25 March 2024 by Limpho Sello

 Est Read Time: 6 min(s) 43 sec(s)

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27-year-old Mampe Motlohi and her three children celebrate being TB-free. Photo Credit: Limpho Sello.

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Six-year-old Tšepiso Motlohi shyly tilts her head down, attempting to conceal the tears welling in her eyes.

However, a single glance from her mother compels tears to escape Tšepiso – a young yet resilient heroine who triumphed over tuberculosis (TB) in January 2024.

Tšepiso and her older siblings—nine-year-old Tšepang and eight-year-old Retšepile—contracted TB from their mother. They were diagnosed in August 2023.

Common signs and symptoms of TB in children include swollen lymph nodes, malnutrition, and reduced playfulness. If any of these symptoms are noticed, regardless of when they started, it is recommended to visit a facility for free TB screening.

On March 15, 2024, the Motlohi family shared their TB journey with Uncensored News. Their mother, Mampe Motlohi, recounted how her young children used to bathe her without gloves or face masks. They also cooked and fed her whatever food they could find in their two-roomed house.Top of Form

“They literally cleaned up after me because they had to empty my potty after throwing up or pooing.”

With a shaky voice, this Ha Motlohi, Mafeteng resident shared how pained her when her children were diagnosed with TB.

“I felt consumed by guilt, often wishing I could take away their suffering, given the journey I had endured with TB,” she said.

The world commemorated World TB Day on March 24 under the theme, “Yes, We Can End TB.”

The World Health Organization (WHO) says this year’s theme conveys a message of hope, emphasising that with high-level leadership, increased investments, and faster uptake of new WHO recommendations, it is possible to get back on track and turn the tide against the TB epidemic.

“Scaling up of access to TB preventative treatment (TPT) and screening services for TB disease is a priority, as this creates efficiencies and can lead to massive health and financial gains,” reads WHO website.

It adds: “Integrating TB screening with TPT increases opportunities to protect people from falling ill with TB as well as saving a large number of additional lives.”

“Mom, are you okay?”

In 2023, a global TB report revealed that in Lesotho, there were 661 TB cases for every 100,000 people. According to Lesotho’s Ministry of Health TB and Leprosy Manager, Dr. Llang Maama, around 15,000 people fell sick with TB that year.

“Out of these 15,000 patients, 11 percent are children,” Dr. Maama stated.

Dr Llang Maama. Photo Credit: Maseru Metro.

Tšepang, Retšepile, and Tšepiso are among the 1,650 children who became ill with TB in 2023. Despite being old enough to express themselves, the anguish of caring for their mother until she recovered, only to then become infected with the same illness that weakened her, remains too raw for them to discuss in an interview.

Instead, their mother told Uncensored News that her three young children bathed her without wearing gloves or face masks, and they also cooked and fed her.

“They literally cleaned after me because they had to empty my pouty after throwing up or pooing.”

She recalled how the youngest, Tšepiso, constantly asked questions.

“There were times when the youngest would ask me, ‘Mom, do you want your tablets? Should we prepare food for you?'”

Her response, she explained, always led to tears. “I would say no, then burst into tears. My illness deeply affected them.”

Then, Motlohi started receiving reports from teachers that her children were frequently crying. They were unable to concentrate in their classes because they wanted to return home to their sick mother.

“I was told how emotionally drained they were because of my illness,” she said.

“Sometimes they couldn’t sleep at night. When they heard me moaning in pain, they would quickly ask if they should give me medication to ease my pain.”

Unknown to the young children and their mother, spending time with their bedridden single parent increased their risk of contracting TB.

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) Lesotho supports 178 sites in eight of the ten districts to provide comprehensive HIV and TB services.

EGPAF Lesotho recently published an article on TB in children, highlighting that children in close contact or exposed to someone with TB are at high risk of infection. The article quoted Maluti Hospital TB Nurse Makuta Tlouoe stating that the majority of children and adolescents exposed to TB face an elevated risk of TB infection and illness.

“This is the reason why children under 15-years in whom active TB disease has been ruled out are still given TB prevention treatment. TPT is meant to reduce the risk that, in future, the dormant infection (latent TB) may develop or progress into active TB disease,” explained Tlouoe.

