Another chapter ending in our lives and another will start soon in January 2014. Not in Africa but still in a country with very high perinatal and maternal mortality, where women have no voice.... Here we go again and this time Dili, in East Timor will be our land. I will be working with the Royal Australasian College of Surgeon (RACS) in their project in East Timor teaching ObGYn. I enjoy teaching very much, but I love my profession and this time I will have the opportunity to do both....
Back to Mozambique in Africa... Wow! This was quite an experience and I am very grateful to have had the opportunity to be here thanks to the American Government as a Fulbright Scholar teaching Obstetrics and Gynecology for medical students at the Universidade Catolica de Mozambique.
I learned that I am so privileged in life to have so many wonderful friends and family members always so present in our lives despite the physical distance. People who always gives with their words of encouragement and their faith, the strength to keep us going when I many times had doubts in my own capacity. Thank you so much because I could not have done without you. Thanks for all my patients, who always post their lives and pictures of their kids on Facebook. You can't imagine how wonderful it is to let me witness the growth and development of your children, whom you had the confidence to let me help bring into this world. Thanks for all of you who post on Facebook not only pictures but words of encouragement and wisdom. You cannot even imagine how many people can benefit from your posts.
I learned that there are tremendous social injustices in this world which I do struggle to accept. I wish I could have the faith most of you have to help me cope with these inequalities of life. However, I learned that it is very important for me to be in peace with myself in order to help. When I first arrived here I felt apart. It was very hard to see mothers dying from ailments so preventable in our country, to witness the struggle of survival of people who live with less than a dollar a day, to cope with trash, poverty, diseases everywhere. The hospital where I taught the students is the worst I ever seen in my life... Hard to believe this hospital is a tertiary referral center. I am glad I never went to a hospital in the middle of nowhere...
I found very good people in this hospital who do their job well done despite the limited resources they have to deal with. I felt well received by the ObGyn Department and I will miss a lot of the people from here. Bob had a great time at Rotary. Well, I bet people who knows Bob are not surprised at all. He always has great time wherever he is. Life is always a big adventure when one tags along with him....My life has being one adventure after the other for almost 36 years.
My husband, friends and family members, yoga and meditation, and exercise, were my strength to keep going. Now at the end of this year I can see that I was able to help, not as much I would have liked. But I learned that the students and some doctors recognized my passion for my profession and my love for the patients. And this is so important in a country where respect and love for patients is unheard. This fact per si is as important as the students learn how to take care of hemorrhages in pregnancy, the number one killer of women in low resource settings. If you care and if you love your patients you will do the best that can be done despite the circumstances.
Today Bob and I went for our usual 3 hour Sunday walk along the beach. Beira behave the best for our goodbye. The ocean was beautiful and not muddy at all, the sun was shinning on the waves and the nice breeze was blowing so nicely that it all made me feel like we were in Paradise. I learned that gratitude is the best action we can take daily in our lives. I was very grateful today for Life. But I am ready to go home for at least 3 weeks and enjoy the warmth of family ties and friendships. Not much the warmth of the weather!
Then the question: where is home? Definitions are plenty once you search the web, however for me home is where my heart is. I am a Brazilian since I was born in Brazil, I am an American by choice and I am a Texan because Texas is where my heart is....
Merry Christmas and Have a Wonderful Year.
Hope you can continue to follow our adventures, not in Africa but in all places where maternal mortality is high, respect for women is low because there is the place where Bob and I will be working to help make this world a better place to to be and always with the support of wonderful family and friends.
Love you all
Bob and Flavia
Sunday, December 15, 2013
Friday, August 16, 2013
My feelings today....
What should
I do? This is a question I make myself millions of time a day for the last month. Stay here or go
back to the USA or find another place to be.
Africa has changed my heart forever. It is very hard to accept the
disparities in our world. Why some are born in Europa, USA and have education,
jobs, a house, time for leisure. What happen that some are born in Africa and
suffer? Women here die like flies during childbirth because they cannot afford
prenatal care, good hospitals, cannot buy medication, do not have enough physicians to take care of them. Where
is God? Why He who is the Mighty, the Savior, the Holy can let these sufferings happen? Why it is so easy to be in a
church in the USA and sing and praise God and think He is awesome and it is so
hard for me living in Africa and seeing all the suffering find God? Why he let people suffer so much and live
miserable lives? My heart cries weekly
when I sit at the Maternal and Mortality conference every Thursday and hear
about all the women who lost their lives giving birth. Sometimes because there
is not enough blood to cure their bleeding and anemia, sometimes because the
medical staff is so tired and overworked that they do not attend properly to
all patients. Sometimes because there is no medication, no shower to clean
the patient’s tired and dirty bodies prior to a cesarean section and they died
slowly over the weeks because of their infected wounds.
