of South Africa. It’s nick-named “the Kingdom in the Sky” and is one of the few places in Africa where it snows. Lesotho’s Maluti Mountains are among the highest in Southern Africa – many peaks are over 10,000 feet.
These mountains are scattered with villages that are inaccessible by car, especially in the winter when the roads (I use the term “road” loosely) are covered in snow and in summer when they are washed out by rain. These conditions create obvious challenges, one of which is access to healthcare. There are health clinics in the mountains, but often the health workers can’t make it down the mountain to get the supplies they need for their patients. This is not a good thing in a country with intense poverty, sky-high levels of malnutrition and maternal/infant mortality, and the third-highest HIV prevalence in the world.
The best way to get around Lesotho – especially in mountainous areas like the Mokhotlong District – is by horse. The Basotho people breed special horses called Basotho ponies – sturdy animals that can carry heavy loads under harsh conditions. So, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and the Lesotho Ministry of Health (MOH) started a program that uses horses reach the health clinics in the sky.
EGPAF contracts with horse-owners in the community to pick up blood samples from remote clinics and transport them to larger health facilities, where the blood is tested for HIV, TB, syphilis, and other conditions. The horse-riders also deliver medications and supplies to the clinics when needed. Sometimes they even carry written messages between clinics because cell phones are unreliable.
The program is called Horse-riding for Health. Joe and I went to Lesotho to tell the story of this program.
Last Tuesday, we drove six hours from Maseru to the Mokhotlong district with EGPAF Country Director Dr. Leo Buhendwa and another EGPAF staff member. The drive was harrowing – I’ll have more to say about that in another blog. For now I’ll skip to our time with the horse-riders in Mokhotlong.
We woke up at 5:30 on Wednesday. I walked onto the balcony behind our hotel room – the sky was just starting to lighten. It was completely quiet except for some roosters crowing and a lone man singing in Sesotho. It sounded beautiful to me but I wonder if the man’s neighbors agreed.
At 6:00, we took off in a pickup truck with Nkalai, an EGPAF driver, and Libuseng Kalaya, the nurse in charge of EGPAF’s program in Mokhotlong. Our destination was Polomiti Village, where two of the horse-riders live.
We took the paved road out of Mokhotlong and drove for about 40 minutes until we reached the town of Mapholaneng. Joe took pictures through the windshield as the sun rose against the mountains. It’s the dry season; the mountains are uniformly brown except for scattered explosions of pink where the cherry trees are in full bloom.
At Mapholaneng we turned onto a dirt road. Then there was no road at all, just huts and animals and people. We drove over boulders and streams. Occasionally Nkalai stopped the truck and got out to make sure the way forward was safe.
Finally we spotted Polomiti on the other side of a small valley. Joe wanted to get there quickly before the sun got too bright. We got out and walked the rest of the way.
We arrived in the village and greeted Potso Seoete, the horse-rider we would be following for the day. Potso is 30 years old and lives in the village with his mother, his wife, his young child, and of course, his horse. I asked Potso what his horse’s name was; he said he didn’t have one. But he came up with a name later that day: Rooikat. (“Rooikat” is the Afrikaans word for a lynx with reddish-colored fur – the same color as Potso’s horse.)
Potso is the horse-rider assigned to the Molika-liko health clinic. Several times a week, Potso and Rooikat leave home at 7:00 and ride four hours up to Molika-liko. Lucy, the head nurse, gives Potso the blood samples taken that day. (The samples must reach the hospital lab within six hours of when they were drawn in order to yield reliable results.) Potso then rides back down to Mapholaneng, where he hands his delivery to a man on a motorbike. The motorbike takes the delivery to Mokhotlong Hospital, where the blood samples are processed in the lab.
Joe wanted to document every aspect of Potso’s journey between home and the clinic. We spent an hour at Potso’s homestead, watching him feed and brush Rooikat and prepare to leave. We then followed him to the home of his friend Tlala, another EGPAF horse-rider. We walked with Potso and Tlala until they parted ways for their respective clinics. Then we got in the truck, which was waiting at the top of a steep gully, and headed back to Mokhotlong for breakfast.
At 10:30 we set off on a 90-minute drive to the Molika-liko clinic. Fortunately the road was dry and there was no snow, so could reach the clinic by truck. Molika-liko clinic is a tiny building with a few thatched huts around it. It might as well be in outer Mongolia, or on the surface of the moon; there is nothing for miles around except desolate brown hills.
Potso and Rooikat arrived a few minutes after we did. Potso went into the clinic to pick up the blood samples – the patients in the waiting area stared at us curiously. Task complete, Potso got back on Rooikat and headed down the mountain. That turned out to be the last time we saw him.
Another bumpy ride back to the hospital in Mokhotlong, where Joe photographed the motorbike riders coming in with the blood samples collected by the horse-riders. Then he took pictures in the hospital laboratory, where technicians process the blood samples.
Our story was complete by 4:00 p.m.
Late afternoon is the best time of day for taking pictures, so Joe and I left the hospital to see what we could find. On the outskirts of town we came across a group of children jumping rope with several tattered pieces of cloth tied together. Joe squatted down among them with his camera and they had a grand time together for about 15 minutes. I enjoyed the scene.
Back to the hotel, exhausted. Our hotel was an interesting place – more on that later. I’ll just say now that the stars are brighter in Mokhotlong than anywhere I’ve ever been on earth.