The Landscape of Lesotho

Lesotho is one of the highest countries and is entirely landlocked by South Africa. 40% of Lesotho’s population survives on less than $1.25 a day. In centuries gone by, the people of Lesotho were driven high up into the mountains by the Xhosa and Zulu people and have repeated a solitary and isolated life, mainly farming, ever since. However, Lesotho is also experiencing one of the highest rates of HIV/AIDs infection rates in the world. This is their modern day crisis. What does survival mean in this situation? How can we conform to a meaning of being human when our human situations differ so dramatically?

In one part of the capital city, Maseru, there is the bustling of the local market. In many of the stalls, traditional remedies are being sold. Amongst this hub, illness can quite easily be spotted. A lady slowly cooks sweetcorn on the side of the road. The smoke from the ash of the charred wood embraces her face. She remains here all day long until dusk falls and the street becomes too dark for the hungry to see. In her world there is darkness too. Cataracts have affected her left eye and she must be at least partially blind. A simple, relatively risk and pain free operation would cure her. A few minutes later, a young boy walks past with a large mass on his neck. Perhaps elsewhere he could be assessed and treated. Just standing there looking around, faces of illness surround me. It is part of the fabric of their society.

The way that illness exists in Lesotho manifests in the way the narrative of illness is constructed. Illness presents itself in a very strange way compared to how we are accustomed to illness in so-called Western countries.

In illness, narrative seeks to tease out the perspectives that have been imposed on our experience of life. We are constantly struck by how paradoxical illness and life come hand in hand. We look at illness in terms of prevention and cure. This helps us to regain a sense of control, to drive life to flourish and not to deteriorate.

The world is divided into the rich and the poor, and this inevitably affects illness. The difference between the wealthy and the poor is the accessibility to medical provisions.

What happens when the story of our illness becomes the story of our life? In our developed society we have the hospital as the central domain for where illness is taken. When this is not a possibility, illness disperses in different ways and into different places than how we may organise illness into our society. It is not kept in the records in the doctor’s office. It is not brought out for observation during a hospital consultation. It is not confined within the safe boundaries of what possibilities medicine can offer. Here is the living story of illness.

  • Deborah Kirklin

    Thank you for this post Ayesha and for articulating so clearly the fundamental way that wealth, or the lack of it, affects what illness means to those experiencing it. I particularly like the way in which you describe how illness can, for those with access to medical care, be removed, both physically and psychologically, from the rest of their lives by taking it to the hospital. in sharp contrast, for those for whom this taking out is not possible, the illness not only remains fully present but ‘becomes the story’.