Blog 26: Mental health, weddings and public transport

The week starts with our usual physio routine at Phelisanong. We walk the kids who can use the walking frames to school, and then for the rest of the morning we see the younger ones who don’t attend school. Children like Loreto, who loves sitting in the little supportive chair I have brought with me this time. I saw Loreto last year and am amazed that with the help of this chair she has progressed to sitting up, controlling her head and even having some direction over where her arms go. When she manages to spin some of the beads on the toy in front of her and make one bead move along the wire in the direction she wants it to go, both she and I are ecstatic.

After lunch we see the older ones who are back from school. We do more walking, use the standing frames to promote balance and strengthen joints, play with the toys to assist hand coordination skills, use the therapy balls for core stability exercises, do some general stretching, get the legs going using the static bike, maybe use some small weights to strengthen the arms, play catch with a ball to assist hand/eye coordination skills, dance and do anything we can think of to get the children moving and stimulate their minds and body.

Its sounds very dry when I talk about physiotherapy this way, but the reality is having lots of fun to achieve higher levels of function and independence. The children are very entertaining to work with and their determination is inspiring. Mothimokholo and Kolosoa can now take a few steps without using their walking frames, but its high-tension stuff. Mothimokholo is ataxic and needs to hang on to his trouser pockets to stop his arms waving about. He takes wide staggering steps and looks like John Wayne about to draw a six shooter. Kolosoa can’t straighten his legs and walks using a very quick Charlie Chaplin type of gait. I follow them along behind, holding my breath, waiting to grab them when the inevitable comes and they fall. Then I pick them up and when do it all again.       

This routine is broken on Wednesday when Owen, from Powys teaching health board (see blog 23), turns up late morning to do some assessments on the children with mental health issues. Phelisanong is the only children’s centre in Lesotho that accepts children with physical disabilities and learning difficulties  and suggested it might be helpful for Owen to see some of them and see if he could offer some advice.

I did say that he could only see children who had a Bukana, to give him a fighting chance of gleaning some background knowledge. This is the booklet children are supposed to have in which medical histories are written in. The problem is that half the children don’t have them and for those that do the information is of variable quality and use. Anyway, it’s something to go on and if you are lucky it might have their medication in.

There is such a variety of problems and so little information to go on its all very confusing. I make a fast exit and leave Owen to the confusion. There are many tragic cases here and it’s so difficult to know where to begin and what a country can offer with so little resources.

Owen bravely carries on with the assessments after lunch. Meanwhile, Ashleigh, who I met last year, has rocked up with her guitar and it’s too good an opportunity to miss. I fetch my sax and impromptu outdoor concert takes place outside the clinic window where Owen is trying to work. By the time about 80 kids are singing and dancing and generally having a good time, I think Owen concludes, “If you can’t beat them, join them”. He finishes trying to assess a boy who runs around making bizarre noises, which sound like a happy lap top on illegal substances and comes outside to join us.

Given the circumstances I think Owen has done very well. Trying to gather information from a Bukana and from carers who don’t know the child well is not easy. Even if you do manage to assess and diagnose a child what then? The reality is that in many situations that there is no support network for parents, no training and carers who are living in poverty, working all day long and cannot give the kind of input these children need.

Owen sees a girl who epitomises this problem and asks me to give my opinion on her.  She was hit by a car and then attacked by dogs, and now she can barely walk and is clearly disturbed. After the accident she couldn’t stop talking and she has been put on a high dose of sedatives to keep her quiet.

Her treatment is far from ideal but presently there are few alternatives available to her. She has not had any investigations or seen anyone able to prescribe more appropriate medication. One doctor has put in her Bukana the banal comment of “Doing well”, I think not. Understanding and treating mental health in Lesotho has a long way to go.

Leaving behind this depressing thought, I head to Maseru on Thursday. We all know there’s a very special wedding this year (which has nothing to do with Prince Harry), and I am lucky enough to get invited to it. First though, I must undergo the ordeal of public transport.

I drag my bags up on to the road and manage to flag down a four plus one taxi and get to London. From there I need to get a mini bus taxi to Hlotse. My heart sinks, I am the first on board and I must wait until it is fully loaded. It’s a precision job and fat ladies must get out so thin men, children and parcels can be wedged into the corners and maximise carriage.

Eventually we leave, and there is constant rearrangement of bodies on route as we drop off and pick up more passengers. The cause is not helped by the sliding door which can only be opened by special technique and falls off every time it is opened. Once it is lifted back onto the runners we can continue the journey. We make it to Hlotse and happily I can join Owen who is getting a lift with Manyanye and make the rest of the journey in more comfortable fashion.