TPT is a course of one or more anti-tuberculosis medicines aimed at stopping the development of TB disease. It’s provided only to individuals who are infected with TB bacteria or have been exposed to it and are at a higher risk of developing TB disease compared to the general population.

Ha Motlohi village is within the catchment area of the Samaria Health Center. Despite the Motlohi siblings receiving their TPT course after their mother’s TB diagnosis at the beginning of 2023, Nurse in Charge Maphakiso Maqeba from Samaria Health Centre stated, “It appears they were already infected with TB.”

Mother blames herself

Back in Ha Motlohi, in Mafeteng district, 27-year-old Mampe Motlohi explained how her children withdrew from their daily routines of playing with other children in the village.

“They always stayed with her in the house, crying together all day. I was afraid I was going to die and leave them, and I’m sure that was their fear as well.

“I love my children unconditionally, and for them to care for me until I infected them deeply saddened me. I felt like I had burdened them beyond measure,” she said.

Then, her youngest child, Tsepiso, developed a bloated stomach.

“They all lost weight and developed a very dry rash. We all had itchy skin, but Tšepiso was also throwing up. Tšepang and Retšepile were still sick, but it was worse for the youngest,” she explained.

As all this unfolded, Motlohi remained bedridden, feeling helpless and guilty for not being able to care for her children.

“If it weren’t for me, my children wouldn’t have contracted TB. They were healthy and chubby, but TB made them lose a lot of weight, and the poverty and hunger in our household only worsened it. No parent wants that for their children,” she said.

As of January 2024, the children have finished their six-month TB treatment and have been declared TB-free. “They are doing well. I feel like they still need to gain some weight to return to their normal bodies.”

The good Samaritan nurse

Samaria Health Centre Nurse in Charge, Maphakiso Maqeba.

Although Motlohi and her three children are now in good health, she emphasises that she will never forget how nurse Maqeba and her colleagues at Samaria Health Centre and Mafeteng Hospital went above and beyond their clinical duties to offer humanitarian aid to her family.

In addition to receiving the usual government-sponsored food packages for TB patients, Motlohi explained that some nurses provided her with groceries, clothes, shoes for her children, and even cash.

The government-sponsored food packages Motlohi received included soya, peanut butter, and powdered milk.

She expressed her gratitude, stating, “Nurses at Samaria Health Centre and Mafeteng Hospital played a parental role to me and my kids. They made us feel that we are not alone. Yes, I have a father, but his presence meant nothing because he never assisted even though I live in his house. However, my grandmother also assisted a lot where she could.”

Motlohi also expressed appreciation for the support received from her children’s teachers at Kopanong Primary School.

She mentioned how they were very supportive, always inquiring about her children’s meals each morning and ensuring they were well fed. Additionally, they often packed food for her, for which she is forever grateful.

In response, Maqeba shared, “Her struggles touched me in a different way, and to be honest, I have never encountered a situation like hers since my arrival here in 2015.”

“I vividly remember when we first referred Motlohi to Mafeteng Hospital. We traveled with all her children. Upon arrival at the hospital, she was supposed to be admitted, but there was no one willing to take care of her children.”

Maqeba then consulted with social workers and orphanages in an attempt to find a safe place for the Motlohi siblings. “Unfortunately, an orphanage was not an option due to their limited capacity,” she explained. “I was advised to seek out a close relative who could care for them before considering an orphanage. Fortunately, we were able to locate their grandmother.”

“That’s how I began following up on the children’s situation and how I could assist them. We reached out to their grandmother to inquire about their needs, and whenever possible, my colleague, Mr. Suping, and I provided assistance from our own resources, whether it was cash or items from our households,” Maqeba said.

Meanwhile, the Ministry of Health’s Childhood TB Program Officer, Mpho Khesa, explained that when children are diagnosed with TB, health workers conduct contact tracing at their school while also providing training to teachers without revealing the child’s identity.

“We also avoid any form of isolation to prevent the child from experiencing stigma,” Khesa added. She emphasized that TB patients are most infectious during the first 14 days, and once they’ve been on treatment for that duration, their infectiousness decreases. Therefore, it’s crucial to administer TPT to close contacts of TB patients.