Geographic isolation and limited healthcare infrastructure create significant barriers to healthcare access in remote mountainous regions, where residents face challenges including long travel distances, poor road conditions, limited medical services, and reliance on donor-dependent medication supplies, making it essential for healthcare systems to make extra efforts to reach vulnerable populations in these areas.
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Extending the Link: Ke Teng, Le Kae? (I Am Here, Where Are You?)Ajouté :
Heat.
Fore speech.
for because Lutu is so remote and so mountainous. It's a very beautiful place, but it's also a really hard place to get to and to get around. And so people have to travel long distances to get to their local clinics and their hospitals, which often includes a combination of walking and taxi transportation. Um, and so the geography is really unique to it and really shapes how people are accessing their healthcare.
People call Lutu the kingdom in the sky.
And if you went there, you would understand why. When you drive in from South Africa, you immediately are in the lowlands, then you drive way up into the highlands, into the mountains.
>> Everything is clean. Let me just say that is clean. You know, the water is clean. You know, you go the air is clean. You know, that's that's that's that's another thing. This it's it's it's it's healthy. Let me just say it's healthy. It's sound. It's it's it's amazing. It's this the beauty makes me go make me go crazy.
When you drive into lutu, it says kinotu. That means come in peace. And that's really an important kind of uh way that basutu people think about welcoming others into their home and themselves going home. they feel very strongly about the peacefulness and loveliness of their own country. Um, but I think it's important not to romanticize that Lutu is a complicated place. Um, it's not a perfect place, but it also has um really a lot of healthcare challenges, a very high HIV prevalence rate, tuberculosis co- infection. Um, it's got maternal and child health challenges. Um, and it has, you know, pretty limited healthcare delivery model. I think above all uh the geographical location for us living in the mountains makes us vulnerable because you don't have access to a lot of uh opportunities that can help you improve your own livelihoods.
Lutu is an enclave completely surrounded by South Africa that's elevated on a plateau. So it's a very rural and mountainous country surrounded completely by South Africa.
for in lutu. People typically seek the care of both traditional healers and biomedical doctors and they pick it based on where they think the efficacy is going to be. So if they see an illness as being something that comes from outside lutu like HIV or tuberculosis then they understand that they need to see a biomedical doctor in order to to deal with that problem. If they see something as being locally defined illness or something that came from within lutu then they might see a traditional healer for that.
Lutu has the second highest HIV prevalence rate in the world and that's been pretty stable since, you know, the 1990s, 2000s. um it has a 23% adult HIV prevalence rate which if you think about that a quarter of adults um are living with HIV and during the height of AIDS mortality where people didn't have access to medication people were dying at a really high rate and leaving children behind and I was really interested in how people were caring for children within the family context. So I went to Rome Lutu and it was a really beautiful interesting but really difficult time um in Lutu where we went to funerals every weekend. We had really sick babies coming through our organization um because of the HIV prevalence rate and so that kind of was the problem that I was looking at.
TTL is a LUT based nonprofit. It runs a safe home or rehabilitation facility for the sickest children, but it also runs an outreach program to support the care of orphans and vulnerable children in the rural area providing nutritional support and monitoring the health of children under five.
>> Yeah, TTL is really an important part of community. Do we load our truck? Then we go.
Oh, holy 80 kilome.
I'm easy.
This march.
Okay.
for the BDC in for heat.
It's it's it's the roads. The roads um are horrible. They travel uh long hours.
So when they travel long hours, it depends with um with um with the weather. When the weather is it's not conclusive, they won't be able to to travel because those people they don't they don't walk. Some of them they ride on horses. Some of them they have to walk. Someone if he walks for more than 7 hours, it's not possible. more especially like I said with the weather condition it depends more especially on these rural areas there will be weather condition like snow there will be storms there will be rainfall so they won't be able to cross over to go to access facility foreign.
If you're regularly going to the clinic, it's because you have HIV, you have TB, you're pregnant, or you have a small child. Those are pretty much the only reasons that people would go regularly.
They come here because we have the medications as the government facility while our neighbors don't have. So the people that travel long distances are not necessarily from our own catchment area. They come from our neighbors catchment area, but they only come here because we have medications and our neighbors don't have.
