It’s 9am and a dozen patients are already waiting on the banks of the Senqu River at Whitehill in Qacha’s Nek, Lesotho, for the boat service to take them to Tebellong Hospital on the other side.
Some have children strapped to their backs while others have come for chronic medication. All are waiting for the free hospital boat because the private boats charge them.
Maliseme Ramolibeli from Whitehill is going to hospital for a routine check-up and to collect her chronic medication.
She says the boatman usually arrives by 8am.
For patients like Ramolibeli, access to healthcare begins with waiting.
Ramolibeli has been crossing the Senqu by boat to reach Tebellong Hospital since she got married and moved from Qacha’s Nek town to Whitehill in 1979. She has gone there for pregnancies, routine care and chronic treatment.
Crossing the river has become routine, but this has never made it safe.
When the river is flooded, Ramolibeli says she misses her check-ups.
Manthabeleng Baholo from Ha Noosi says many people choose Tebellong because they cannot afford the cost of going elsewhere.
Transport from Whitehill to Machabeng, more than 40km away, costs R40.
Once patients have crossed the river, their journey is still not over. Rorisang Thaha says, “We wait here in the rain for the boat with children on our backs.”
After crossing, they walk up the steep hills because they cannot afford a hospital vehicle. Thaha says the hospital vehicle costs R55 for a normal trip and R100 for emergencies at odd hours.
The river is not only a barrier for patients; it also shapes how Tebellong Hospital operates.
Hospital administrator Libuseng Malataliana said that when there are floods, patients and some staff are unable to come to the hospital. “We then refer our patients to a hospital in Maseru. We have to wake up around 3am to cross the river early enough to reach Maseru on time.”
“Crossing the river when it is dark is most challenging,” Malataliana says.
“Boatmen do not have equipment that can help them in terms of light. They just cross that river with their knowledge … somehow we do not hit the big stones,” she says.
In some cases, Malataliana says, women in labour give birth at the river with the help of the boatmen.
Ntšolo Molefe, co-ordinator of nursing services at Tebellong, says moving critically ill patients across the Senqu requires the assistance of several members of staff.
Some patients are too frail or too heavy to be carried, making urgent transfers difficult. “Some injuries worsen during the transfer process, from the vehicle to the boat, and then again into a vehicle on the other side of the river,” she says.
Molefe recalls one patient with a spinal cord injury whose condition had worsened by the time they reached Maseru. Premature twins who needed oxygen had to be disconnected from the oxygen to cross the river. One twin died during the crossing. The second died on the way to Maseru.
When the river is flooded, Molefe says, patients are sent on the longer route, taking a rocky road. This adds more than two hours to the trip.
Medication shortages are a challenge for the hospital, says Malataliana. She says chronic patients are beginning to feel the impact. “The little we have … we are trying to manage.”
The hospital is owned by the Lesotho Evangelical Church in Southern Africa under the Christian Health Association of Lesotho (Chal).
After a visit to the hospital in March, Chal deputy executive director Libete Selapane told parliament CHAL was R152m in debt, much of it owed to the National Drug Service Organisation for medicine and to the Revenue Services Lesotho in unpaid PAYE. He said the debt was already affecting services.
Under an agreement signed in March 2026, government committed to providing medical supplies directly to Chal facilities and to settling Chal’s debt.
While past promises of a bridge have not materialised, last year’s national budget saw government commit to its construction. A tender was issued in June, stating the project would start in November 2025 and run for 24 months.
But at Tebellong, there are still no signs of construction.
-GroundUp
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