Calling out for National Health Week

Spent the day in Marracuene district today to do some monitoring of the National Health Week initiative here in Mozambique. Will share a couple of photos tomorrow but until then, here’s a short video. The man with the megaphone was shouting out information in both Portuguese and the local language Shangana, urging parents to bring their children to the mobile health post in the market for their essential vaccines.

In the end, however, as we all know – what draws most attention and interest is music.

The Mozambican Health Ministry has launched a nationwide “Health Week” starting on Monday the 26 November. During the week, all involved partners will cooperate to offer interventions aiming to improve the health of more than four million children under the age of five, and almost a million of women of reproductive age.

In all of the country, all children up to the age of five will be vaccinated against polio, children aged from six to 59 months will receive essential Vitamin A supplements, and children that are more than one year old will be dewormed.

Information campaigning and social mobilization has been carried out over the past 30 days to inform parents and other care givers such as teachers, community leaders, the private sector, political parties and religious leaders, of the need to ensure that all children receive the polio vaccination and the vitamin A supplement, which are essential for strengthening the immune system of children, protecting them against disease.

Additionally, all people of reproductive age are invited to attend counseling sessions on family planning where they will receive contraceptives of their choice during the entire week.

The initiative will take place in all health units in the country and mobile health brigades will visit villages and communities from 26 to 30 November.

As published on the UNICEF Mozambique website

“The health center is my home and family”

Photos and story from the visit to the Health Center in Changara, Tete province. Published on the UNICEF Mozambique website.
© UNICEF Mozambique/2012/C.Bach

Ladies dressed in colourful traditional capulana fabrics are standing in a long line outside of the main health center in the district of Changara in Tete province in Mozambique. They are accompanied by their children and are today attending the monthly health control where their babies will be weighed, measured and checked for diseases.

Little Debora Inácio is four months old and is being held by her grandmother. The mother stands next to them, explaining why they have come today. “We come here once a month to check that everything is okay with the girl. It is very hot sometimes and we have to wait for a long time, but we are very thankful that the health centre takes care of us and our children,” she says, showing Debora’s health card with charts showing whether the girl has the weight adequate to her age.

Almost 200.000 people live in Changara and this is the only Health Center where a licensed medical doctor and admission facilities can be found. Dr. Fausto Muzila is the young doctor that is taking care of the entire district and supervising nurses and other health professionals. He has some support in his work from medical technicians and 12 smaller health clinics, but not even this main health center has advanced enough facilities to take care of some of the most acute and severe cases.

“We do what we can here in Changara, but when somebody needs a surgery after a car accident or when a mother is delivering a baby and acutely needs a caesarian, we simply cannot help them,” Dr. Muzila explains.

Patients in need of urgent medical attention that require surgery or x-ray are sent to Tete, the capital of the province, 100km away from Changara. “It takes more than one hour to reach Tete so it happens that patients die in transport just because they don’t reach the hospital on time, this is very sad,” Dr. Muzila says.

A bit further away, a team of health workers are showing young mothers how to prepare nutritious food for their children from locally grown ingredients such as corn, peanuts and moringa leaves, a very vitamin-rich plant that also contains magnesium and proteins. The mothers are informed that they only need to feed their babies with breast milk during the first six months, as it contains all nutrients the babies need, contrary to the belief in some of the communities.

Carmita, a 19 year old mother, is watching the presentation with her four month old baby, little Beyonce. “This is my first baby and now I will be able to cook food that is good and healthy for her,” she smiles, letting the girl taste some of the mash that the health workers have prepared.

HIV and AIDS related symptoms and diseases, malaria and diarrhea are the main reasons people come to the health centre. Lately however, after a large distribution of mosquito nets in all the communities, the numbers of cases of malaria are less than half of what they used to be.

“The mosquito nets have made a huge difference in the communities,” Dr. Fausto explains. “Now I only work 24 hours a day,” he jokes, smiling and pointing out that he has dedicated his entire life to working at the health center. “I don’t have my own family, I wouldn’t have time. Besides, the patients, the work I am doing here, it is all very rewarding. The health center is my home and family”.

The value of a stranger’s life

“This boy is a thief, they should just let him die.”

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We stopped the car when we suddenly saw a young man laying on his back in the middle of the highway. Thick, dark blood running out of the back of his skull, short jerking breaths, eyes flickering back and forth, body crooked into an unnatural position. The heat was unbearable, the sun was stinging.

