Dr Margaret (Peg) Cumberland - Mozambique |
 |
mp news
email:
cumberland[at]
crosslinks.org
c/o Crosslinks,
|
Peg is an Associate, and works in Community based health care in the diocese of Niassa
Here's her letter, dated 10th April, 2007
Dear friends,
I find it difficult to write without anyone specific in mind so I’ve failed miserably at sending out regular prayer letters via Crosslinks. I would appreciate your prayers however, so here’s an attempt at a letter which I hope will give those of you who haven’t been receiving e-mails from me some impression of my life here, with it’s joys and demands – there are many of both.
The health project has been gradually growing as more and more communities have asked to be included. We’re now working in several areas in the hills, as well as along the lakeshore, and I reckon that a complete ‘medical round’ to see all the people I’m involved in providing health care for requires a hike of about 360km (one pair of treking sandles per round). I aim to to do one round every three months, with the weeks in between being taken up with my main duties of project management and training.
I returned a couple of days ago from three weeks spent hiking down from the Mozambique/Tanzania border holding meetings in all of the project communities in the northern area of the project to get feedback from the local population, discuss plans for the next couple of years and give health teaching (mainly on schistosomiasis, malaria, family planning and HIV/AIDS). As usual during such a trip I ended up seeing a lot of patients as well as holding meetings, trying to squeeze in consultations early in the morning or after meetings before walking on to the next community. There are always more people waiting to be seen than I have time to attend to so I leave each community feeling guilty for having turned some away.
It was good having eight members of the health team (all local people) with me on this trip. They chaired the meetings, and did most of the health teaching and also helped with the consultations, seeing the simpler patients, like children with uncomplicated malaria, on their own. Definate progress. There were too many of the health team to expect the community to feed us completely themselves, so we made life easier for ourselves by hiring a fishing boat with an outboard motor to take us up to the border and dropped off some rice, beans, sugar, cooking oil and a few other things at several vilages on route so we wouldn’t have to carry it all. In general we ate really well as the 'Teams for life' (the HIV/AIDS education teams) in each community took responsability for feeding us and usually arranged a chicken or big fish from somewhere and collected donations of cassava flour to prepare us nsima. Sometimes we slept in people's huts and sometimes in a church or one of the community health posts.
The feedback from the communities was extremely encouraging with a lot of praise for both the volunteers and the health team itself. We asked all the volunteers (we now have about 150, excluding the HIV/AIDS education teams which have a total of around 300 members), in front of the their communities, if they were willing to rededicate themselves to continue working, with no remuneration from either the Diocese or the District Health Department, until at least December '08. Everybody agreed - I was amazed.
In many ways it's wonderful to encounter so much enthusiasm about the project, but it also leaves me feeling rather overwhelmed. The volunteers want lots more training and the communities want to build more health posts and maternity units and people are eager to start addressing health issues that we haven't yet tackled and it all means more and more work for me, unless I can find other people to help – difficult given that they need to speak either Portuguese or Chinyanja.
My sense of inadequacy was exacerbated by hearing, just I was getting to the end of the three-week trip and tremedously looking forward to few days with less pressure, to hear that a cholera epidemic had begun in Metangula, 20km south of the project area and a few cases had been reported that week in the southern-most project community. I've left the team doing a big hygiene and sanitation campaign and had a good meeting with MSF on Friday with the agreement that we'd work together, with them giving support with treatment, should that become necessary.
I’m a bit stressed about funding at the moment. For the past two years we’ve had a 100% grant from the Swedish Cooperative Centre but, unfortunately, they’re making big internal organisational changes which mean that, although they’d expected to fund the second phase of the project, which should start in April, they won’t be able to give us another grant until September at the earliest and even that is uncertain.
We’ve submitted a proposal to MSCI – an American based charity that USAID have contracted to dispense funds to faith-based organisations involved in HIV/AIDS work. The proposal’s currently being discussed in Washington and hopefully we’ll hear by the end of the month if it’s been approved. If it’s is we’ll have most of the money we need, but MSCI won’t fund the construction work (health posts and maternity units) so I need to hunt around for more support for that – it works out at about £10,000 per health unit (the community do a lot of the work, like making and burning the bricks) which includes running a 12 week construction training course for 30 local people, the practical component of which is to build the health post. We want to build one more maternity unit and a health post this year.
I had a few days in Cobue before and after the trip and managed to do some work on my hut (it has a thatch roof and is about 5x6 metres in size, built with locally made burnt bricks held together with mud mortar, with the luxury of a cement floor), making and hanging curtains and painting the roda pé (I don’t think an equivalent term exists in English - it's a 6” strip of dark paint, green in my case, at the bottom of internal walls that is a compulsory part of the decoration of any Mozambican house), and also made a start on painting the window frames (the walls have already been painted white).
