Mozambique: The Work

July 13th

When I’m on the ground working at one of our project sites, I spend most of my day observing. I walk with our public health workers through the villages, watching how they interact with families, seeing what their communities look like, scrutinizing the children and trying to tell if they are getting enough to eat, if there are mosquito nets hung in their huts, if there are pit latrines and clean wells available in the area. I take a lot of photographs and notes and try to come up with a plan to make our health projects more effective. A bit of what I saw in Beira — and I’ll warn you, some of these are disturbing:

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This is a typical home in a village near Beira.

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This is an improved method of hygiene that has been introduced. If your dishes air dry off the ground, they’ll stay cleaner and animals and children won’t be able to touch them either. (Obviously these still need to be washed.)

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A health promoter interviews a family in Msena — a local language.

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This family cultivates rice in one of the many flood plains nearby. They dry the rice on plastic sacks and then grind it with a giant mortar and pestle. They then take this ground material and put it in a large flat basket and wait for a slight breeze. When the breese is just right, they bounce the ground rice in the basket and the husk — which they’ve separated from the rice with the mortar — blows away in the wind leaving the rice ready for cooking. This process takes days for very little in terms of calories or vitamins gained. In other words, this isn’t Uncle Ben’s.

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Speaking of vitamins, there is a malnutrition issue in many of these communities with babies. Babies who can’t breastfeed — because the mother died in birth, her milk didn’t come in, she’s HIV-positive and doesn’t want to feed the baby her milk, or the baby is lactose intolerant and can’t keep the milk down — die quickly. There is Plumpynut available for those who bring their children to the malnutrition feeding centers. This is a healthy baby being weighed.

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In constrast, this is the one-year-old I described earlier. She was later taken to the central hospital and put on a feeding tube. She weighed 5.5kg at 14 months.

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Her brother, who I carried to the clinic that day, was also malnourished and was cared for at the hospital. A more urgent issues was matakenyas — a worm that had invested his sweet little feet.

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I heard the little girl in this photo crying before I saw her. Her mother is resting on the reed mat under the blankets in the far right side of the yard. She was 18 and had been sick since February.

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Her little girl sat in the dirt, listening to her mother moan. I can’t imagine she was older than a year. She cried when we appeared, but seemed to otherwise be entertaining herself.

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One week later when we returned to the community, the mother had died. I am not certain what will happen to this adorable little girl. With any luck, she’ll be taken to an orphanage where she’ll be fed and eventually sent to school. There was an HIV clinic offering free testing and treatment within a 15-minute walk of this village. I would guess stigma kept this woman initially from seeking care and handcuffed her family from doing anything after she was unable to do so for herself. If we can change one thing in southern Africa, may it be HIV-testing and treatment stigma. With treatment, people can live 20-25 years longer. It isn’t a cure, but it would have been a chance for this mother to see her little girl through childhood.

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These beautiful women are some of the Mozambican saints who work and care for such children at orphanages. The work is thankless, tiring and never-ending. Yet, they do so with a smile that I have to believe only comes from a spirit fueled by God. They give me hope for the future of Mozambique.

Nothing subtle about this prevention message

That and the exceedingly obvious prevention messages that are becoming part of the culture. This condom machine provides customers at a cafe in central Beira more than just decaf or full-jolt.


Posted in
Africa, Journal, Public Health, Travel
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22 Responses

  1. This just breaks my heart!

  2. This post has really touched my heart. Looking at the pictures of the beautiful little girl in the pink shirt and the sister and brother that you took to the clinic. Thank you for being there for them.

  3. Jeez. No wonder you got those 2 little ones to the clinic – that’s just heartbreaking. It’s hard to even read things like this, I can’t imagine seeing it right in front of me. I guess you have to focus on the progress that IS being made. Bless those dear ladies and others like them that are caring for the orphans.

