Day 2 – calling 999 in Mulotana

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When I arrived at the Mulotana Health Centre, I was feeling rough.  We had bounced along a very bumpy sandy road for ages in our bus, and made slow progress into an increasingly rural area of the district of Boane.  I was feeling a bit travel sick.  Poor me.

Xavier Albert, a Healthcare Technician showed us around the Health Centre, which provides outpatient and maternity services.  This health centre, made up of a handful of rooms, serves 80,000 people.  Some people walk 10km to get here.  There were four other staff on hand today.

Is this the same world in which we moan about a 6 hour wait in A&E because we sprained a wrist, or needed stitches?  Standing in Mulotana Health Centre, the extent of our privilege, and the inequality of our world hit me square on.

Xavier cut to the chase – his main challenge was water scarcity.  The health centre has one well to source water from and some erratic tanker deliveries of water.  One toilet currently works.

What is health care like without clean water?  There were rows of metal implements and tools laid out by sinks for washing.  A nurse told us that she is meant to wash her hands after touching patients, but she just is not able now there is no water.  The taps do not run.  The water is collected from the well in the yard of the centre.

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Xavier showed us the well, and pulled up a container of water.  It looked cloudy and it is likely that it was salt water, which is a common problem with the groundwater in this area.  Whilst using this scarce water supply to wash equipment was done with the best intentions, it was not going to sterilise that healthcare equipment and facility.  We worry about outbreaks of resistant superbugs on hospital wards – at this moment, that concern felt ridiculous.

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I asked Xavier whether he enjoyed his job and he smiled, laughed and said that he did.  He had not smiled much before that point.  I asked what he enjoyed about his work, and he explained that he enjoys consulting his patients.  I was moved by his words and was full of admiration for him.

My partner, John, has recently qualified as a paramedic and started working in Sussex.  I have huge respect for healthcare professionals working for the NHS, and their dedication, compassion, professionalism and resilience.  In that moment, I felt the same respect for Xavier, as I do for John when he talks about his work, and I can sense his utmost concern for his patients’ well-being.  I admired Xavier valuing that time with his patients, despite all the challenges he faced, and for his commitment to serving his community.

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In the UK, our ambulance services have to meet 8 minute ambulance response times for Category A calls.  Here in Mulotana, if a difficulty is encountered during childbirth and the patient needs to be transferred to the larger hospital, Xavier estimated the ambulance response time to be 1.5 hours.  And the ambulance comes with a driver only; no medical professional.

It was clear to see why WaterAid have identified this Health Centre as an area of need.  It was encouraging to see work underway on building a rainwater harvesting system and sanitation block with four latrines.  The need for clean water has never seemed so great to me as when people are ill, or pregnant, and vulnerable.  And when so many people are dependent on this healthcare provision.

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Nothing is ever simple though – Xavier was not overly optimistic about collecting rainwater as rains have failed in recent years.  And there remained the issue of medical waste disposal, which he pointed out, with waste dumped in a shallow dip within the centre’s yard.

I am reminded that life expectancy in Mozambique is 50 years.  At 32, I would be facing a very different outlook here.

Travel sick?  I feel ashamed.

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