For the past 30 years, nurse-midwife Semakaleng Phafoli has worked to prevent the spread of HIV among pregnant women and their newborns, advocate for quality health services for families, and ensure that nurses and midwives have the skills to deliver lifesaving care.
Phafoli’s outstanding work in her home country of Lesotho has earned the 55-year-old educator and trainer the distinction of Heroine of Health. She was one of 13 health care providers recognized last month at the World Health Assembly meeting in Geneva, Switzerland.
As a child growing up in a small village in Lesotho, Phafoli admired nurses for their bright white uniforms and aspired to be one of them. She saw that many of her neighbors weren’t as lucky as her mother, who survived giving birth to 11 healthy children at home. Home births were common in Phafoli’s village because the nearest health center was 25 miles away, making it difficult for pregnant women to reach.
Recognizing the importance of the local health care provider, Phafoli studied hard to become a nurse, eventually earning a doctorate. Her doctoral research led to the first Teenage Pregnancy Awareness Week in Lesotho in 2005. Along with this advocacy effort, she created a program that led to an increase in the number of pregnant teens attending antenatal care early in their pregnancies.
Phafoli’s work in HIV/AIDS came about because of a great need in her country, one that still exists: In 2015, the Joint United Nations Programme on HIV/AIDS reported that 310,000 people (of a total population of 2.1 million) in Lesotho were living with HIV.
Meanwhile, she traces her determination to ensure equity in health and justice for women to one particularly heartbreaking case. She was working in a clinic when a teacher brought in a 7-year-old student, a girl whose mother had recently died from an HIV-related illness. The girl’s father also was receiving treatment for HIV. When she examined the child, she learned that the girl had been raped by her father.
“This became another reminder that improving the health and welfare of a woman, a family and a country is an ongoing endeavor that requires much of a commitment,” she said.
Phafoli is living that commitment through her work as the senior nursing and midwifery technical advisor at Jhpiego. To strengthen primary health care services and ensure that nurses and midwives have the proper prerequisites and skills to deliver high-quality care, Phafoli is working in conjunction with six nursing and midwifery institutions in Lesotho. She has also partnered with the Ministry of Health, the Christian Health Association of Lesotho and the Lesotho Nursing Council.
For the past year and a half, she has presided over the Lesotho Nurses Association (LNA), established in 1966 to look after members’ welfare by ensuring a healthy, motivated and efficient workforce. In that role, Phafoli strives to fulfill the LNA mandate to raise the confidence of women in general, and specifically that of nurses and midwives.
Nurses and midwives in Lesotho account for more than 70 percent of all health care workers, with a presence in all settings, she explained, adding that more than 80 percent of nurses and midwives are women.
She’s proud that the health care system of Lesotho is nurse driven—and motivated by the daunting responsibility. Because her profession—and her country—depend on more nurses joining the ranks of the LNA, and on greater numbers of smart students electing to study nursing and midwifery, she is an ardent recruiter.
“With the high prevalence of HIV/AIDS and TB—Lesotho has the second highest HIV prevalence rate in sub-Saharan Africa—the health care system is overburdened,” she said, citing a client-patient ratio of six nurse-midwives per 10,000 people, compared to neighboring South Africa with a ratio of 41 nurse-midwives per 10,000 people.
An inspiration to many, the newly named Heroine of Health said she is encouraged to keep advocating for nursing leadership opportunities and advancement by nurse Leslie Mancuso, Jhpiego president and CEO, who says, “If you do not have a seat [at the table], bring your own [chair].”
Vaidehi Kaushal, a student at the Bryn Mawr School, worked as an intern in Jhpiego’s Baltimore office.