  4. These pictures and stories of the women and children are heartbreaking, and yet there is that glimer of light in the distance. You do so much Kelli as do the women who work the orphanges. It may seem like little steps at times in the scale of the big picture, but really they are huge steps. It is easy for me to see why you have left your heart in Africa. In each child’s face I see part of your heart.

  5. Oh, it brings tears to my eyes. Thank you for sharing. I am very glad to have the perspective these days.

  6. Thank you for sharing the pictures and your words Kelli. You know if we’d (America)stop worry about having the bigger house or stop buying all things we “think” we have to have our society could contribute so much more to children in S. Africa and all over the world. A lot of us need that Spirit of God like those wonderful ladies in Africa caring for those children.

  7. oh Kelli, your posts break my heart. I must take a photo tomorrow when I walk my dog. There is a table on the front lawn of the house down the road that is being thrown out with the rubbish and is in perfect condition and there is that family with a table made of sticks… makes you wonder what is up with the world at times hey?

  8. Oh those poor little children, those pictures broke my heart. Thanks for sharing Kelli.

  9. You make the headlines so real… your photos are eye-openers.
    At three months old my baby is also 5,5 kg… I do hope that little boy will be alright!

  10. Your photos make it real! I appreciate what you’ve said about HIV – the attitude of most people we speak to is they don’t want to know if they have it. They’d rather just die for some unknown reason than live ‘knowing’ they have a death sentence.

  11. My heart is experiencing two simultaneous feelings after reading this post: (1) love for the work you and others to do in helping and (2) heartbreak for the suffering these people endure.

  12. Children in need are the most heartbreaking thing in the world.

  13. Can you describe the current efforts taking place to change the HIV stigma and encourage treatment? What languages are being used in that effort?

  14. Wow! I don’t know what to say. Thank goodness for people like you and those kind women in those beautiful-colored skirts! Those children are precious.

  15. It must be so hard to not want to pick up those children and pack them in your suitcase and take them home with you?

    I guess you get hardened to the situation over time? You must have to otherwise you couldn’t cope? Just like policemen, firemen, and doctor’s and nurses do.

    Once again great photo’s.


  16. Thanks for your site and the photos.

    I was wondering if you could tell me what kind of work/volunteer opportunities there are in Africa.

    I know you’re busy. So whenever you get a chance.


  17. Sigh. Keep passing along your observations, it sounds like you are uniquely positioned to look at both the big picture and the individual stories. It is good to hear that you have hope.

  18. What they all said 😉 Nothing to add. Except my own thank you for doing this work.

  19. My heart is breaking but I hang on to the hope that comes from the good work you and others are doing in Africa. Blessings!!

  20. Very very sad to see the children and women that are sufforing.

  21. these women- and you, my friend- are doing the most needed work on earth. bless you all for it. you are an inspiration. xox

  22. Hi, Good to see your blog – just a couple of clarifying points though. You mention about malnutrition in babies if they are not breastfed. This is a HUGE problem worldwide and research has shown that if women breastfed optimally it would save more children than any other public health measure e.g. clean water, vaccinations, etc. However, telling women to breastfeed doesn’t help – they need ACTIVE support to breastfeed. Breastfeeding is so beneficial and artificial feeding so dangerous in places such as this that the latest WHO guidance is that HIV positive women should exclusively breastfeed – as the risks of them giving HIV to their infant through exclusive breastfeeding up to 6 months is about 4% compared to the much higher risks of the child dying through not being breastfed. The risks of getting HIV increase if the mother mixes breastfeeding with something else – especially solid food such as Plumpynut, so care must be taken – also Plumpynut is NOT designed for infants under 6 months of age as the nutrient content is not correct. Finally in all my time as a nutritionist specialising in infants I have never come across a baby unable to breastfeed because of lactose intolerance – this is much more likely with formula, which is made of cow’s milk and hence is made for calves not babies! I really like your blog it’s just I know the importance of actively supporting women to breastfeed and how people think that ‘alternatives’ are good and necessary when if an infant is breastfed optimally they won’t get malnourished and will be protected from diseases in the environment that they are in.