BU Today

Health & Wellness + In the World

Confronting Lesotho’s Health-Care Crisis

Outreach reviewed: Faculty form an alliance to train medical personnel


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Small world, big needs. One steady focus at BU Today is sharing stories about outreach, human to human and program to program, and ways members of this University community extend that concept, crossing barriers (physical and otherwise) to offer hands-on help, advice, and wisdom. This week, we’re returning to some of those inspirational accounts.

The tiny country of Lesotho, a small nation surrounded by South Africa, has a population of roughly two million people — and the third highest prevalence of HIV/AIDS in the world, at 23.6 percent. Approximately 225,000 people ages 15 to 49 are HIV-positive.

The crisis doesn’t end there. Lesotho’s mountainous terrain limits access to health care. Many patients walk for hours, sometimes an entire day, to reach a hospital or clinic.

And the country has a severe shortage of doctors and nurses (there is only one pediatrician). Lesotho has no medical schools and few nursing schools. Fewer than 20 percent of the students who leave to pursue those careers will return to practice.

But some Boston University faculty and staff members are trying to change that. In 2003, the School of Medicine and the School of Public Health, along with the Lesotho Ministry of Health and Social Welfare, formed the Lesotho-Boston Health Alliance (LeBoHA), which is working to educate and retain physicians and nurses who will then practice in Lesotho.

The alliance is addressing other needs as well, such as hospital and clinic management. “If there’s no syringe or needle when the nurse goes to give the injection, it really doesn’t matter that the nurse is well trained,” says LeBoHA program director William Bicknell, a professor and chair emeritus of international health at the School of Public Health and a professor of sociomedical sciences and community medicine at the School of Medicine.

Since the program’s inception — and with funding from the W. K. Kellogg Foundation, the International Finance Corporation, the U.S. State Department, the U.S. Agency for International Development, and the Dreyfus Health Foundation — 25 LeBoHA faculty and staff from the School of Management and the MED departments of family medicine, obstetrics, emergency medicine, internal medicine, and pediatrics have traveled to Lesotho to work on the project. In addition, 65 SPH and MED students and Boston Medical Center fellows and residents have volunteered in Lesotho for LeBoHA programs or in clinical services at the district hospitals.

“Sending first-class people and having the very highest standards and a long-term commitment are what make a difference,” says Bicknell, “and from that we enrich our teaching and contribute to the knowledge base of how to make health care work in resource-constrained areas everywhere in the world.”

Robin Berghaus can be reached at berghaus@bu.edu.

This story originally ran October 6, 2008.

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