Lesotho's Crisis: 6 Doctors -- 800,000 Kids

Sept. 3, 2007 — -- In a dimly-lit ward in the one public hospital in Lesotho's capital city, Maseru, the sickest infants have to take turns using the only oxygen tanks available. One mother sits nervously watching her tiny child's labored breathing. Another is slumped over, perched halfway on a chair with her torso bent over on her child's bed, her face buried in the sheets.

Mothers are everywhere here. They stay with their children 24 hours a day and administer medicine the way nurses and doctors do at hospitals in the United States. They have no choice.

In this small mountainous nation there are nearly two million people, including about 800,000 children. At the moment, there are six pediatricians to serve them all. You read that right. Six.

Only one pediatrician is on staff at the public hospital, Dr. Grace Phiri.

"We admit the children with their mothers to help us with the care of the child because the mothers do the feeding, do the changing of the babies, and also they assist in the administration of the medications," said Phiri.

Lesotho's government pays for medical students to leave the country for their medical training. But despite agreements with the government, many of those students simply never return to their home country. Job offers and higher salaries in nearby South Africa or Europe are too enticing.

So most of the pediatricians in the country now are Americans working at a clinic that was opened a year and a half ago by the Baylor College of Medicine in Texas.

Training Parents to Help the Country's Too-Few Pediatricians

Health Minister Mphu Ramatlapeng acknowledged the country's health care system is in crisis.

"One doesn't have to look too far to see why it is stressed. It is mainly because of the HIV/AIDS pandemic," she told ABC News.

Of the 800,000 children in the nation, an estimated 18,000 are infected with the HIV virus. Most of the children at the public hospital are HIV-positive.

Retsilisitsoe Sekoai was one of them. When we visited recently, his tiny face peered out from under layers of blankets. At nine months old, he weighed just eight pounds. He was battling pneumonia and diarrhea.

Sadly, little Retsilisitsoe passed away shortly after our visit. It is unfortunately all too common here.

At the Baylor clinic, American-educated doctors see as many patients as they can in a day. They also travel to other regions to train local physicians and nurses.

"We have the medications. They are distributed throughout the country. What we need are people who are comfortable administering those medications to children," said Dr. Lineo Thahane -- an American-born pediatrician whose family is originally from Lesotho.

At the clinic, Thahane speaks to her patients in their native language, comforting them, explaining that the medicines available now can allow a child to live a long life with the HIV virus in check.

There are success stories. Two-year-old Lebohang Sekeleoane is thriving now after receiving anti-retroviral therapy through the clinic.

His mother, Matsietsi, said she used to be up all night listening to his cries. Lebohang is HIV-positive and was also suffering from tuberculosis.

"My son was very sick," she said. "And he was very thin. Right now I see changes. He can play and go around."

Through the efforts of the Baylor clinic and a project run by the foundation of former President Bill Clinton, many more children here are receiving needed medication.

A couple of years ago, only 600 children were on anti-retroviral treatments. Now more than a thousand are receiving the lifesaving drugs.

But they still need more doctors trained to administer those drugs.

The hope is that even if there aren't enough pediatricians to go around, there will one day be enough trained family doctors and nurses to care for Lesotho's kids.

"We would like to not have to be here forever," said another of the Baylor pediatricians, Dr. Tony Garcia-Prats. "African doctors and nurses can take care of kids well. That is sort of our goal and training is a huge part of what we do."

It is a goal that may take a long time to reach.

For now, many of the mothers here are filled with worry.

Matsietsi said she won't have any more children. She is HIV positive and worries she would pass the virus on to another baby.

"I don't want to see another child go through so much suffering," she said.