This article is concerned with two factors affecting the health status of the people of Lesotho: (1) the nation's function as a reserve labor economy (that is, the primary source of income for about half the country's male labor force is employment in South Africa); and (2) the health care system (its size, composition, accessibility, and efficiency). Although such apparently diverse factors usually are analyzed independently, they might be combined to provide a more complete understanding of the determinants of health and disease.

The paper reaches the conclusion that any substantive solutions to the problems of Lesotho will be found primarily in the wider southern Africa setting, and not within the context of small, dependent national states. At the same time, these small, dependent national states must make development decisions considering existing geopolitical realities. Foresightful decision making on these issues could both contribute immediately to the health of the people of Lesotho, and also increase the longer-term possibilities for a better life for all the people of southern Africa.

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