MOKHOTLONG, Lesotho — In the high-altitude mountain kingdom of Lesotho, where one out of every four people is HIV positive, horses are playing a key role in the fight against the spread of HIV/AIDS.
With 80 percent of the country more than a mile high and few paved roads, horses are life-saving couriers, shuttling vital medical supplies, anti-retroviral medicine (ARVs), mother-to-baby pregnancy kits and lab samples to remote clinics that serve villages inaccessible by car.
“In certain regions of the mountains, like Mokhotlong, Qacha's Nek and Thaba-tseka, the people are cut off from the rest of the world for four to five months every year,” said Dr. Leo Buhendwa, country director for the Elizabeth Glaser Pediatric AIDS Foundation. “We were trying to figure out how we could reach everyone, all year round, and we realized that most already use horses. Horses are the most reliable mode of transport up here.”
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The Horse Riding for Health program was started four years ago as a coordinated venture between the Glaser foundation, the Lesotho health ministry and the local communities in the mountainous Mokhotlong province.
With an HIV infection rate of 23.6 percent — the third-highest in the world — Lesotho is working to provide crucial medical care to its population in remote areas, and the horses are key components in the strategy. Horse-delivered medicines will help the government reach its new goal of providing 100-percent coverage for prevention of mother-to-child HIV transmission and pediatric HIV services, one of the most effective and proven ways to stop the spread of the virus.
The program employs four riders throughout the Mokhotlong province, one for each clinic that cannot be reached by vehicles.
When health workers first came to Potso Seoetoe’s village asking for volunteers for the program, no other residents were willing to help.
But Seoetoe, a maize, beans and wheat farmer whose younger brother, Mohlouoa, died from HIV, didn’t hesitate to raise his hand.
“No one else wanted to do it because they didn’t want to be associated with HIV/AIDS,” Seoetoe said, sitting on a rock by his house. “But people were sick and dying, and no one was doing anything. I wanted to do something to help people recover.”
Once a week and occasionally when he's on call, Seoetoe wakes up at first light, saddles up Kroi-Kart, his reliable red horse, and braves the unpredictable and sometimes volatile weather conditions to make the trek into the mountains.
First, he goes to the nearby Mapholaneng Red Cross Clinic where he is given an insulated medical bag, ARV deliveries, mother-to-baby packages, and any other additional supplies that might be needed.
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From there, it’s about a three and a half-hour ride to the Modikadi clinic, situated on a central highland, nearly two miles (9,800 feet) above sea-level.
“The hardest part is the weather,” Seoetoe said. “During the summer rains, the rivers are full and the horses don’t want to cross. During the winter when it’s snowy and cold, it’s difficult to leave my family behind in our cozy home to make the trip."
Seoete’s vital deliveries serve villages tens of miles away, meaning that he never even sees the people he’s helping.
Because Lesotho has an unemployment rate estimated to be between 24 percent and 45 percent, the program also helps to provide a livelihood for couriers like Potso that helps him take care of his family.
The use of horses has proven more successful than Buhendwa anticipated, helping to expand health-care services to an additional 30,000 people across Lesotho’s mountainous Mokhotlong province.
It's often difficult to judge the exact size of the population served by the clinic. Some people walk miles to reach them.
Originally intended as a winter program, the horses have been making runs all year round. In 2012, the program will be expanded to the southern districts of Qacha's Nek and Thaba-tseka.
The high profile of the couriers within the community has also helped to combat the stigma of HIV/AIDS.
“There used to be more of a stigma around HIV/AIDS, but we are now finding that pregnant women are coming in for voluntary testing and coming to support group meetings very readily,” said Msetima Nkere, a lay counselor with the Mapholaneng Red Cross clinic. She said that the participation of local residents, like Potso Seoete, has helped break down prejudices.
“Since Potso stepped forward the stigma in this area has gone down a lot,” Khoanyane said. “It’s not really an issue anymore."