There was a pickup truck on the side of the road, the men in the back were discussing, hesitating whether to stay or to leave. “He’s a thief, he jumped out! We are going to the police!” the men shouted as the car drove away.

We were left alone with a body we didn’t know anything about. There was a rope tied around the boy’s wrist, he had been tied up like an animal. He was wearing nothing but a pair of jeans shorts. His lips were dry and he had bad wounds all over his body. He looked younger now when we were closer, like a teenager, alive and awake, but not present. What happened here?

“We have to set up the warning triangles from the cars.” “We have to get the boy out of this sun, he is barely breathing.”

We brought umbrellas for shadow, a first aid kit, desinfection fluids. A person in our group was a doctor, the first thing he did was putting gloves on. “Of course.” I thought, running the HIV prevalence numbers in the province through my head while looking at my legs that were covered by small drops of blood. The boy was coughing and the wind was carrying the blood my way. “You have no open wounds there, Caroline. Focus.” I had bought a simcard from a differnt provider as I knew my normal number wouldn’t work out in the field. It was the only phone with reception and I called the only medical doctor in the entire district, I had saved the number in my phone just in case I would need it. The ambulance would be there in 30 minutes, at least. We were very far out in the middle of nowhere.

Curious people from the villages nearby stopped to have a look. The level of proactivity from their side was below zero. “Get two strong branches, we need to move the body.” We took our mosquito nets and secured them between the branches, building a stretcher. A person walked around desinfecting hands. I finally got that blood off my legs. The boy went into a seizure attack.

“Keep that head up, he is choking on his own tongue!” Basic things you learnt in school come back to you as the most obvious things ever. You forget that it’s not clear to everybody that a wounded person might need help breathing and keeping their airwars cleared. That a body and head that clearly has suffered from an impact shouldn’t be moved around too much. What was clear was that this young man had hit his head very hard against the paved road.

The men lifted the boy using the improvised stretcher and took him to the side of the road, into the shadow. The doctor was keeping the head in place as the boy had a seizure again. “This happens when things are starting to go really bad on the inside.” the doctor quietly explained in English. “I am not very hopeful about this one, this is all taking way too long.” The endless wait for the ambulance.

The people with the pickup truck came back. They told us that the boy had stolen some cows. The men had caught him and his three friends when they were on their way to the city to sell the cows, it was 11 cows. They had tied the boys up and were taking them to the police station when this one suddenly jumped out of the car. A man came, it was the boy’s uncle. “His name is Edmo, he is almost 20 years old.”

“Why don’t they just leave him here to die?” somebody in the group said in a local language. “Yeah, he is just a thief.” a person added. Our driver understood enough. “A judge can tell you if he is a thief, and a prison will punish him if it is true! Who are you to decide if a person is to live or not? You are responsible by leaving him here instead of taking him immediately to the health center – you are the one’s who will be judged for murder.” the men kept quiet. The ambulance wasn’t arriving. We shared the water we had with the villagers.

“This thing won’t open, it’s closed.” a man said, fumbling around clumsily with the lock at the back of the pickup truck. “I guess we have to just throw him in from above or something.” he stopped trying and waited for further instructions. I grabbed the rope holding the door closed and untied it, it was a very simple knot. “What do you mean it doesn’t open?!” I was so angry about the lack of proactivity that I was boiling on the inside. The men lifted the man into the back of the car. He sounded as if he wanted to scream out in pain but didn’t have energy or control enough to do so.

The pickup drove off. A dying boy, ten clueless men and an uncle. 45 minutes after the accident. We urgently needed to leave in the opposite direction.

“Are you sure they are taking him to the health centre now?” I was in doubt. “Yes, they are many and the uncle is there,” the driver answered. “If there were only four of them it could have been dangerous”.

The doctor called us later in the evening. The boy had made it to the health center but needed to be transported to the nearest city 100km away, as the local health centers don’t have enough capacity to take care of such serious cases. He died on the way there. Because he stole a cow. Because people chose not to save him. Because there was no ambulance close enough. Because this is Mozambique, one of the world’s poorest countries.

Filming in Changara

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Three months later, I’m back in the little district of Changara in Tete province.

This time, I am accompanying a UNICEF Finland National Committee, a national celebrity and UNICEF goodwill ambassador and a film crew to collect some material for Finnish TV. My role here is to take care of everything, translate, solve, inform, fix, accomodate and – apparently – walk, talk, and pretend like I am not seeing the cameras in front of me.

