…says facility being‘run like a tuckshop’ amid growing crisis
Mohloai Mpesi / Mathatisi Sebusi
A senior doctor at the Maseru District Hospital and Eye Clinic has blamed mismanagement and financial hurdles for plunging the institution?into a full-blown crisis.
The Head of the Eye Department, Dr Wenjun Fan, claims the state-of-the-art health facility, inaugurated in June last year, is being run “like a flea market”, with little to no accountability among its management and staff.
The 200-bed hospital was constructed through a CNY400 million (approximately M1 billion) grant from the Chinese government. Built by Shanghai Construction Company, the hospital was handed over to the Lesotho government in June 2024 and designed to deliver advanced medical services, including ophthalmology (eye care), intensive care, dialysis, CT scans, and treatment for infectious diseases.
However, Dr Fan says the hospital has quickly descended into chaos and poor administration.
In an exclusive interview with the Sunday Express on Friday, Dr Fan painted a bleak picture of the facility’s operations, describing it as being “in the abyss of mismanagement”.
“There are numerous challenges with the hospital’s management. We face issues in leadership, manpower, finance, essential services, and service delivery,” Dr Fan said.
“The entire country struggles with these challenges, but here, the problem is compounded. We don’t have a proper Director-General, which affects the whole health sector. The Principal Secretary (PS) and the Minister are political appointees and lack medical backgrounds. At the very least, the Director-General should have medical expertise. Mismanagement, corruption, and incompetence are rampant nationwide. Hospitals and headquarters operate in isolation. If I encounter management issues here, there is no clear line of communication to headquarters.”
Dr Fan also pointed out the absence of accountability, noting that meeting minutes are not recorded and some staff members evade their duties.
“We hold regular head-of-department meetings with the management team, but there are no minutes, no follow-up actions, and no feedback. Meetings occur every month, yet nothing is documented. Some staff do not work here—they may be working from home or elsewhere. Certain departments operate like a flea market.”
He further highlighted the shortage of resources, despite the hospital being allocated M10 million in its annual budget, with unclear utilization. Patients, he said, continue to suffer as a result.
“We are unable to perform essential tests and operations because the microscope is broken. We have to borrow one from Mafeteng or Leribe. Although the budget is provided annually, last year we were told we had M10 million for the hospital, yet we cannot purchase necessary resources. When we ask why, we are told the money is used for ‘other purposes,’ without explanation. Patients requiring immediate surgery are sent to T?epong, and the waiting list is nearly three years long. The Chinese government donated a microscope, but the lens is incorrect and has not been replaced since last year despite our requests.”
Of further concern, Dr Fan noted the absence of a Death Review Committee. He said that without it, it is impossible to determine whether a patient’s death resulted from negligence or a critical condition.
“There is no death review or patient committee. I asked why we don’t have one and why we cannot establish it. Without such a committee, we cannot determine if a death was due to negligence, lack of knowledge, or the severity of the patient’s condition. They are running this hospital like a tuckshop.”
Dr Fan also criticized the lack of data management, despite available computers, with most records kept manually, undermining reliability.
“There is no proper data management. Computers are available, yet departments still use handwritten records. This duplication makes it impossible to analyze or rely on hospital data.”
He raised concerns about patients being denied care due to lack of funds.
“In emergencies, if a patient cannot pay, they are denied a CT scan. Patients are dying, yet the hospital demands money first.”
Dr Fan also reported frequent absenteeism among doctors.
“One medical doctor disappears constantly, leaving patients unattended. I repeatedly reported this. In July and August, the Chinese government funded training for three Eye Department staff in China. They sent this incompetent doctor along with two nurses. I questioned this decision because this doctor frequently misses work and provides poor care. They didn’t consult me, even though I am the eye specialist and know who is capable. If the Chinese government knew how these funds are misused, they would be concerned.”
He added that staff returning from training do not share their knowledge.
“When staff come back from training, they are expected to share their knowledge—nothing happens. Dr Masupha did not attend head-of-department meetings for six months, and less than half of the HODs regularly attend. It feels like we are running a flea market,” he said.
For her part, Director of Clinical Services, Dr Lucy Mapota-Masoabi, told the?Sunday Express?that the hospital’s budget is never truly sufficient. While she said she was not aware of the reported M10 million, she stressed that they always prioritise spending according to need.
“Anyone at management level in the hospital knows how the money is used. The hospital is new and large, and the government budget is never enough. Health issues are too numerous. Look at any country—nations are constantly struggling to allocate adequate funds to healthcare. Gaps will always exist. When we receive our budget, we assess priorities based on the disease burden and allocate resources accordingly,” she said.
Dr Mapota-Masoabi explained that every budget is divided into segments to serve different priorities.
“As much as I am not responding specifically to the M10 million because I don’t know about it, the money doesn’t just sit idle; it is allocated to specific activities. For example, if the budget is M10 million, M2 million may go to security, M1 million to cleaning, and M3 million directly serves patients. Even if the hospital lacks equipment, we still need to feed the patients. The government does not allow us to divert money to other projects unrelated to its intended purpose. Government funds do not go into anyone’s pocket.”
Asked about the absence of death review meetings, Dr Mapota-Masoabi clarified that these are the responsibility of each Head of Department (HOD).
“It is not hospital management’s duty to conduct death review meetings. Each department is responsible. When a patient passes away, we review their files at the end of the month, checking the cause of death, the patient’s condition on arrival, and other relevant factors. This introspection helps the facility determine if anything was missed in patient care, as sometimes conditions change and the patient dies despite best efforts.”
She also said postmortems were conducted in cases where a patient’s condition suddenly changes, leading to death.
“As the hospital, we request a postmortem to investigate what caused the change. After the investigation, we review whether there were signs we may have overlooked. Some situations are beyond the control of doctors or nurses; only God knows everything. But death review meetings should take place in every department,” she said.
Dr Mapota-Masoabi also highlighted the shortage of specialists and consultants as a challenge.
“If a department only has junior doctors, even if they conduct death reviews, it is not the same as having a consultant or specialist to guide them and point out mistakes.”
She further noted that some patient mortalities are due to the severity of their condition upon admission.
“Many patients in Lesotho arrive at the hospital very sick, often in end-stage conditions. There is little we can do for them because they have exhausted all other options. If we keep such patients here, the hospital will be filled with people who are going to die. There is a need for additional facilities beyond the hospital where such patients can stay and receive care from nurses,” she said.