The biggest factor driving expired medication is that countries like Lutu rely heavily on donations of pharmaceutical meds and so they get a big shipment that ends up up in the highlands. And usually if you if a health care system knows exactly what kind of medications they're going to need, then they will be able to more or less get the amounts that they need for a particular thing. But if you're relying on donations, then you get what you get.
Another issue that people in Motang face is it's not just getting to your clinic, but once you get there, what can they do for you? The the types of healthcare that are offered in the rural clinic are pretty basic.
We said doctors in in a facility like in hot now the doctors we have a few of them I would say that way sometimes yes because of the staff shortage you find maybe one nurse will be allocated to manage maybe those 200 >> antibiotics you can get family planning you can get HIV meds medications for tuberculosis um you can get multivitamins maybe you can get your blood drawn but you can't get any kind of specialty care you there are no scans >> we don't have the chemo we don't have the chemo therapy in in in in all scopes. Even if we we have um a woman that we examined, then we see that um he or she might or she might be having um a cancer, we can't be able to to treat.
>> Healthcare is a human right. Everybody deserves access to health care. But if we aren't making an extra effort to reach them, then they're not going to get care. And they deserve care just as much as anybody else.
The most vulnerable people often live in these rural areas. And if you aren't making the effort to travel across difficult roads to go into the mountains to provide the care, then those people are going to fall through the cracks.
people don't plan way ahead the way we do. And the reason for that is because life is so unpredictable. People don't know who's going to be living, who's going to be migrated for work.
forch.
I got one phrase that I heard many many times over and over again in lutu is modopa and that means only god knows. So if you ask someone you know what's going to happen when this grandmother can no longer care for this child then someone will say modima.
Adichier argues that the single story of Africans which emphasizes suffering leaves no possibility of feelings more complex than pity.
No possibility of a connection as human equals.
As a social worker, I find it fulfilling in helping others overcome their challenges.
When you travel from there to the hospital, it's it was 6 hours.
So, we we we had a woman, he came along in the hospital uh with labor pains. And then when I made my own assessment, I found there was a qu prolapse.
So with a quad prolapse, what you do is once you find it with examination, you only have to remove your hand. You have to maintain that up until the time you go to the hospital. So I had to maintain my hand just trying to push the court so that the child cannot press against the cause or the child might suffocate. But it's 6 hours drive and then on a bedroom. So in your cooperation we can be able to read the hospital so that the kid can be delivered alive.
The cooperation that we did with the woman while we were traveling while my hand is still inside for 6 hours. It was very good that when I reached the hospital, the kid was still alive and kicking healthy and the kid was being delivered, held in sound. It was 2015 I met the kid. Then the mother was saying, "You know what? This is your kid." I'm like, "Who?" I said, "You remember this day?" And I'm like, "Wow, it was very amazing." So I felt so so good in my heart. No. I said, "Okay, after all this, I've seen my results." And and the kid was held in sound.
We cross rivers. We climb mountains just to get to that child.
>> One child at a time. We don't care where they are. As long as that one child, whether they are in the rural, whether they are wherever we can drive for 5 hours on whole day walking or hornsburg, it's okay for us.
advocate being the voice of the voiceless. Premium hope to the hopeless.
Yeah.
Being the hope of the hopeless go being the counselor.
just bringing hope in someone's lives especially those who are vulnerable being there for them supporting them over the years we have seen its impact we have seen children's life change positively Please When you greet someone in lutu, you might say duma to them which means hello >> and then they might respond which means I am here. Where are you?
I've seen a lot of babies die and I've been to a lot of funerals and there's no silver bullet solution to these healthcare problems in the sutu.
>> But every effort we make, every time we move the needle a little bit, we improve somebody's life or we save somebody's life. So I think it's really important to keep making these efforts even though we know we can't solve this problem.
And we need to keep moving forward because it matters. And we need to keep moving forward because people need to have hope.
>> And the work that TTL does, the work that other organizations in the area are doing are helping to give people hope.
Are you follow?
to the two we go.
Oh yeah.
>> Happy to meet you.
Hello dear.
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