- Malnutrition, non-communicable diseases, shigellosis, gastroenteritis, and anthrax emerge as high-risk dangers
Staff Reporter
The 2023/2024 El Niño event has devastated Southern Africa with widespread drought, extreme heat, and prolonged dry spells, exacerbating food insecurity, water shortages, and disease outbreaks across the region.
Lesotho, in particular, is bracing for severe health risks in the coming months due to the unprecedented drought, the worst in 40 years.
The World Health Organization (WHO) released a Public Health Situation Analysis (PHSA) report this week, sounding the alarm on critical health concerns stemming from the harsh conditions.
“The current El Niño event has severely impacted maize production across the region,” the WHO report said. “Communities have exhausted their food reserves with months still remaining before the next harvest in April 2025.”
WHO has classified several health threats as “very high risk,” including malnutrition, non-communicable diseases, shigellosis, gastroenteritis, and anthrax.
These threats could result in high levels of excess mortality and morbidity if not urgently addressed.
Malnutrition Crisis
With 19 percent of Lesotho’s population already in IPC Phase 3 (Crisis) or worse, the prolonged drought and economic challenges have pushed 293,000 people to the brink of starvation.
WHO’s report highlighted that severe acute malnutrition (SAM) cases have risen sharply, exceeding 200 by August 2024. The situation is especially dire in Maseru and Qacha’s Nek, where 30 percent of the population is facing a crisis.
“Severe acute malnutrition (SAM) cases have exceeded 200 as of August 2024, with management challenges due to frequent staff changes, impacting children with HIV/AIDS and adults on TB/HIV treatment.
“This situation is expected to worsen, with 403 000 people (27 percent of the rural population) projected to be in Crisis by early 2025 due to ongoing price hikes and La Niña impacts, while food availability remains unaffordable for poorer households,” the report warned.
Non-communicable Diseases (NCDs)
Non-communicable diseases remain a major health burden in Lesotho, according to WHO. As of 2021, the age-standardised mortality rate for four significant NCDs — Cardiovascular Disease, Chronic Respiratory Disease, Cancer, and Diabetes — stood at a staggering 1,320 per 100,000 for men and 970 per 100,000 for women.
“Lesotho has made minimal strides in addressing NCDs, with limited efforts focused on developing guidelines and implementing tobacco taxes,” WHO stated. However, it added, there has been “very limited progress” on other critical NCD control indicators, making these diseases a pressing health threat.
Shigellosis
WHO also identified shigellosis as a high-risk disease, especially during droughts, when clean water becomes scarce and sanitation deteriorates, increasing transmission.
It said by August 2024, Lesotho had recorded 431 cases of shigellosis, marked by diarrhea with blood, across different regions.
Gastroenteritis
The ongoing food insecurity in Lesotho has led many people to consume substandard food, including dead animals, putting their health at further risk.
WHO reported that, as of August 2024, over 6,399 cases of gastroenteritis had been recorded. This number is likely to rise if food security and risk communication are not urgently addressed.
Anthrax
Anthrax, particularly cutaneous and intestinal forms, has also been flagged as a significant risk, with outbreaks expected when droughts compromise livestock health.
“Increased human-animal interactions during droughts can lead to anthrax outbreaks,” WHO explained. Weak regulation of livestock movement, the absence of proper abattoirs, and poor veterinary services exacerbate the situation.
Measles
Measles outbreaks pose another threat, especially in areas where healthcare systems are weak or displaced populations congregate. Lesotho experienced a measles outbreak in Maseru district in 2023.
“Measles is particularly deadly in malnourished children, with mortality rates of up to 10 percent in such vulnerable populations,” WHO reported.
Protection risks, including Gender-Based Violence (GBV)
The WHO report highlighted Gender-Based Violence (GBV) as a severe issue across Southern Africa, where GBV prevalence is notably higher than the global average. In Lesotho, more than 86 percent of women and girls have experienced GBV at some point in their lives, a stark indicator of the pervasive threat in the region.
Acute Respiratory Illness and COVID-19
Droughts also pose a significant threat to respiratory health.
“Droughts have significant impacts on respiratory health. Drought-related changes in air quality, such as increased concentrations of air particulates and airborne toxins resulting from freshwater algal blooms, can irritate the eyes, lungs, and respiratory systems of persons with chronic respiratory conditions,” WHO stated.
It explained that Lesotho experiences seasonal Influenza like-Illness during winter season.
“Malnutrition in children can affect their immune system and thereby predisposing them to pneumonia that may lead to death especially in weak health systems like in Lesotho,” it said.
It mentioned that this can also be worsened by the hard topography in the highland areas of the country where access to health services is very challenging.
“By August 2024 more than 3 700 cases of pneumonia were recorded in OPD of the country including more than 580 cases of severe form of pneumonia,” it said.
