The Warmth of Connection: Practicum Reflections from Mozambique

Two months ago feels like a lifetime ago, before I fell in love with the vibrant, charming city of Maputo. Before heading to Mozambique for my practicum, I was filled with nervous anticipation, and I had set a goal for myself that no matter how the whole of my practicum goes, that I would advance my life-skills of flexibility, adaptability, and self-sufficiency through this experience. I wanted to confirm that I had the commitment and ability to enter the field of global public health and be able to make meaningful contributions to the communities I worked with. I knew that it was easy to say that I am interested in working in a global setting, but of course an entirely different story when I am in a new country, navigating cultures and experiences that are unfamiliar to me.

With gratitude, I owe it to my parents for raising me as a global citizen. They raised me in a bicultural household in the United States and Japan, encouraging my travels and experiences in different countries, and fostering my love and never-ending curiosity of people and their cultures. My bachelors in Anthropology gave me the tools to lovingly interact with the core of people’s identities and taught me grave warnings of how curiosity without boundaries, permission, or consideration of power-dynamics brings considerable, tangible harm to individuals and their communities. My bachelors in Women’s and Gender Studies taught me that no work is done in a vacuum and no research can be objective so long as the identities we hold move us in the work that we do and the products we create. Both fields showed me that it is crucial to understand and reflect on the identities and beliefs I hold and taught me how to acknowledge this in the work I do, qualitative research, whose heart lies in the connection between people. Now, my studies in Public Health give me the language and skills to navigate the culture and landscape of global public health and connect the gap between understanding problems and creating meaningful solutions.

All of these parts of my identity and education are what I brought along with me in my journey to Mozambique, but one crucial part was missing, which was my ability to speak Portuguese. I realized that in contexts where I understood the language, I was receiving so much connection daily with others, through small interactions, that I was unable to do in this setting. But I also discovered how much I was able to communicate through body language and context clues (my beginner level Spanish also helped). Gratitude bloomed at every interaction where patience and effort were afforded to me and I was never treated with annoyance for my inability to speak. So despite the language barrier that existed with many of those I interacted with in my time in Maputo and Lichinga, the work I did was informed by community workers and local staff, which I was able to build relationships with. The many conversations I had over translation apps warmed my heart, knowing that despite the difficulty of communication, my coworkers and community partners were willing to sit and patiently create a bond with me.

Photo taken at the end of a training day for qualitative research.

 

From these connections was I able to offer my services in qualitative research, always deferring to the knowledge and experiences of the community facilitators who conducted focus groups with youth to understand what they wanted and needed from the Center for Reproductive Justice. There was of course another barrier, culture, but similar to how I adapted questionnaires and materials based on feedback, once the community facilitators understood the intent of our questioning, was able to adapt the language to something that was more appropriate for the setting. So, although at times I felt alone during my time in Lichinga (less so with my furry friends!), connections are what drive the heart of public health work we do with communities, and I hope to see Maputo again after I graduate. Tchau tchau until then!

Pretest for questionnaires being conducted by Ipas staff and community partners.

 

Anselmo Matambo (Ipas community facilitator), me, and my research assistant, Dr. Sandra Mulumba.

 

The lap cat at my guesthouse who often kept me company.

 

Alyssa

My Journey Through Mozambique: Innovating for Sexual Rights and Reproductive Health with Ipas Mozambique

What a journey I’ve had since arriving in Mozambique 2 weeks ago! This is my second time visiting a country in Africa (my first being Uganda in 2019 for a summer internship through the Campus Y) and I was anticipating flight delays or missing luggage and had booked a flight directly from Lisbon to Maputo, following a week-long trip in Portugal with my mother, to ensure that my belongings would arrive safely with me. The predicted incident happened when we were scheduled to arrive in Maputo at 5am, but were diverted to Johannesburg, an hour flight away, because the city was too foggy for the plane to land. There, the sleepy passengers who had taken a red eye were taken to a lounge (after a few hours of waiting) and after more waiting, were loaded onto a different flight that arrived around 2pm. Our luggage of course was left in Johannesburg but was delivered promptly (shockingly) the next morning. I had no idea what to expect from Maputo, as I had observed photos and videos but was imagining a city such as Kampala (the capital of Uganda) which was entirely overwhelming for me when I had visited as a 19-year-old. However, Maputo proved to be a lovely, slow(er) city with its sunsets at 5:30pm and delectable seafood.

