From the magazine

A Q&A with the writer of our story on the flying doctors of Lesotho from issue 59 of Delayed Gratification

The 59th issue of Delayed Gratification features a story by Julie Bourdin about the flying doctor service of Lesotho, which declared a national state of disaster shortly after the Trump administration exacerbated an economic crisis by ending critical USAID programmes and slapping sky-high tariffs on the southern African country. Matthew Lee spoke to Julie about her work on the story…

Why did you want to report on the flying doctors of Lesotho? The idea originally came from Tommy Trenchard, who took the photos. He had been in contact with MAF, the Mission Aviation Fellowship, for a while. We thought it was a really interesting way to approach the issue of healthcare and access to healthcare in such a poor country, which has a very big challenge with remoteness and lack of infrastructure. We also thought it would be a very visual story.

How critical is the flying doctor service to Lesotho’s healthcare system? It’s quite critical. For many rural communities, for thousands of people, they are the only access they have to doctors. There are often rural clinics with nurses, but not experienced doctors. For many people it’s a lifeline.

Was it challenging to arrange access for this piece – to get interviews with doctors with busy schedules, and to fly with them? The team were very open to us interviewing them. It was a bit complicated logistically, because obviously they need to prioritise healthcare workers and healthcare equipment over journalists, and on every flight everything and everyone is weighed. So when we went we could only bring a tiny little bag with maybe a toothbrush and the camera. And also, since on any particular day it’s dependent on both weather conditions and the medical needs of people, it’s hard to set up in advance. Travelling with them was a great experience.

Lesotho came in for extra punishment from the Trump White House in the first half of this year. The devastating spending cuts to USAID, in a country which relies on that money for its HIV-related prevention projects, were** followed by Lesotho getting the highest tariff in the world, 50 percent, later reduced to 15 percent. What were people in Lesotho saying about Trump and the US while you were there?** A lot of people were saying that it was a wake-up call, that we shouldn’t rely so much on a single country, and that maybe there was an opportunity for Lesotho to become more independent. But overwhelmingly the thing I heard was that it was unfair to just abandon people overnight, to cut programmes with no warning. Maybe the country needed to become more independent in its health system but it needed a transitional period, and people felt quite betrayed in that sense.

The situation in Lesotho does seem bleak. Did you find any reasons for optimism about the country’s future? Optimism might be too big a word. I mean, it’s possible that thousands of people will die from the USAID funding cuts. I’ve spoken to community health workers who say they already know dozens of patients who have died, from defaulting on their medication because the community health workers weren’t there. Not only HIV patients, but also TB patients. So I think it’s very hard to feel any optimism when there’s such a huge impact of the cuts on the healthcare system. Maybe it’s a bit inspiring to see some people in Lesotho say “we can do it” and look for a way through, and maybe we’ll see resilience in the medium- to long-term, but in the short-term it’s a disaster for the country.

You can read the full story on the flying doctors of Lesotho in issue 59 of Delayed Gratification, available from our online shop here.

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