Week 1 Blog: The challenges ahead (31/1/16)

Hello from planet Lesotho.
Nothing seems to have changed since I was last here in 1994. It is as hot and crazy as ever, except everyone in Maseru is now attached to a mobile phone.

My own in country phone has given me much grief since I was issued it, primarily because with my eye problems I can't see to operate it. I feel a bit like a secret agent with all the people I am supposed to stay in contact with, I'm sure James Bond never had these problems. I had a weird experience of topping it up (a first for me) from a street vendor who issued me with a scratch card. I have no idea how this worked but it did.

This first week has been spent with Ma who is the program coordinator for Sentebale, the charity that I am working for. It supports Lesotho's most vulnerable children by working with various care partners, some of whom I have visited this week. On Monday, I will start work for St Angela's home for disabled children. It is run by a nun called Sister Augustine.

There are about 30 children there and I will assess their physiotherapy needs and set up a program for them to be incorporated into the daily activities of the orphanage. When I told the staff that they would all be involved in this they seemed amazed. They thought physiotherapy was something that happened once a week with a physiotherapist who did something with a child and then disappeared.

I will live at St Angela's for the next two weeks so I can spend more time with the children and help them with their activities of daily living. I haven't met the children yet as they were all at school. I feel sure I will get on with the staff and we will achieve good things. I'm not sure about me and Jesus, particularly the pictures of him on the front and back of my bedroom door, but I will practice religious tolerance :)

Yesterday, I went with Ma to visit Phelisanong orphanage, which will be the next place I go after St Angela's. It is set right out in the middle of nowhere in the Lesotho highlands. The surroundings are stunning, but it became quickly apparent the orphanage has many challenges. There are over a hundred children there, a number who are profoundly disabled.

We went into one of the houses which had over twenty children in it, two to a bed. Some were lying twisted on their beds; some were crawling around on the floor. There were two house mothers feeding two children lying flat on their backs. I was wondering how they weren't choking and how long I could stand the heat, smell and inertia of a place where life appeared to have stopped.

One child, of about three, with a normal head and body, but grossly swollen limbs, came up to me and obviously wanted to sit on my lap. Nobody knows what's wrong with her and she was abandoned by her mother. When I tried to pick her up I hadn't calculated that due to the swelling she must have weighed at least 6 stone. I managed to lift her on the second attempt and she sat happily on my knee while I tried to work out where to begin.

I told Ma that I didn't think I could work very effectively in such a chaotic atmosphere. She said, "Don't worry, we will have a physiotherapy room".

We went to see the proposed physiotherapy room which appeared to be a shed with some rusty animal feeders in it. I was wondering how I could adapt the feeders into useful physiotherapy equipment, but Ma said Sentebale will buy whatever I need and asked me what I wanted. At that moment the first thing that came into my head was sterile wipes, closely followed by hand gel, plastic aprons, soap and water. The hygiene at the orphanage appeared very limited and I had become acutely aware of all the children that had touched me, that I hadn't seen a sink, or had a chance to wash my hands, I had a small cut on my finger, and some of the children were HIV positive.

I repeated the soap thing several times, before moving onto some floor mats, a small bench and table. We agreed the rusty bits of metal will go and I will make a more comprehensive list later. We went to look at a small hut up the track, where I will probably stay, but the door was locked. The view was breath-taking and I'm sure it will be fine. There is no Wi-Fi here and I will have to work out the mystery of a dongle if I want to stay connected, but that seems the least of my problems.

On the bright side, there is a young social worker here who seems very enthusiastic and I hope I will be able to train her up to oversee the physio when I've left. Also, any input will be more input than at present. Ma is very keen to make physiotherapy available to all the disabled children they support and keen to incorporate physiotherapy into the child care index they use. She is open to ideas, flexible and very easy to work with. In view of what we have seen and discussed in the last two days  this is just as well and my schedule has already changed several times.

It was a long hot drive back to Maseru. I am chilling this weekend at the guest house that I am staying at whilst contemplating the challenges ahead.

…

Reflections:

During the first week I had seen every kind of child with disabilities that Sentebale worked with, blind, deaf, speech impairments, and a whole spectrum of physical and mental problems. I was concerned after my visit to Phelisanong.  I have never felt a calling to work with people with learning disabilities. Now I was faced with the prospect of working with dozens of such children in the most primitive conditions. How was I going to unlock their minds and communicate with them? What was I going to do with their twisted bodies? Why were they being fed on their backs? 

The orphanage was located out in the wilds of the Leribe district, set in a rough circle, with huts and a path around the outside. In the middle were some gardens where vegetables were grown, an outdoor kitchen, and a few cattle tied up with ropes. There were also some commemorative headstones. I couldn’t see what was written on them, but I had the uncomfortable thought that some of the children that had died were being buried in gardens, next to the vegetable patch. I didn’t dare ask anyone to clarify this and pushed it to the back of my mind along with all the other disturbing questions I had about Phelisanong.

I decided I needed to clear my head and took a trip out to visit Tabu Bosiu. This mountain was King Moshoeshoe’s, stronghold for his people during various wars against other tribes, the Boers and the British. The name Tabu Bosiu, translates as “mountain of the night”. It reflects a local belief, of that time that the mountain grew at night and shrank during the day, leaving enemies stranded on its cliffs. Whatever the qualities of the mountain, it seemed to have worked in the Basotho chief’s favour. He had defeated many enemies in his reign, and become the founding father of the Lesotho nation.      

I took a taxi out on Saturday afternoon. Tabu Bosiu, isn’t far outside Maseru and you pay for a guided tour to the top. Fortunately, the guide had already left with a group, so I paid and went up by myself. I much prefer to explore alone. It was hot and the sweat trickled down my back as I made my way up the steep path, occasionally stopping to check the view and take a picture. It took less than an hour to get on to the plateau and find the remains of the village where King Moshoeshoe lived and the graveyard where he was buried.

I stared at the magnificent shrine for some time, before I realised it belonged to King Moshoeshoe II. I cast around trying to find his predecessor. There were random graves all over the place, belonging to various political figures and a strange statue which popped up from behind a pile of rocks. He was just a torso and stared madly straight ahead. I had no idea who he was but he must have been important because he had an impressive looking Basuto stick. He made me feel slightly uncomfortable and I decided not to get too close.

Eventually, I tracked down King Moshoeshoe’s grave. I’d missed it because it was an insignificant pile of rocks. The protectors of the site had decided that it was best to leave it as the traditional grave of that period, rather than build some glorified edifice. I quite liked the solid timelessness of his memorial. The plateau stretched away in the foreground and a distant range of mountains rose in the distance, as they have always done. Today the mountains were topped by a line of cumulus clouds with acres of blue skies above. 

King Moshoeshoe would have looked at this view countless times as he strove to protect his people and territory. He was a canny warrior and diplomat. He was never defeated in a major battle and managed to retain most of his kingdom and culture with his astute governance. Now his country lay wasted by a different enemy, with nearly a quarter of the population HIV positive and young people chopped down in their prime by this unseen enemy. Its attack insidious, building up in their bodies over time, and leaving them vulnerable to attack by all manner of diseases.

Success in fighting this enemy had so far been limited, and survival into later years only possible if victims receive anti-retroviral drugs. There are hundreds of thousands of orphans in Lesotho and life expectancy is only into the forties. I wondered what King Moshoeshoe would make of it all, as he lay under his pile of rocks, and what advice he would give me for the challenges ahead? I’d be starting at Saint Angela’s on Monday and the kindly guidance of a wise old chief might come in useful.