Sunset in Maputo
Seafood in Maputo

 

 

 

 

 

 

 

 

I was warmly welcomed to Maputo by my colleagues at Ipas Mozambique, and as an intern, spent the week getting oriented to the NPO and reading grant reports about the work I would soon be doing in Lichinga, Niassa, a northern province of the country (of which I am now on week two of six). Ipas is an international organization focused on safe abortion access, reducing gender-based violence, and promoting sexual health and reproductive rights (SRHR). Through a grant received by SIDA (Swedish International Development Cooperation Agency), a Reproductive Justice Resource Center is to be established in the Lichinga Ipas office, to foster healthy attitudes about SRHR and provide engaging activities for participants, including local feminist and girls-led groups, enabling them to learn about their physical and mental well-being. Additionally, the Center would assist these women in developing essential social skills including effective communication, self-advocacy, and healthy relationship building. My task has been to help Ipas create a plan for the future development of this Center, which would include its design, creating rules for the space, what activities will be needed or wanted by community members, and imagining how the space will be utilized.

In front of Ipas Mozambique’s Maputo Headquarters Office

My week whisked by as colleagues took me to various food and scenic spots around the city. I enjoyed salsa and kizomba nights, which struck me deeply, when I realized that so long as there was a salsa/bachata/kizomba (usually all mixed-in during a social) dance group, I had a community anywhere in the world. Two days before I was to leave Maputo, I received a call from the Niassa regional director, and was asked if I would want to tag along on a sight-visit to the Lago district, to see how Ipas worked in communities and regional health facilities. I of course agreed, and the day after I arrived in Lichinga by plane (three hours with a quick stop in Nampula), we were on our way to the Lago district by car. It was around a two-hour drive, on bumpily paved roads that transitioned to unpaved roads, that proved treacherous to my motion-sickness. Our skilled driver maneuvered around and honked at adults, children, motorbikes, chickens, dogs, and goats (I was told that if you hit a goat, you would have to pay its market price because they are prized) so that they would move out of our path, and I realized that cars were the right-of-way on Mozambican roads (at least to an extent of where I would never consider to have my American-college-campus-pedestrian attitude: “I dare you to hit me”). Another thing that I had realized in Maputo and had reaffirmed in Lichinga, was that the distance pedestrians kept to cars was much closer to what I was used to, and I felt my pulse quicken whenever a person came into proximity of our vehicle. (Entertainingly for a colleague in Maputo on a day when we walked to lunch, I had squealed and jogged to get across the road through traffic while they strolled after me and was told “you don’t have to run, they’re not going to hit you. Now walk on the right side of me.”)

We spent three days in Metangula, where I came to learn how Ipas worked in communities and felt a thrill of seeing public health in action. On our first day, there was a three-hour meeting with various community members, hospital administrators, healthcare workers, traditional midwives, and other stakeholders, where my Ipas colleagues facilitated dialogue on issues of SRHR. The emphasis was placed on community-led discussions and those gathered identified issues such as unsafe abortion methods used (mixing many different liquids to ingest), child-brides for the financial benefit of parents, and gender-based violence. All information I received during this meeting was through my regional director, who was translating the Portuguese discussions to me in English, while an older nurse translated Portuguese into a regional language and back again. As a native Japanese-English speaking person, I know how much energy it takes to verbally translate discussions on the spot, and although my middle/high school Spanish skills afforded me a few words here and there, I was immensely grateful to the director for the effort he was putting in for me to learn and be a part of this work. The following two days, we visited the regional hospital where the doctor working for Ipas (of whom the regional director and I were tagging along with) and the Niassa Provincial Director of Maternal Health for the Mozambican Ministry of Health (she must accompany Ipas whenever the NPO interacts with public health facilities) looked over abortion record-keeping methods and correcting errors, trained health workers in vacuum aspiration, and made sure that abortion medication was supplied at the hospital. There was also a task force convened for the healthcare workers that again was facilitated by the Doctor, but was lead largely by the medical staff, to continue to promote safe abortion. Finally, I was also able to visit a local radio station that has 40,000 listeners in the region that Ipas has partnered with to create educational content that promotes Ipas’ mission of expanding reproductive justice.

Dr. Nkulu facilitating a community meeting
Regional Hospital in Metangula

 

 

 

 

 

 

During these three days, I realized how complicated and multi-layered the work Ipas does, working at all different levels of healthcare and working to tie in community members and local organizations to their work. I also learned about the barriers that exist at every step, including cultural stigma, corruption (the illegal medicine-selling business in Mozambique is big), and the retention-issue of medical workers. I even was able to experience Mozambican medicine, up close and personal, when upon returning to Lichinga, I fell ill with diarrhea, vomiting, and body aches, and was taken to the local hospital where they took a blood sample to see what the issue was (they suspected food poisoning or water contamination) and received an IV. Now that I am feeling better and am sticking to bottled water only (I was using filtered water instead, not tap water!) I am ready to get back to work and am excited to see what else I learn during my time here.

Ipas Niassa Team (and me) on the Lake

 

Alyssa Cooper