In Lesotho:
Hind Satti, Clinical Director
hsatti@pih.org

Archie Ayeh, Programme Manager
aayeh@pih.org

t: +266 2231 2399
t: +266 2231 2349
f: +266 2231 2394

In Boston:
Cheryl Snyder
Partners In Health
641 Huntington Ave
1st Floor
Boston, Massachusetts 02115
USA
t: +1 617-432-5256
t: +1 617-432-6724
f: +1 617-432-5300

Postal:
Private Bag A391
Maseru 100
Lesotho

Physical Address:
Prosperity House
4 Bowker Road
Maseru

International NGO

90 Rural Initiative staff, 900 paid village health workers, and 36 MDR-TB program staff. 1,026 total.

Two

Partners include:
Clinton Foundation, Irish Aid, Catholic Relief Services, Mission Aviation Fellowship, Ministry of Health & Social Welfare, Riders for Health, United Nations, and World Food Program.

PIH works in all 10 districts through the MDR-TB Program.

Rural Initiative districts and current sites are:

• Mohale's Hoek (Nohana and Nkau)
• Mokhotlong (Tlhanyaku)/ Qachas Nek (Lebakeng)/ Thaba-Tseka (Bobete and Methalaneng)

Worldwide, PIH works in five core areas:
1. Access to primary health care PIH integrates infectious disease interventions within a wide range of basic health and social services.
2. Free health care and education for the poor
PIH works to ensure that cost does not prevent access to primary health care and education for the poor.
3. Community partnerships
PIHs health programs involve community members at all levels of assessment, design, implementation, and evaluation. Community health workers are seen as a vital interface between the clinic and the community.
4. Addressing basic social and economic needs
Through community partners, PIH works to improve access to food, shelter, clean water, sanitation, education, and economic opportunities.
5. Serving the poor through the public sector
PIH works to strengthen and complement existing public health infrastructure.
The work of PIH has three goals: to care for patients, to alleviate the root causes of disease in communities, and to share lessons learned around the world.

In Lesotho, PIH seeks to provide comprehensive, quality healthcare in the hardest to reach areas and with a preferential interest in the poor. Specific activities and core areas include:

MDR-TB Program:
- This program works in all 10 districts of Lesotho, country-wide with a system of rotating doctors and nurses at the district-level hospitals as well as community-based Treatment Supporters. To date, PIH has trained more than 2,000 Treatment Supporters, of which approximately 170 currently visit actual MDR-TB patients on treatment twice daily. PIHs Treatment Supporter-to-patient ratio is 1-to1. In addition, a doctor and nurse makes a home visit to each patients once per week.

- PIH has more than 700 MDR-TB household contacts, which are screened and tested as potential cases for follow-up.
- PIH provides comprehensive social support to all of its MDR-TB patients and their families. These services range from income generation and life skills, to food supplements and transportation fees.
- Regular trainings are provided to MDR-TB patients on infection control and treatment adherence, among other health topics. Quarterly trainings are provided to health professionals. In 2008 alone, PIH trained 106 health professionals in three weeks, and more than 2,000 village health workers. The 2008 target is to train 6,000 village health workers and to train or re-train 500 health professionals.
- The MDR-TB component consists of 17 medical staff, 12 support staff, and 7 medical auxiliary staff.

Rural Initiative:
- This health program works at 6 clinic sites in 4 districts of Lesotho. It provides HIV prevention, counseling, testing, and treatment as well as a basic healthcare and treatment package at all 6 clinics.
- Most sites also have solar power as well as VSAT/internet connection which is used to connect clinics as well as to enhance the electronic medical record-keeping system.
The Rural Initiative Program works in the following program areas:
1.HIV Prevention & Testing: Since the program started in 2006, nearly 14,000 people have been tested for HIV.
2.HIV Treatment: Since 2006, more than 4,000 HIV patients throughout all 6 clinics have been enrolled in the ART treatment program. Since January 1, 2008, 1,517 people have enrolled in the ART treatment program, 5% of which are children 14 years and under.
3.Training: Since 2006, PIH has trained 41 lay HIV counselors and 900 village health workers. PIH conducts new and refresher trainings to this group of 900+ people each month.
4.Social Support: Comprehensive support is provided to patients and their families. One of these services is malnutrition support, which has reached 408 children and 350 infants to date. PIH also helps establish pre-schools in some sites and supports teachers by providing training in healthcare and education curricula. PIH also provides referrals for OVCs so they can access services from other OVC-specific organizations nearby.
5.Psycho-Social Support: This includes counseling for patients on HIV, trauma, death, and other issues.
6.Infrastructure: PIH builds clinics and facilities, including x-ray and laboratory facilities.
7.VSAT/satellite internet: PIH is providing VSAT connectivity to all of its current 6 sites through solar-powered energy and installation of internet services. VSAT will also be rolled out at all future Rural Initiative sites.
8.Basic healthcare and treatment: All Rural Initiative clinics provide basic health care to community members, ranging from trauma and referrals, to safe delivery and PMTCT.

PIH intends to expand to 2-3 additional Rural Initiative sites by the end of 2008. This expansion will include roll-out of complete health treatment and are package, as well a s VSAT solar power and internet connection.

PIH will also expand HIV treatment and training. They will also create a wider socio-economic assistance program reaching new groups including OVCs.