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| Crowd that gathered at the airport while we were waiting for the plane to arrive |
The week before last, I had the
opportunity to fly out to the District of Gurué with one of the doctors that
MAF flies on a regular basis. Located west
of Nampula in the Zambezia Province (about an hour and fifteen minute flight in
the Cessna 206), the area is characterized by beautiful mountains, tea and
macadamia tree plantations, and huge stands of eucalyptus trees.
We were scheduled to take off at
6:30am. While Dave prepped the plane, Dr.
Hanneke Dekker went to the hospital to pick up the patient that had been
brought to Nampula on the previous return trip from Gurué. As Dave went through his run-up, he discovered
a problem with the plane. Fortunately,
the Cessna 210 was available, so off we went, leaving Dave with wrench in hand
to work out the problem on the 206.
Although I didn’t get to fly with my Dave that morning, I did get to be “co-pilot”
with the veteran Dave, our Program Manager, and he even let me take the
controls for a bit :)!
Upon arrival, we were picked up
in the medical team’s Land Rover and the first stop was the hospital in town of
Gurué. Here Hanneke does ultrasounds
with her portable equipment each visit because the hospital does not have
ultrasound equipment. We also picked up
plastic boxes of medicines that are stored at the hospital’s pharmacy that she
would use at the various clinics throughout the week. We also met up with José, a Mozambican who
knows the local language and assists quite a bit with the patients.
The doctors rotate between 12
villages where one afternoon they will make house calls, visiting patients who
are too ill to travel to the clinic.
Each village has a volunteer (Activista de Saude) who help locate which
patients need visits in their village.
This week, the Activista organized a town-hall style meeting where they
discussed the methods of preventing diarrhea and the importance of building
latrines and afterwards Hanneke examined several patients.
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| Folks gathered from the village for the meeting |
The next day we headed out through
the mountains to a remote area that is approximately a 2 hour walk from the
nearest clinic. On our way, we hit a
muddy spot in the road and got the Land Rover stuck. An hour and half later and with the help of a
dozen folks who wandered out to watch and help, we were “un-stuck” and back on
the road.
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| Does this really need a caption? |
As we neared the make-shift
clinic, we met up with the queen of the village, who rode with us to the clinic
along with another patient. Our delay
was unfortunate because the doctors are only here one afternoon twice a month
so you can imagine the number of people that wait for a turn to see the doctor. Because we arrived late, we stayed late, and
as dusk was approaching Hanneke and José quickly administered malaria tests to
babies, knowing that if they didn’t get the meds, the outlook might not be
good.
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| Arrival at the remote clinic |
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| Queen of the village |
The following day, on our way to
another clinic, we dropped off letters at a couple of schools in the area to
find out if they would like to have a visit from the dentists to talk about good
dental health.
When we arrived at the
clinic, we saw that a tree had fallen on the building and collapsed a corner of
the building since the last visit, but fortunately the examining room was still
usable.
Again, there were more patients waiting
for a turn with the doctor than there was time.
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| Dropping off a letter at the school |
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| Clinic hit by the tree |
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| People waiting their turn to see the doctor (tea plantation in background) |
That afternoon, the Activistas from
the various villages traveled to the old tea factory for a training
session. The topic of the day was
nutrition and diarrhea prevention. Afterwards,
they took a test so the doctors could see how effective the training sessions
have been. A t-shirt and cap was given
to each volunteer so they could be identified in their village as they go back
to encourage others to have healthier lifestyles.
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| Activista and her daughter sporting her new cap |
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| Activistas with their new shirts and hats |
The last morning before leaving, we
visited one more clinic. This clinic has
a medical assistant available and can see patients even when the doctors aren’t
in town. But even this isn’t without
problems as the assistant told us that they had already run out of malaria
medicine earlier that week.
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| Examining room at one of the clinics |
After several days just being a
fly on the wall, watching Hanneke diagnose patients (occasionally I counted out
pills or carried equipment), I gained a new understanding of the culture and
the challenges of practicing medicine in rural Mozambique. Sometimes people come to see the doctor much
too late and at other times for almost no reason at all. One man had a burn wound that was several
years old and the skin had healed in such a fashion that he could no longer bend
his arm at the elbow or shoulder. Some
are hopeful for a magical cure (as evidenced by the scars left behind by the
traditional healers) for problems that have no simple cure. I watched a man learn he tested positive for
HIV but couldn’t discern if he really understood the gravity of the
disease. Will he find a way to get to
the hospital in Gurué for treatment when it is over an hour’s drive away? Multiple people came in with aches and pains
making me realize how much I take my bottle of Ibuprofen for granted. A simple sore knee is not so simple when you
walk everywhere you need to go, often carrying heavy loads of water and
supplies. Many folks suffered headaches
solely because of dehydration or had sick babies only because of
malnutrition. But did they understand
the simple advice of the doctor or would they go back to the witch doctor for a
“better cure”? I watched the emotion on
a woman’s face as she learned she was pregnant (her only other child was 18)
and couldn’t tell if she was happy or sad, amazed or shocked. I saw parents bringing in children with
mental disorders hopeful that the doctor could make them normal again. An older gentleman came in with his Bible in
hand, hoping for some reading glasses, and he left smiling knowing that he
could once again read God’s Word. One
woman brought in a baby with a severely infected eye that was not responding to
the antibiotics. Will that baby end up
losing its sight? One woman and her four
year old daughter came in each carrying one of her twin infants. She had walked to a different clinic the day before
only to find they were out of the malaria tests so she had walked several hours
that day to the clinic we were at.
Listening to Hanneke ask the patients questions, I was shocked at some
of the answers. Many mothers don’t know
how many months old their babies are, many children don’t know how many years
old they are (often the parent would make a guess), and sometimes the symptoms
were blamed on evil spirits.
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| Hanneke and Jose administering malaria tests |
The clinics are simple, just an
examining room with a table and a place for the patient to lie down to be
examined. No running water, just a
bucket of water and some soap in the corner.
The pharmacy consisted of the plastic boxes of common medications that
the doctor would sort through, hopefully finding the right one. The next time you visit your sterile, fully
equipped doctor’s office, say a prayer for Dr. Hanneke and Dr. Pim as they practice
medicine under these challenging circumstances.
The next time you complain about sitting in the air conditioned waiting
room watching TV, instead pray for patients here who walk for hours and would
wait the day to see the doctor. And
the next time you grab for that bottle in your medicine cabinet, remember those
who can’t just run to the drug store to soothe their aches and pains. I know I will!
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| My Dave coming to pick us up |
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| Kids posing after the town-hall meeting |
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| Woman talking during the meeting |
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| Landing strip at Gurue |