Unprepared and surprised, I was thrown into the show because I could do the translation between Portuguese and English. I also got to coordinate the team and give instructions to people we met on what to do and how to act on request of the director and TV crew. Totally new thing for me and great amounts of fun.

The team has chosen to focus on health, so today we visited the Changara health centre where we met with the only medical doctor in a district of almost 200.000 people. When I asked him how many hours he usually works a day he answered 24 and that he basically lives at the health centre. Committed people really do inspire.

We attended a demonstration where mothers were taught how to prepare nutritious food for their children using locally grown ingredients. Later we went with a local community health worker to visit a family where we got information about the distribution of mosquito nets and malaria and in the evening we attended a big outdoor movie screening for the community where mobile multimedia units were showing video clips with discussions in between and where the focus was malaria, malnutrition and tubercolosis.

And those wonderful baobab trees? You knew I wouldn’t write a blog from Tete without mentioning them but this time I will give you a photo of me hugging one instead. That’s how much I like them.

Tomorrow the filming continues. And then we leave this difficult but very real place that should not be forgotten. I would wish for more people to get out of Maputo every once in a while to also see and understand the problems in the rest of the country. This is Mozambique, as real as it gets.

All I want for Christmas

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– So when are you coming?
– I will probably be home on.. I mean, in Malmö on the 24th..

And the feeling that immediately strikes you afterwards, about definitely not identifying with that city as your home.

Should I stay or should I go, now?

I need my palm trees. I just wish I could bring all my close one’s here and show them the beaches, the sea food, the long nights full of dancing, the people and the wonderful sun. Might change my mind next week though. Going to Tete province and I have been told I will most probably melt.

UNICEF Mozambique – the page

This week, the focus on the UNICEF Mozambique Facebook page will be the Child-Friendly Schools initiative, presented through my stories and photographs from the field. Do you recognize the photo in the header? They are the two lovely girls Winet and Stefi who I met in Changara, Tete, when I was there in August.

The page is very popular, closing in to 6,000 likes and sharing information and stories about the situation of children in Mozambique both in Portuguese and English. Only 12 of my friends are currently liking the page so I would be very happy if more of you clicked the photo below, liked, and followed my stories. :)

 

UNICEF Publication: Child-Friendly Schools, Stories from Mozambique

New page in the projects section:

August-October 2012

 

As part of my 5 month assignment for UNICEF Mozambique, I travelled to the field to photograph and write stories related to our activities within the Child-Friendly Schools initiative. The final product was a bilingual 40 page booklet that was published and disseminated internationally. Click above for the pdf.

Under the aegis of Schools for Africa, the Child-Friendly Schools initiative in Mozambique promotes the rights of children and aims to improve the quality of primary education through a set of multi-sectoral interventions. It reinforces the goals of the Government of Mozambique’s Five-Year Plan (2010-2014) to realize an integrated and cross-cutting approach to basic education.
This includes child-centred teaching approaches, life skills education, physical education and sport, the provision of water and separate sanitation facilities for girls and boys, construction of classrooms, immunization and health screening, mechanisms for the prevention of violence and abuse, and initiatives to reach orphaned and vulnerable children. The programme also empowers children to voice their opinions, and uses various forms of media in the social mobilization of communities in order to promote the rights of every child—especially girls.
This booklet presents inspiring stories about Mozambique’s Child-Friendly Schools and the difference they are making in the lives of the poorest children. These stories, from two districts, are representative of experiences from all seven districts engaged in the initiative —Changara in Tete province, Chibuto in Gaza, Buzi in Sofala, Mossurize in Manica, Maganja da Costa in Zambezia, Angoche in Nampula and Montepuez in Cabo Delgado.

© United Nations Children’s Fund (UNICEF) October 2012
Permission is required to reproduce any part of this publication.

Back

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And just as infallibly as always, it cured everything. The sad face, the sore throat, the melancholy, the boredom and the uncertainty. There is nothing in the world that can compare to the wonders that dancing does to me, my body and my mood. I’m back on track again.

The painting above is from Núcleo de Arte here in Maputo, the Sunday hangout venue where art meets live music, grilled food, expats, rastas, dancers, painters and – unfortunately I don’t know the name of the artist.

(The sore throat might also have been cured by a wonder-spray that I got from a friend and sprayed onto my non-existent tonsils a couple of times. And the bottle of wine we shared the same day while painting our nails and talking about girly stuff.)