The more time I spend at my hut the more I enjoy it. I still haven't slept there as I’m on the move so much I haven’t found the time to finish setting it up to be habitable, but when I'm in Cobue I've taken to going round there (it's about 10 minutes walk from the training centre on the opposite side of a shallow river) in the late afternoon to bathe and rest until the sun sets. The beach in front of the hut (the water's edge is 33 paces from my front door) is great for swimming. The lack of rocks means there aren’t nearly as many brightly coloured fish around as some other places, but there are far fewer crocs and on balance, given it's the equivalent of my bath, I'm quite happy. The water is much cleaner for bathing in than on Cobue beach, where so many people go to wash their plates and pans that unless I'm careful I can end up with lumps of nsima stuck in my hair. I’ve dug out a hole for a vegetable patch just alongside the hut and am employing a local woman, who's very poor and has six young children to support, to cut lots of leaves and collect goat manure and other things to make compost to fill the hole with. The mango, pomegranate, lemon, guava and papaya trees I've planted are growing well. I've got a table and three chairs but haven't quite got around to the luxury of a bed, although I could easily just use my sleep mat, like I do at the training centre. For about 6 weeks, starting in mid May, I'm going to be running a lot of health trainings in Cobue and I'm very much looking forward to staying in my hut then and having the evenings to myself to work on the computer, rather than being bombarded with requests by the course participants.
For those of you who haven’t yet read it I’d recommend a book called ‘Last orders at Harrods’ by Michael Holman (2005). It’s a satire based in a shanty town in a fictitious city in a fictitious African country (parallels of Nairobi and Kenya) written by someone who used to be Africa Editor of the London Financial Times. It includes some rather wonderful (at least I think so) portrayals of the international aid industry and African politics and economics: painful truths expressed in an extremely entertaining manner. The writing style is copied from the 'No 1 Ladies Detective Agency' series (which if you haven't yet read you should also try).
During this last trip there was a typically African incident with the tragic and the amusing all tangled up together in an insoluble knot. The Cobué river is still so deep and full of crocs that virtually everyone crosses it by canoe-ferry. The young man who ‘operates’ the ferry is a one-legged 21 year old lad called Kandola. His missing leg was savaged by a crocodile a couple of years ago while he was returning from Chigoma one evening after a drinking bout. I’m full of admiration for the way he can pivot his skinny body around on his one remaining leg to manoeuvre the big canoe (large enough for 3 people as well as the boatman) off the bank into the water, and then paddle it accurately across the current to the other side. He’s kept extremely busy by the children attending Chigoma school:- he takes them back and forth for free, making his money off the adults. Anyway, after ferrying us across the river for the community meeting in Mataca, he followed us there for a medical consultation as his stump (it was a very high amputation, leaving him with only a few inches of femur) is still oozing pus. After the meeting we had to return across the river to take the track up through the hills to Mkondessi. Arriving at the river we shouted and shouted for Kondola but there was no response, although the canoe was clearly visible on the opposite bank. After about 10 minutes someone appeared to explain why: A small child in Chigoma had been sent to bring fire from a neighbour so his mother could cook (matches are an expensive luxury here). The child, realising that the flaming grass he’d collected would burn out before he got home, added some more from a pile of old thatch, failing to notice that in the process he’d dropped some smouldering ashes. The thatch mound caught fire and set light to the adjacent hut. The hut belonged to Pedro, one of the Chigoma health post volunteers. Pedro, was up in the hills teaching about HIV/AIDS, his wife was in the fields and the only person in the hut was sick and asleep and woke too late to prevent it burning down. Pedro’s son had been on our side of the river when he heard the news. He immediately ran to the river and, finding Kondola absent, jumped into the canoe, paddled it to the other side, tied it to some reeds and dashed off home. All the men in the huts adjacent to where the canoe was moored were away fishing, so there was no one who could paddle it back, and no one on Kondola’s side of the river who was willing to risk their limbs to swim across and retrieve it. Eventually someone volunteered to walk up stream to a place the crocodile’s don’t hang around, and wade across there. It delayed us for about an hour and, as it is a tough four-hour long trek up into the mountains to Mkondessi, we didn’t arrive there until an hour after dark, by which time we were extremely tired and hungry. Not nearly as bad for us as for Pedro however; he’d only just finished building the hut and it was a large one with proper doors and windows. All these overlapping circles of poverty > disaster > more poverty > more disasters > ……….
Sometimes I get very, very tired. I’d appreciate your prayers for me to have the energy to keep going and that the loneliness I often struggle with won’t become too much for me to cope with.
Thank you all for your support,
Peg