The first week of June provided me a quick orientation to the excellent work of Friends in Global Health (FGH) in HIV care in Mozambique. It also served as an eye-opening reminder of the human devastation caused by AIDS when acting in concert with extremely poor primary healthcare, frequent natural disasters, population dispersion, inadequate infrastructure, and tremendous logistical challenges. These challenges have come to characterize Zambézia, the most populous province of the country and the staging ground for FGH’s PEPFAR-funded campaign to bring HIV detection and treatment to the rural areas of the country. In Zambézia, rural areas represent the second and most critical focus of PEPFAR projects which have traditionally neglected such regions due to the difficulty of operating in these settings.
Soon after arriving in Quelimane, the capital of Zambézia province, I traveled with the Friends in Global Health team to a rural district with one of the highest volumes of HIV patients seeking care. On a slightly overcast winter morning, I set out for Inhassunge district with Dr. Monica Carvalho, FGH’s clinical adviser for the district. Inhassunge is only some 25 km from Quelimane but is separated from the provincial capital by the River Cuacua. We left at 7 am from the port of Madal in Quelimane by a small ferry owned by a local shrimping company that has been giving passage to Ministry of Health staff and partners working in Inhassunge. After a 10 minute boat ride, we crossed over to Inhassunge district and traveled via land-cruiser to the district hospital in the locality of Macupia. Although the distance was only 15 km, it took us nearly 45 minutes on an extremely rough and bumpy dirt-road. Locals either walk or travel by bicycle within the district but in the rainy season the dirt roads can become virtually impassable. Dr. Monica mentioned that even in the land-cruiser it was very difficult to get to the district hospital in the rainy season due to heavy flooding, which increased the complexity of providing healthcare to the region.
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Michael Lear, Haiti, Jan 25th 2010
Worldwide, Cancer is on an exponential rise. The WHO says that 80% of deaths related to disease of affluence occur in developing countries, roughly 28 million a year, and that this number is expected to quadruple over the next decade.
August 2009
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