I am back in Mozambique, working at our health project and adjusting from the life of a spoiled expat to a quickly overwhelmed NGO worker. Today I started out in Mbatwe, a small village of mud huts built near the airport in Beira. We have had an on-going health project in this community for three years. We have more than 1,000 families participating in our HIV, cholera and malaria programs. They are wrapped into other social development projects too. The idea is after four years, participants will have improved health, housing, job training, education and well-being. The theory is that you use these public health models in communities that are hungry for change. It takes a village, so the story goes. In this village, we see progress in some areas (less standing water, better wells, more kids in school, more people being tested and treated for HIV) and then we have days like today.
I walked with two of our health leaders to do house visits with some of our families who have been struggling with health issues. I made it to three huts before I thought I was either going to quit and immediately go back home, or just sit down and sob. In each of the first three homes there was a child at the edge of death from malnutrition. In each of these homes, the child also had other complications — TB, HIV, orphan status, etc. And in each of these homes, the child’s caretaker knew how to reach out for help, where the feeding centers are located, how to get the dying baby into the hands of a health official and yet did nothing. If anything, they were angry (and perhaps shamed) that we showed up today to ask a few questions about the status of their family’s health. They are voluntarily participating in our project. Otherwise, we wouldn’t be stopping by. Each of these women presented a lengthy list of daily challenges that kept the baby’s health from being a higher priority. By the end of the third conversation, I felt my neck turning red in a flush of anger. Enough. I couldn’t hear another excuse.
I couldn’t be culturally competent or kind or compassionate or understanding that life is seemingly values life differently, and one more child dying isn’t that big of a deal. It is a big deal. They are a big deal to me — this bleeding heart liberal still thinks perhaps I’ll do something to make this country’s health a touch better.
And so I grabbed the third woman (the grandmother) and peppered her with a slew of questions before I put her two-year-old on my hip (suffering from malnutrition and a worm disease) and asked her to take her one-year-old (malnourished, HIV-positive) and said we were going to the clinic this very moment. These kids weren’t dying on my watch. I can’t be there everyday to guide decisions but I was not — absolutely not — walking away from this family. With a child bouncing from hip to hip, I walked behind this grannie (who managed to walk much faster than I could with a cloth wrapped around her waist, plastic flip flops on her feet and the sick baby on her back) for several miles before we reached the clinic. I sat with her at the malnutrition clinic, kept the kids entertained and soothed with hard-boiled eggs, oranges and bananas I bought from a roadside stand, and tried my hardest to keep my cool. The grannie spoke very little Portuguese, a language I have very little understanding of myself. Needless to say, my Msena isn’t so great either. But with my insistence and a bit of money, we got those kids into see a doctor. I don’t know what will happen tomorrow. I know I didn’t solve any problem long-term by putting my cultural competency aside and demanding we care for these kids today, but I can’t help but home for some change. Maybe another woman in the village saw us marching out toward the clinic. Maybe the two-year-old will fight on and survive and become a great leader for Mozambique. Maybe.

~K