In its commitment to support Lesotho’s efforts to reduce the spread of HIV and Tuberculosis (TB), Jhpiego has since broadened its Voluntary Medical Male Circumcision (VMMC) services under a three-year project codenamed THEBE.
THEBE is an acronym for Prevention of HIV and TB in Lesotho through Evidence-Based Interventions and Education
THEBE commenced in July 2018 and is scheduled to end in June 2021.
Those who undergo VMMC substantially reduce their chances of getting infected with the Human Immunodeficiency Virus (HIV) the lentivirus which, over time, causes the Acquired Immunodeficiency Syndrome (AIDS). No medical cure has yet been found for AIDS hence the importance of preventing HIV-infections.
According to THEBE Director, Dr Semakaleng Phafoli, the project is being implemented in the sustained (with low HIV prevalence) districts of Mokhotlong, Butha-Buthe, Quthing, Qacha’s Nek and Thaba-Tseka.
“Under THEBE, we are working in hospitals and also our VMMC-providers take services to the community. We also have programmes that focus on HIV and TB, which are TB Contact Tracing and Clinical Mentorship,” she said.
Dr Phafoli explained that TB Contact Tracing is where Jhpiego workers reach out to the community, screen residents and if they are found to have TB, transfer them to a health facility and put them on treatment.
“Since we started engaging TB Contact Tracing, we see an increased number of TB cases as we all know Lesotho is having a high TB-prevalence, as much as we have a high HIV-rate,” Dr Phafoli added.
Reports show that Lesotho has the second-highest incidence of TB in the world, estimated to be 724 cases per every 100,000 people. Approximately 73 percent of these patients are co-infected with HIV.
“We currently have 41 people who have been found to have TB and are now enrolled into TB treatment and care,” she said.
Jhpiego reports that in the aforementioned districts, a total of 2142 people have undergone VMMC, with Dr Phafoli expressing confidence in the positive impact their initiative is having on the community.
However, Jhpiego is not only focusing on VMMC and TB services as the organisation is also running a Pre-Service Education Programme, which is specifically supporting nursing education in Lesotho.
The organisation is working with nursing schools to ensure students are placed at health-centres to acquire the necessary experience of their chosen profession. This project, according to Dr Phafoli, has been very successful.
“We know that in order to attain universal health coverage, as well as Sustainable Development Goals (SDGs), we cannot succeed without strengthening nurses because they are mainly the primary care people found in all the healthcare services,” said Dr Phafoli.
“Today, we have more than 2000 student-nurses who have been placed in health-centres and they have acquired a great deal of competence on managing clients with TB and HIV.
“We are also supporting the Lesotho Nursing Council (LNC) because we know this is the institution which ensures that nurses are well-trained and competent to provide quality services to Basotho.”
Dr Phafoli added Jhpiego had also strengthened the LNC to produce the necessary policies that could guide it to ensure Lesotho produces quality nursing graduates.
“By strengthening the Council, it means we are ensuring the product our nursing schools produce is the one we need in order to be able to fight against diseases or to be able to ensure that there are preventative disease, curative and rehabilitative services provided to Basotho,” said Dr Phafoli.
She also commended the Ministry of Health for its intention to engage about 250 nurses “because Lesotho currently has a great shortage of nurses in health-centres, as well as in the hospitals.
“That is why our healthcare services are really not that good because there is a shortage of manpower, particularly of nurses.”
Another new programme Jhpiego is implementing is CHATSI, which is also working in the five sustained districts but focusing on inmates.
According to Dr Phafoli, CHATSI supports the inmates to ensure they are screened for TB and HIV and are on treatment if found to be infected.
“As we all know, testing for HIV is still voluntary. With CHATSI, we also encourage inmates to know their status and enrol into ARTs if infected.
“What is key under CHATSI is we make sure these inmates, when they are released from prisons, as they go to the community, they find a community which is receptive to them. It also ensures they are linked to nearby health facilities so that they continue with their treatments for both either TB or HIV.”
She further explained while engaging with the inmates, Jhpiego starts by involving the management to ensure the programmes are effective.
“We first get the buy-in from the prison management, involve them, and make sure we capacitate them so that they continue even in our absence.
“We make them understand that it is important to prevent and minimise HIV and TB infections within the inmates, as well as ensuring that when they go out, not only them or their families are predisposed to the infections.
“However, since HIV-testing is voluntary, we still come across inmates who are not willing to test, even after we have educated them.”
Dr Phafoli continued: “We are all ambassadors to encourage people to know their status because the more you know your status, the more you know what action to take.
“The community is still having that stigma against HIV-positive people, as much as we still address that issue through health-education and encouraging them to talk about their status.
“When it comes to community-engagement in the support of HIV-positive inmates, we identify where they come from so we can be able to know their family members and the nearby health facilities so that such patients freely continue with their ARV treatment even while at home.”
Meanwhile, Jhpiego Programs Management Officer, Jennifer Berg says other initiatives implemented by Jhpiego Lesotho in an effort to fight and reduce HIV and TB infections include Pre-Exposure Prophylaxis (PrEP) and TSEPO, which is under KHOTLA (PEPFAR-funded project).
PrEP is an antiretroviral drug taken daily by HIV-negative people who are at substantial risk of being infected by the virus.
“PrEP reduces the chances of getting HIV-infections by 90%,” Berg said.
Berg also said the KHOTLA programme focuses mainly on male services that include HIV-testing, TB-screening and diabetes, among others. TSEPO is focusing on the five priority (with the highest HIV prevalence in Lesotho) districts of Leribe, Berea, Maseru, Mafeteng and Mohale’s Hoek
She further said during this winter school holiday, Jhpiego is embarking on campaigns for VMMC. “The idea is that as we are targeting young people, a lot of our clients for VMMC services are learners. So now that the schools have closed for winter, this will be an opportunity for them to get VMMC services and heal while still at home,” she said.
Berg further reaffirmed Jhpiego’s commitment in supporting the wellbeing of Basotho. “We encourage all males to visit health-centres frequently. Jhpiego is committed to supporting Lesotho to fight HIV through both PrEP and VMMC.” Jhpiego started operating in Lesotho in 2009.