Special Report: Starlight Hospice of Hope, Kingdom of Lesotho - International Association for Hospice & Palliative Care

Volume 23, Number 9: September 2022

Editor’s note: This story, submitted to and edited by the IAHPC Newsletter editorial team, also appeared in an issue of ehospice.

Starlight founder Malichaba Tebellow Lepheane (right) with Her Majesty Queen ‘Masenate Mohato Seeiso, who made an impassioned plea to recognize the urgent need for palliative care in Lesotho. Photo used with permission.

The Flowering of Palliative Care in Lesotho is “Ambitious, but Realistic”

By Malichaba Tebello Lepheane, RN
Founder, Starlight Oasis of Hope Hospice, Kingdom of Lesotho

On August 18, Starlight Oasis of Hope Hospice (SOHH) held a launch to mark a new phase in our provision of palliative care: extend training and services, and begin fundraising for two projects: the Kingdom of Lesotho’s first dedicated palliative care hospice, and a day care center. The event was attended by: SOHH patron the Queen of Lesotho, Her Majesty ‘Masenate Mohato Seeiso; government officials; several corporate guests; and cancer survivors.

The Kingdom of Lesotho

Population: 2.3 million.
About 57% of people live below the poverty line; life expectancy is 42 years.
There are 0.9 doctors per 10,000 people (well below the World Health Organization’s desired 1 per 1,000).
There are 21 hospitals but only 1 cancer clinic. In 2018, 1,888 new cases of cancer were recorded, and 1,335 deaths were attributed to cancer.
It has the 2nd-highest prevalence of HIV in the world: 24%.

The 2017 Atlas of Palliative Care in Africa reported that Lesotho had no hospice care, no national health care funding for palliative care, no home-based palliative care, and no national palliative care plan.

I witnessed many patients, family members, and friends who are living—or who have died—in much pain and distress. I realized that it didn’t need to be that way.

I began Starlight Palliative Care Services in 2017 as a consultancy, to advocate for palliative care and train health professionals in end-of-life care and pain management, as they lacked confidence in providing such care and feared using strong opiates.

By 2020, we naturally progressed to become Starlight Oasis of Hope Hospice, providing training, advice, and direct care. Raising public awareness was a key part of our advocacy. It resulted in a section on palliative care in Lesotho’s 2021 noncommunicable diseases plan.

With this launch, including a Just Giving campaign, we hope to have put a seed in the hearts and minds of potential sponsors, including our corporate guests, to help us continue to build our services.

Future plans are solidifying

The launch was attended by Minister of Health Semano Sekatle, Director of General Health Services Dr Nyane Letsie, and Principal Secretary Health Maneo Ntene. Photo used with permission.

Training: Thanks to reaching out to a team from Wales, we arranged for palliative care training as part of the local Family Medicine Specialty Training Programme. A team from Palliative Care Works will provide training to other frontline health and social care workers in early 2023. Further sessions are planned to train champions to provide ongoing training and support.
Clinician & patient support: The Ministry of Health has agreed to a Memorandum of Understanding to set up a palliative care team in Maseru (the capital) to support clinicians in hospital and, later, provide advice to primary care providers as well as homecare services for patients.
Service sites: Thanks to the generosity of a local chief of Letsatseng Berea, SOHH has acquired a site and approval to build a day care centre and, in time, a hospice facility for inpatient and outpatient care. In return, SOHH has funded a project to supply water to the local village. A team of architects has volunteered to design the facilities. The Ministry of Defence pledged to provide a workforce to build the hospice, while the Ministry of Water Affairs pledged to install systems to equip it with running water.

Our immediate need is for 4x4 vehicles to enable our outreach teams to deliver home care services. We need to deliver palliative care as soon as yesterday to help end unnecessary suffering.

Our approach is to be ambitious but realistic; bold but sensitive. We need to stress that palliative care is not necessarily a specialist area; all health practitioners should have basic palliative care skills; much care can be delivered at home and effective palliative care can ease the psychological, physical, social, spiritual and, just as importantly, the economic burden on families.

For more information, contact us via [email protected].

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