Thumbs up to one of our incredible team members and volunteers on the left in this pic, Tracey Allen, NNP! In Mozambique her strengths, skills, and concern for others shined. She was an attentive teacher, always assuring that the message was received and understood in her students' language of origin. She taught her team members through modeling that taking time for reflection and recharge are essential on medical volunteer trips. Tracey gave and gave and gave and yet still had more to give. Thank you for everything, amiga! Here is Tracey's personal reflection on our trip, in her own words:
Mozambique is HARD. The air is filled with smoke from burning trash in the streets and with smog from outdated and overused busses and trucks that lurch along, each packed so full of humans that the wheel wells touch the tires. Most people make a living by selling used goods out of shacks, which are lined up along the road. The merchandise, I learned, is shipped to Africa after being passed over in American and Canadian secondhand stores. So one shack has t-shirts from Super Bowl 1982 displayed on stick hangers, and the next has a variety of stretched out and used bras. A little farther down the road you can find metal pans, Tupperware, phone chargers, produce, some eggs stacked up in the heat.
Mozambique is HOT and without much vegetation to offer shade, and yet I saw mothers walking for miles along the highway with piled up laundry on their heads and several shoeless toddlers in tow, making their way to the nearest river in order to simply do laundry.
Mozambique is CROWDED, shoulder to shoulder, with people who look desperate and who looked at us with suspicion and what felt like disdain. Initially I took this personally, but over time, I learned a hard truth about Mozambique. Our group went on a grocery outing in the city in order to buy snacks for our students and sheets for the hospital. Escorted by our wonderful translators, Alexandre and Dicla, we set out through the city, in search of a “Trader Joe’s” and “Joann’s Fabrics.” They advised us to walk in between them with one male in front of the group and one male behind. Now, being an independent woman, and being from the bustling metropolis of Denver, Colorado, with its dangerous hipsters and their humanely harnessed golden retrievers, I felt this was a little dramatic, but none-the-less, went along with their patriarchal recommendation. When we reached the “Trader Joe’s,” we were followed around by no less than four store employees, each of whom watched us so closely that we could barely even walk through the aisles. When we had decided on our purchases and were ready to pay, Dicla leaned all the way over the counter and watched the computer as the sales person scanned each item. I was a little embarrassed by his behavior because this seemed really rude to me, and just when I wanted to disappear from the mortification, he doubled down, pulling out his phone and manually checking the math as each item was added. The sales person wasn’t the least bit phased by this. When we left the store, I asked him why he felt like he needed to double check the computer. “If you don’t show them that you are watching, they will add on extra charges,” he said, simply, as if this was common knowledge.
I was still processing this as we walked back to our bus, one male interpreter leading the way, and another in the rear, making sure all was ok, both carrying crates of water for us because, we were women, after all. When we reached the bus, Chrystal motioned for Dicla to get on the bus ahead of the two of us because he was carrying the heavy box of water. One split second after he stepped onto the bus, two men came running up the side of the bus, one of them pushing Dicla forward, trying to get on the bus, and the other, blocking the door, separating Chrystal and me from the group. Immediately, our driver, Diogo, our two translators, and our one male nurse, Josh, jumped into action, charging off the bus, forcing the one man off the bus, and pushing the other away from Chrystal and me. One of the men snarled and bit at Diogo, making snapping motions in the air with his mouth. Chrystal and I quickly jumped on the bus, Diogo ordered us to close all the windows, and within seconds we were driving quickly back to our gated, guarded hotel.
Letting off some steam, we shared some laughs about this adventure on the way back to the hotel, but a hard truth was settling in. In Mozambique, Africans don’t even trust Africans, much less do they trust outsiders. They spend every second of the day looking over their shoulders, looking for danger. There is a lack of honesty and of basic safety in Mozambique, and I’m still realizing how much I take for granted, the blessing of living in a safe community; the simple freedom to wander aimlessly down the aisles of a real Trader Joe’s, my purse sitting recklessly in the child seat of my cart, while I consider various salsas and gourmet popcorn varieties. The extravagance of this gift is outrageous. And so, as our group adjusted to this reality and in a very short period of time, we also began to adopt this look of suspicion and disdain. We began to see others not as simply human beings, but as potential threats, and I learned that my “assumption of good intention” is a luxury of the privileged.