Yes, Justice and Thato are getting married and I am about to find out what a themed bohemian, exotic African wedding exactly is. I first met Justice when I came out to Lesotho in 2016 and he was such a great help to me when I was working at Saint Angela’s. I know Thato from a hiking trip last year and I am almost as thrilled as Justice’s mother, that they are getting married.  

On Friday we head out to the lodge where they are holding the event. It’s a beautiful venue and I’m up early watching the frantic preparations of tents going up, chairs being put out and hundreds of flowers being cut. The guests start arriving, dressed in their finest, the ladies in their beautiful exotic African prints. The ceremony takes place under two trees, it’s mostly in Sesotho and I don’t know what’s going on, but it doesn’t really matter as when a point of significance is reached their plenty of ululating, so I get the gist.

The bride and groom look radiant. Once the priest has said his piece and the knot is tied, there is more ululating and they are congratulated by everyone. The rest of the day takes the usual format of weddings, speeches, food, music and dancing. I have said I would play “The wedding” from the African suit by Abdullah Ibrahim, on my sax. When I was introduced to this tune last summer I felt I was destined to play it at Justice’s wedding, the only problem being I haven’t yet met the key board player or rehearsed it with him. 

We meet on stage and there is a hurried agreement on the arrangement and we agree to wing it. The singer kicks of proceedings with a series of love power ballads and has the mad idea that I join in with them, having not played any of them before. I wing it, fortunately the singer likes to hang on to notes for ages and fill in the rest of the spaces with lots of doo bee doo’s. I fill in the gaps when he comes up for air. Classic numbers by Celine Dion and Lionel Richie never sounded so good and playing “the wedding” after “Endless love” was a cinch.

We take a break for food and speeches and the day winds up with the evening venue at the bride’s house. I get a ride there with three UN workers and we spend the journey discussing such diverse topics as genocide and gender awareness in agriculture. It appears the UN has a department for everything, but when it comes to the big issues of genocide has proved to be totally ineffectual. The workers feel it might be a massive unwieldy bureaucracy, but at least it lays down the principles of cooperation … I suppose its always possible to put a positive spin on these things.

I get a taxi back to the guesthouse and we get snarled up an accident at a crossroads. Its chaos and its every man for himself. There are people shouting in the road and cars pointing in all directions as drivers try to get around the blockage. A mini bus daringly rides up a bank at 45 degrees while we join a group of vehicles going off piste down a muddy path strewn with potholes. Driving in Lesotho is always an adventure. 

We make it and I arrive back at the guest house and I can’t find the keys get in. I wait it out on a settee until Justice gets back. Despite not having slept for 24 hours he is positively glowing, and you would never know the stress he’s been under for the past few months with work, Saint Angela’s and trying to organise the wedding. Its been a beautiful day, with the usual moments of African chaos, topped with the happiness of two people I hold dear… and that’s what happens at a themed bohemian, exotic African wedding, should you ever be lucky enough to be invited to one.  

The following day friends, relatives and a sheep have been invited around to Justices garden for the final celebrations. The sheep quickly finds out it is on the menu and is slaughtered, butchered and its carcass hanging from a tree before it can protest. I was hoping to join the party but unfortunately my lift back to Leribe has fallen through and I must endure public transport again.

I get down to Maseru bus station to find a 100-seater bus with 4 people sitting in it and know its going to be a long day. An hour and a half later I think we’re finally off, but the bus driver decides if everyone standing in the aisle moves up more people can be fitted in. Two hours after I got on the bus we set off.   

Its baking hot, but everyone when is cheerful, even those standing in the aisle for hours. I try to adjust my mind set and chill, after four hours it’s getting hard. We have stopped at least a hundred times and taken a long diversion to the border post at Maputsoe, where we come to a complete standstill in a massive traffic jam. It’s now been six hours since I’ve been able to empty my bladder, its dusk and I’m facing taxi changes in the dark.

Happily, my luck changes when I get to Leribe, where I thought the bus terminated. It turns out the bus goes all the way to Phelisanong and I won’t have to make any changes. The heat from the day has gone and there are only a few people left on the bus. The sun is setting giving the mountains a red glow as we drive towards them. It’s very peaceful and the atmosphere puts a different spin on the day as I look at the beauty around me. 

I stumble down the track and get back into my hut. The piece of carpet is wet by the door, so I guess it’s been raining. A quick dash to the long drop toilet relieves my bladder from its 8 hours endurance test. I remove the beer cooling in my multipurpose washing up bowl and so that I can then use it to have a standing wash. Then I’m ready for food, … peanut butter sandwiches again, and a Maluti beer to celebrate. It’s good to be home, and sometimes you have to suffer a little to appreciate the small comforts around you. Only and week and a half to go so every moment is precious.