Africa-Press – Lesotho. Growing up in Mokema, Ha-Lebakae, Dr Mahali Ntšasa always wanted to do something challenging and medicine seemed a natural choice. “It is an honourable profession, it deals directly with human life.
And I wanted to impact people personally,” she said. “Also, it was a smart choice for sustainability. I am happy I chose it. I love my job. I would never want to do any of their job.
” She holds a Bachelor of Medicine and Bachelor of Surgery (MBChB) from the Walter Sisulu University, Eastern Cape, South Africa.
Initially, she didn’t want to return home after her graduating as the only lifestyle she could imagine was that of being in South Africa as a medical doctor.
“It was disappointing to learn that I had to come back home and after our arrival we didn’t have enough people training us as interns at Queen ’Mamohato Memorial Hospital (QMMH) as specialists were inadequate.
“My management of patients was quite narrowed because I didn’t have enough investigations to support the diagnosis I could make,” she recalled. In more advanced countries, medical personnel have plenty of resources at their disposal.
She said this continues to be a challenge because at the district level, one is expected to be independent but at the same time there is a need for mentorship which isn’t possible as there is a national shortage of doctors.
“We are very few to support one another and some wards just have one doctor. It’s not supposed to be like that, we need to be consulting each other but we are very few and burdened with a lot of work.
“It’s quite a challenge to work as a doctor in Lesotho because our health system is also burdened with a lot of challenges. It’s not the easiest of jobs,” said the 34-year-old who is in her eighth month as the Mafeteng District Medical Officer (DMO).
After her internship at QMMH, she worked at Motebang hospital for two years before transferring to Ntšekhe hospital, in Mohales Hoek for a year and then joining Mafeteng government hospital as the Medical Superintendent when Covid-19 became a crisis.
Dr Ntšasa didn’t have a smooth upbringing as she grew up an orphan who lost her parents as well as her grandmother who was her guardian at the time in three consecutive years.
“I come from very humble beginnings,” she said. As the seventh child, she and her siblings were raised by their aunt and uncles.
“But I grew up in different houses from my uncle, aunt and my elder sisters when they got married. A lot of people contributed to raising me. ” As a top student, she got a scholarship that paid her fees throughout high school.
“I only struggled with uniforms and cosmetics but food wasn’t a problem since I stayed in boarding school.
” She says she became a top student throughout her lower education; primary, secondary and high school.
“I have always been book smart,” she says.
However, things quickly changed when she got to the National University of Lesotho where she was studying for a Bachelor of Science degree. “I didn’t do well.
I was quite depressed because I wanted to go to Machabeng College for IB. I was sure from Form D that I wanted to study medicine. But I wasn’t allowed to switch to Machabeng after attending the PESP programme at NUL for three months.
So I stayed and I almost failed. ” She said she was then restricted to a single major in physical geography, quite different from what she wanted. “But because God has never forsaken me, I was admitted into MBChB.
” She completed her medical degree in six years.
“My life has been amazing ever since, financially speaking,” she says, laughing. Dr Ntšasa said her main motive was to get an education and work for her bread.
She said she joined the hospital in the middle of the chaos caused by the pandemic. Her biggest challenge was to ensure teamwork amongst doctors and all the clinical staff.
“My reception was quite good as I was a Mosotho and the language was not a barrier.
” One challenge, she said, was that it was her first time in high office.
“Even though I had leadership qualities growing up as I was chosen to be a leader from class monitor, head prefect and the president of Lesotho Medical Students Association. But still it was nothing compared to this,” she said.
“It was a big adjustment for me to deal with issues such as assets, finances, people’s management and having to deal with other people even though I was the youngest in the room outside medicine,” she said.
She said occupying the office was a challenge as the hospital was transitioning to have a quarantine facility. “It was busy and we had a lot of problems with oxygen challenges which led to needless deaths as people succumbed to Covid-19.
“Having to deal with all that at once, including getting used to my new role in a district I didn’t know anyone was a bit challenging.
Fortunately I got all the help I needed from other role players in this fight and we did well. ” Dr Nts’asa says infrastructure is the biggest challenge facing the Lesotho’s health system.
“The hospitals have become so small for the population we are serving – all the buildings are too small to accommodate everyone.
” She says equipment is another problem as there are no CT scans and IMR machines and people have to go to private clinics that charge over M4 000.
“Not everyone can afford that amount and it’s unfortunate as we live in a country with a lot of people suffering from hypertension. It’s very difficult,” she lamented.
Also, Intensive Care Unit (ICU) services are a challenge as they are only available at Queen Mamohato Memorial hospital and the capacity is small with just 10 beds.
“Fortunately, the ministry is working on introducing nationwide critical cares at Mafeteng, Motebang and Berea as we now have oxygen plants at those places and clinicians, nurses and doctors are being trained.
” She says human resources are another problem.
“We don’t have doctors but it’s said the establishment list is full so doctors can’t be hired. We are short staffed. ”
She said the hospital is only left with four Basotho doctors as the contracts of foreign doctors haven’t been renewed. Of the four, one was attending a workshop and the other was off after working for 36 hours.
“It was just horrible and this halted the outreach programme. We can no longer do that because we don’t have enough doctors and it’s not just a case in Mafeteng but it is a countrywide concern.
Without doctors, the hospital might be just a clinic yet this was supposed to be a regional hospital. It should really be stocked with doctors and specialists.
” She said upgrading oneself is a challenge and people are forced to study in their own time at their own expense.
“Study is not happening at the rate that it should be. The country lacks specialists.
It’s just a mess as to why role players don’t push for Basotho to pursue their studies and specialise so that the people can get quality health services and this can only when there are specialists in all relevant fields.
She says “it’s easy” to overcome these challenges: extend hospitals, hire doctors, send doctors to school, buy the needed equipment and pay people what they are worth.
“I really don’t think it’s difficult to address these challenges…we just have people who don’t want to deal with them.
She says she would like to specialise in internal medicine but “my leadership qualities overshadowed everything I was doing clinically and I was needed.
She says since she is now into administration, she plans to take “the office route” by studying public health, business administration or health care management.
“But since I am a clinician at heart, I still believe that if an opportunity comes to specialise in internal medicine I will happily grab it. I would be the happiest person if that happened. ” “However, I also realise that our ministry is lacking in several departments.
It would be wise for me to further my studies so that if an opportunity to work at the ministry’s headquarters presents itself, I will have the right qualifications.
“Most of our bosses in the country are old and the problem is our youths are now more interested in entrepreneurship than holding positions in offices for the betterment of Lesotho,” she says.
She says for her, saving just one life was a milestone as it is something she prayed for when she was still at medical school. “The more lives I save, the more grateful I become and the more I want to save.
If I had to change to clinical practice I would happily do but I am also happy that I have been afforded a chance to be in a big office at my age. I feel honored and privileged and it only means I can go higher from here.
She says she has a supportive environment at home as she is married to a doctor as well. “It’s very nice to have someone understanding and supportive whether clinically or administratively. It indeed makes the journey quite easy.”
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