Mozambique is dysfunctional at a baseline. Nothing works correctly, from the computer system at the VISA department (what ?!), to electricity at the university. Nothing is reliable. When things break down, no one fixes them. There is a pervasive apathy that I began to understand only after experiencing the never ending barrage of difficulties one faces when trying to accomplish ANYTHING in Mozambique. Every seemingly simple task turns into a monumental undertaking because the tools that, in the US, we take for granted, simply don’t exist in Africa. Students don’t have chairs to sit on, don’t have food in their bellies. Nurses don’t have water for hand washing, much less IV supplies or antibiotics to administer to their sick patients. The patients don’t have sheets on their plastic mattresses, don’t have food to eat while admitted unless family members bring it in for them. There are no cafeterias in this hospital, there is no Panera Bread across the street. There are holes in the ceiling of the hospital, black mold running down the walls, pigeons flying in and out of the building, insect nests on the banisters of the staircases, roaches crawling down the walls. The toilets don’t flush. Hand soap and toilet paper are non-existent. The autoclave screeches relentlessly for hours each afternoon while it “sterilizes” materials. It’s hard to describe the futility that one feels in this reality. It is exhausting, frustrating, hopeless.
There’s not enough food in Mozambique. It became apparent that many people spend each day trying to obtain enough food for themselves and their family just for TODAY. There is no meal planning for the week, no crock pot preparation to streamline Wednesday night. At dinner one evening, although I was hungry, I had decided that my chewy calamari tentacles were just not going to go down the hatch. There were two cats wandering around the restaurant, one meowing loudly, soliciting scraps. I decided to be a humanitarian (ha!) and offer him some squid. He gobbled down each bite with enthusiasm, and when his fellow cat arrived next to him, he repeatedly and selfishly took each bite, denying his friend even one piece. Irritated with him, I tried to maneuver my hand so that the less dominant cat would get some food. In response to this, the dominant cat swiped at me, drawing blood from my hand. While our group discussed the transmission of rabies and my potential risk of infection and need for transport to South Africa, I told Micah, one of the nurses, how disappointed I was in that cat. “Why was he such a jerk?” I asked her. “He literally just bit the hand that was feeding him!” She looked at me and cocked her head just a bit. “He’s hungry,” she said, shrugging her shoulders. And I started to understand.
I met a boy named Antonio on Mozambique Island where we spent our weekend in a VRBO on the beach. We arrived on Mozambique Island on a flatbed truck. We had hitched a ride after our bus had a flat tire that was unrepairable. The truck dropped us off in the main circle of Mozambique Island because we didn’t know where our VRBO was and we were finding it difficult (impossible) to get WiFi. Antonio spoke only Portuguese so I had no idea what he was telling us, but he confidently led us down the cobblestone streets. We followed him and, sure enough, he led us directly to our VRBO, one of two buildings on the island that typically host “rich people.” To thank him for his assistance, I gave him a soccer ball which he happily accepted. That night, he wandered up our beach, looking for me because he wanted to give me a handmade shell necklace in return for the soccer ball. Of course, I fell immediately in love with this little guy. The next morning, I pilfered some food for him from the breakfast that was included in our VRBO. I didn’t know if I would see him again, but I had a feeling I might. About an hour later, I spotted him on the beach and called out “Antonio!!!” He looked up, threw his hand up in the air, and waved at me with a giant grin on his face. As I started down the stairs, I noticed him motion to his friends around a group of rocks. I wanted to give the food only to him, so I was frustrated that he was bringing his friends over, but I had no way to tell him not to, so I just hurried down the stairs, hoping to give him the goods before his friends arrived. Once on the beach, I realized why he motioned for his friends. They were carrying a hand woven grass basket full of sea shells which they had collected for me. “This is for ME?” I asked. “Yes!” he told me, looking perfectly pleased with himself. I handed him the baggie which contained two rolls, each filled with eggs and cheese, and one half roll, all that was left from our group’s breakfast. He smiled broadly and said “obrigado” (thank you) as he took the bag and began handing out the food. One sandwich went to a friend around his same age, and the ½ roll went to the younger boy. As they ate, continuing to speak to me in Portuguese with full mouths, Antonio noticed that the half roll, which he had given to the youngest boy, didn’t have eggs or cheese inside. He opened up what was left of his sandwich, scooped out the now melted cheese with his dirty hands, and began wiping it onto the roll for the younger boy. Over the next few minutes, I made out the word, “aqua,” from their chatter and realized that in addition to not having any breakfast, they also didn’t have any drinking water. I proceeded to steal abandoned water bottles from around our VRBO and shuttle drinking water down to them.
Of course you want to know if I gave him any money, and the answer to that was a long, thought-out and complicated decision that was influenced by our lack of local currency (ATMs don’t work and currency exchanges don’t exist) and my worry that giving him American bills would endanger him. In the end, I did give him $40 US dollars, which is the equivalent of $2400 in Mozambique. I still worry that this wasn’t a good decision, but I felt so helpless to do anything else for him. I wanted to fix his life so badly. I wanted to give him a refrigerator full of food, a bedroom with his name stenciled above his bed, a chance to go to school. I wanted to protect and encourage his already abundant generosity. I couldn’t do any of those things, so I gave him 40 bucks and, in a language that he didn’t understand, I told him to put the money in his pocket and to be careful with it. It was such a lame response to human suffering. I felt so completely helpless. I worry about him every day. I worry that his generosity will turn into the skepticism and suspicion that I witnessed in the city. I worry that someone will hurt him for that money. I worry that someone will take advantage of him and sell him a pair of flip flops for forty bucks. I worry that, without shoes, he will cut his foot and contract an infection for which there are no available antibiotics. I worry that he will continue to be hungry. I worry that he will get HIV, that he will father 14 children that he will not be able to feed. And I just left him there. I waved goodbye to him from the bus, telling myself that stealing children from Africa is frowned upon. As if that’s an excuse.
