Vaccine Brigade - Bev Wudel - June 2010
It is overcast and 17 degrees, cool for Mozambique, even at this time of year. I’m riding in the back of a pickup truck, my new friend Gloria, a nurse in maternal and infant health, beside me. Across from me is a young mother with her nine month old son, who is wrapped in a capulana to shield him from the wind. He’s so quiet during the ride that I almost forget he’s there. The road is rough, even by my rural Saskatchewan born-and-raised standards, but the view is breathtaking. The road is lined with small “machambas” of maize, peanuts, and cassava, widely interspersed amongst the wild vegetation of the area. The coconut trees, many stretching over 30 feet into the air have been notched by machetes to allow people to climb them to reach the coconuts that grow in clusters at the top. The red dirt of the road beautifully contrasts the green of the trees and farmland. In the clearing are small clusters of grass huts and corrugated tin houses, the simple dwellings that are common in rural Mozambique. We occasionally pass by women balancing large jugs of water on their head with expertise that can only be mastered with a lifetime of practice. Understandably, I get curious looks from many people we pass on the road. I look even more out of place than usual, wearing my stark-white scrubs. I am so captivated by the view that I occasionally duck a little too late and get smacked in the face by a low-lying tree branch. Gloria notices this and asks me if we have trees in Canada. At my feet is a cooler of vaccines and a pile of mosquito nets that we picked up at the health post on our way. When I see the crowd of women and children in the clearing ahead, I know that we have reached our destination.
This is what public health looks like in Mozambique. I’m on a mobile brigade to a peripheral community in the Massinga Health District, about 40 kilometers from the Massinga hospital. Each peripheral community is visited by agentes de medicina preventiva (Agents of Preventative Medicine) monthly. They provide primary health services similar to those that one would receive in Canada at a visit to the public health nurse. Infants and young children are weighed in scales that hang from trees to screen for growth and malnutrition. Children are vaccinated for polio, diphtheria, pertussis, tetanus, and tuberculosis and their mothers are given tetanus boosters.
Our group consists of two agentes de medicina preventiva, Gloria, Linda (another U of S medical student) and myself. When we arrive, the apparent chaos quickly turns to order. The women take their seats on a bench that has been fashioned out of logs. Gloria begins her lecture on public health and preventative medicine with the women. She speaks in Xitsua, the local language, so I don’t understand a word, but she speaks with such animation and authority that she holds even my wandering attention.
Each of the agentes de medicina preventiva takes a turn speaking to the group. Linda and I make use of the few words we know in Xitsua to introduce ourselves to the group. Afterwards, the women begin to line up with their children. Each child is given a yellow health record card at birth. Many of them are worn to the point that they have fallen apart at the creases, but amazingly, every mother has one for every child. As the women bring their children to be weighed, I take their yellow card and mark the date and the child’s weight, before passing the card onto the agente, who records their age and growth for statistics, and checks if they are due for vaccinations. Those that are due for vaccination are sent on to Linda, who is working with the other agente. Linda administers the required vaccinations and the agente makes a record of the vaccinations received. They don’t need us there – they usually do the brigade with only the two agentes – but we’re happy to be included in the experience.
In under 3 hours, we have weighed and vaccinated about fifty children and give tetanus boosters to a couple dozen women. The agentes will be back next month, after we’ve left Mozambique. For them, it’s all in a day’s work, but for us, it will probably be a once in a lifetime experience. We pack up the truck, and I take one last look at our unlikely health post before climbing into the cab of the truck. This time, it’s Linda’s turn to ride in the back.
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