The Lesotho Highlands Development Authority (LHDA) has come under fire over a sharp increase in teenage pregnancies and sexually transmitted diseases – including HIV/Aids – in the town closest to ongoing construction work on the Polihali Dam.
Realeboha Tlhabi, nursing officer at the health centre in the town of Mapholaneng in Mokhotlong, pointed a finger at workers involved in dam construction under Phase II of the Lesotho Highlands Water Project, which the LHDA is overseeing.
The project aims to provide water to South Africa, Gauteng Province by storing waters of the Orange River (Senqu) and Khubelu River. This is accordance with the 1986 agreement between the two countries.
The project is estimated to cost at least M23 billion.
“There might be other factors but construction workers are mainly responsible,” Tlhabi said, adding that he had seen young girls selling sexual services on the side of the road in Mapholaneng.
“I have witnessed girls of 15 to 17 years marketing their bodies to the construction workers. When transferring patients to the district hospital at night and early mornings, I see young girls in miniskirts on the roadside and we all know why they are there and what they are doing,” he added.
He said that the health centre had seen 80 teenage pregnancies since November to July, an increase of 31% from 61 in November 2018 to July 2019. It had also recorded seven new HIV infections and 19 other cases of STDs among pregnant women in the town since the beginning of the year.
The age of consent in Lesotho is 16 years old meaning that much of the sexual acts are unlawful.
Tlhabi said the LHDA had a responsibility to explain this to its employees and to ensure that they use condoms. “Teenage pregnancies and the rate of infections can only increase if contraceptives are not taken seriously,” he told MNN.
However, the authority denied the allegations. The authority’s chief executive, Tente Tente, said the claims are not new and have been discredited by a recent social impact study finding that there is no connection between the project and the rise in adolescent pregnancies.
The LDHA’s own 2019 health impact assessment found that Mokhotlong has a high rate of school dropouts and early and child marriages, as well as a 24% teenage pregnancy rate and an HIV/Aids prevalence rate that is 3% higher than the national average.
Tente said this was “a pre-impact status”, but added that the rate of negative impacts was expected to increase “as a result of the influx of people into the project area. The LHDA is addressing this as part of the public health programme.”
He said the authority’s mitigation strategy includes a comprehensive school health programme “which will be done in collaboration with relevant stakeholders”.
“A number of awareness meetings have been held in schools around Mapholaneng, the Polihali communities and communities along the Polihali Western Access Corridor on the Katse side of the Phase II area between 2019 and March 2020,” he said.
He added that Phase II service providers and their employees are expected to abide by all the laws and regulations of Lesotho.
According to the Lesotho Demographic Health Survey report of 2014, Lesotho’s health ministry has no coordinated system for the distribution of condoms and no standard guidelines or publicly available documentation on their use.
The impact of the Lesotho Highlands Water Project on sexual and reproductive health in the surrounding areas has previously been documented in the first phases of the authority.
According to a report in the Archives of Internal Medicine published in 1995, there were no reported cases of HIV/Aids in Lesotho until HIV-infected construction workers arrived during Phase I.
The report said that by 1992, the HIV infection rate in the villages around the dam stood at 0.5%, while the rate in the work camps were more than 20 times higher.
In the nearby town of Leribe, the rate among those aged between 15 and 24 years jumped from three percent to 12.6% in 1993. According to the 2014 Lesotho Demographic Health Survey, the Mokhotlong area had the second highest teenage pregnancy rate in the country, of 24% of girls between the ages of 15 and 19.
One of the victims of the first phase of the project, centrally involving the construction of the Katse Dam, was ‘Manteboheng Ndaba from the Khokhoba municipality.
Ndaba fell pregnant at the age of 18 years during the last year of dam construction. She said the man who made her pregnant did not use contraceptives.
In 2010, African Institute of Southern Africa confirmed the public health impact of the water project, noting the widespread prevalence of STDs and an increased likelihood of HIV/Aids infection in surrounding communities since the project started.
Research in 2004 found that the residents of Ha Theko in Katse were deeply concerned about the rapid spread of transmissible diseases, particularly HIV/Aids, in conjunction with the project.
Another research study found that a striking 33 of its research subjects – more than 90% of total – mentioned the increase of HIV in the community as a negative impact of the construction of the Katse dam, and that this was most often discussed in relation to a change in the teenage behaviour.
The Mokhotlong district education officer, ‘Mabataung Metsing, said his office had received informal reports that girls in still high school are associating with men working on the Polihali construction site. Metsing said the lockdown had cut short ministry plans to collect data and plan mitigation strategies.
“It is apparent that there is still more that we and the LHDA need to do to keep our children in schools,” she said.
Mophalaneng High School principal Tiisetso Pae said that the LHWP team in Polihali had visited the school earlier this year to warn students against having sex with workers during the construction season.
Chabeli Monyake, Skills Share’s Mokhotlong district manager, confirmed that there are sex workers as young as 15 years in Mapholaneng and that the number of girls and women providing sexual services is rising. He could not provide numbers.
Skill’s Share is a local volunteering and development organisation which works among other things with commercial sex workers, advocating for their rights and well-being in Lesotho.
“Younger sex workers are particularly exploited, selling sex for as little M10, for data or rent,” Monyake said.
Serame Linake, Mokhotlong district administrator, commented that while unemployment and poverty are driving the sex trade, the LHDA too needs to enforce policies that lower the social impact.
“You will hear girls say they have been affected by the project (re amehile ke morero)” Linake said.
‘Manthabiseng Khoale, a mother of three living in Mapholaneng, told the MNN that when her daughter asks for money to buy data, “I tell her I only have enough money to buy the next meal.
“Next thing you know, she has enough data for the whole month after being away from home all night.”
Tente said the LHDA’s public health programme is designed in such a way that health service provision remains the responsibility of the health ministry, with the LHDA providing support and oversight.
This had not been the case during Phase I and the major challenge encountered then was “the collapse of project interventions following the completion of construction”.
He said that contractors may have their own codes of conduct and are required to have robust HIV/Aids policies that promote infection prevention and adherence to treatment, as part of their occupational health and safety plans.
In addition, the authority undertook a study in 2014 to that determined the baseline health of the affected communities and the level of existing health services in the project area. It had also performed a health impact assessment in 2018-2019.
“LHDA will implement a comprehensive public health programme, which will address the health impacts of the project on the affected communities, including adolescent girls,” he said.