So in the midst of this HARD setting, in this country so full of HARD things, we taught “Helping Babies Breathe” and “Essential Care for Small Babies” to approximately 120 health care students and health care workers. We squeezed into impossibly small spaces with our smelly bodies and their smelly bodies, and we taught them how to use a bag and mask to breathe for a baby who cannot breathe for him/herself. One nurse told us that she got a chance to put her new skills to use during her first clinical rotation after our class and that she “saved the baby.” Our students shared stools when there weren’t enough seats, shared lunches when there wasn’t enough food. They sat in a stuffy classroom with their precious white lab coats that must have been impossibly hot to wear. They stuck it out and we stuck it out, not really sure if what we were saying was resonating. At the end of one training, as if in response to our uncertainty about the relevance of our curriculum, one of the nursing students pulled out a guitar, and led the class in a song for us in order to express their appreciation of the knowledge we shared with them. Many students asked to take selfies with us. They told us that we had become “a part of the history of the university.” So of course, we cried.
Your donations allowed us to buy so many needed items. First, we provided snacks and water for our students. The first day, these were small, and relatively insignificant snacks, but when we saw the enthusiasm that these treats elicited, we asked Dr. Ron what was going on. He told us that the majority of students come to class hungry. In Mozambique, some students have scholarships that cover the annual university tuition of $80 US dollars, but they struggle to afford housing and food. Needless to say, we began providing more substantial snacks thereafter.
Your donations allowed us to buy fabric that will be turned into sheets for the hospital mattresses. We bought 36 yards of dark green fabric and presented it to the nurses at Mararre Hospital. When considering such an abundance of material, one nurse said “We should cut them longer so that we have more to tuck under the mattress!” Another nurse said, “No, we should cut them the normal length so that we have more of them!” And of course, in that moment, we all wished that we had bought two bolts of fabric, rather than one, but when we were buying supplies in the city of Mozambique, we had to buy only what we could carry back to our bus, so food and water for our students won out over more fabric. Hence, the obstacles one faces when trying to perform simple tasks. . . .
We paid for our own translators which we recruited after the university failed to provide the 8 translators that they had promised. More of typical life in Mozambique! These men worked so hard for us, showed up on time every morning, and truly made our teaching possible. Alexandre was separated from his family because he was looking for a job in Mozambique. At the end of our time with him, we loved and appreciated him so much that we doubled the wage we had been paying him, the cost of a trip to visit his family. We donated all of the teaching material that we purchased from the AAP so that the students we taught can teach others. We donated “ambu” bags, which are the devices needed in order to “breathe for a baby.” These are tools you will find in EVERY delivery room in the US. We throw them away if they touch a patient and become “contaminated,” yet, they are pure gold in Mozambique.
We purchased and brought 60 foley catheters, which are needed in emergency situations to decompress a woman’s bladder during a difficult delivery, making birth of the baby possible. They asked us to bring these from the US because it is impossible to even purchase them in Mozambique.
We donated sterile gloves that will be used during c-sections. If no sterile gloves are available, surgeries are performed using non-sterile gloves.
I’m still processing many of these stories. I keep thinking about that cat. I keep thinking about how disappointed in him I was. I really thought he should be better. I think I would have been different if I were him. I think I would have been like Antonio; that I would have shared my cheese. But the truth is that I have no idea how I would behave if I were hungry because I’ve never been hungry. I know that seems like a stupid thing to say, but when you have SEEN what hunger does to a person’s life, how it takes over and demands priority EVERY day, you don’t realize what it is to be free of this daily burden.
Finally, because I know you are worried, no I did not get THE rabies. No one on our team even “pulled a gazelle” and went down with a stomach bug. The antibiotics that all of our PCPs had prescribed for us “just in case we needed them in Africa,” we were able to leave with the doctors at Marrare Hospital. We all stayed safe and healthy. We were the inaugural group of nurses for “Nurses En Route,” the non-profit established and led by our friend, Stephanie Krall, and we experienced Africa. We gained more than we gave, as is always the case in trips like this. Thank you for your generosity and for being a part of this HARD, perfectly imperfect and miraculously successful trip. Thank you for your prayers and your well wishes. Please keep Antonio in your thoughts.