Here there
is no epidural for pain, no narcotics no nothing!!!! No medication for
vomiting. You must deal with the pain. You can suffer days and then deliver a
dead baby because your family sold you to the old man when you are only 13 ( they desperately need the money to feed your younger siblings) and your body cannot afford a pregnancy and much less a vaginal delivery. You then suffer and your
body expels a dead baby. You cannot hold your urine anymore and will be cast
off your family, your village. You will suffer alone and you will die from the
complications of a VVF.
Most women in the USA have no idea about the lives of
the African women. I now do and I want to escape, to leave, to not see more of
Lydia Esmeraldas and Pascoas died of very easily treatable problems elsewhere
but not here. But I cannot leave, I
cannot abandon these women. I need to be here to treat them, to teach the
students how to care for them, how to show love, to help patients deal with
their miserable lives. It is very hard
to wait days to have a simple CBC back, to not even have acetaminophen for your
pain and much less antibiotic for your infection. A mother died of HIV, malaria
and she leaves behind 4 orphans, who will not have anybody to love them, to
tell them that they are loved, to teach them their homework. Where is God????
The hospital
is dirty, the roaches reach everywhere. There are no sheets. Bob and I have
donated 80 sheets but most of them disappear.
Today a patient “called” me to her room to show me her baby. It was hard to get to her bed since there are 10 beds in her room. She is 39 years
old, mute and deaf and this is her first baby. I told her a week ago that she was
going to have a baby boy and she was astounded that I was right. (Ultrasound makes wonders around here). Her
baby was only 2400 gm., but is doing well. The twin brother had died in her
uterus weeks prior. Her baby had no diapers, no baby clothes. He was only
wrapped in a “ capulana” the material the women use here for skirts. She was
luck she had a good doctor taking care of her. He is a Mozambican doctor who
cares about his patients. A lot of them do. But it is so hard to practice
Medicine when you do not have labs and studies to help the diagnosis. You do
not have the meds or the nurses to take care of your patients. You see then die
all the time. Here the babies stay with their
mothers, not in little cribs but in the same bed. Last weeks 3 babies died.
Were they suffocated by their mother’s tired body? Who knows?
I came here
to Africa to help, but I am so overwhelmed with all that I have seen that I
want to escape. I never imagine so much
poverty would exist. I was told the city
is good, I should see the interior….. I currently live in the second largest
city in the country and teach at the tertiary care hospital and it is a
disaster. So far I do not want to go to the interior, I could not take it… Bob
was there and he told me that he was shocked. You know Bob, very few things can
shock him in life….
I am sorry
my friends I dumped on you. I need to
find strength to not abandon this place. I want to find God again in my life to guide
me, teach me the steps to
walk to Him and find peace in my heart to continue teaching the students and to
pass to them the love I have for my profession and for the patients……
Tuesday, June 25, 2013
Tears for the Mozambican Women...
Today Mozambique celebrates 38 years of Independence from Portugal. The country is partying... However Mozambican Women do not have yet much to celebrate...
It is well known that maternal conditions are the leading causes of death and disability among women. 99% of these deaths occurs in low resource countries especially Sub-Saharan Africa.
Nearly all maternal deaths are preventable through availability of contraception, timely prenatal and postnatal care, skilled birth attendance and ways to reach emergency care to deal with complications. To obtain all these improvements women have to fight poverty and inequality.
Most of the pictures were not mine but taken from the Internet:
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According to the International Fact-Finding Mission document Mozambique is a patriarchal society where the men dominates and put women in a position of inferiority. Domestic violence has a social legitimacy since men is the head of the family and has the "rights" to solve marital conflicts. As per UNICEF statistics: Justification of wife beating reaches the level of 36%.
Rape, sexual violence are common and specially growing is the harassment of girls students by teachers and fellow students.
Most of the population is still in rural areas where polygamy, early forced marriage remain widespread. Early marriages lead to girls be taken out of school by their husbands, increase illiteracy, and causes high number of pregnancies: 24% of women ages 15 to 19 already have 2 children. Remember most of these are unwanted pregnancies because destitute women have no access to contraception.
Believe or not despite the Mozambican Family Code reads that marriage is "monogamous", polygamy is still very prevalent in rural areas.
Rural women for whom land is the source of their live hoods have no rights to ownership. The houses belongs to the husbands who holds the assets. The husbands can get rid of their women simply throwing them on the streets with no warnings or rights... I know nurses who went through hell because of this tradition but slowly rebuilt their lives. By the way a good nurse from the hospital wants now to find an American husband, she heard they make much better husbands then her ex- Mozambican. If you know of any available American man just let me know...
On top of all the inequalities there are a lot of widows in Mozambique due to the civil war and HIV/AIDS high rates. These are vulnerable women whose traditional customs strip them of their rights specially ownership and inheritance.
The single-parent household led by women have the highest rates of extreme poverty. It's very unheard of single-parent men in this country.
Although Mozambique has ratified the International Women's Right Protection measures violation of these rights is common: persistence of discriminatory laws, violence against women, limited access to property, education and health care as well obstacle to access to justice " African for Women's Right" March 2010
Here are some statistics from UNICEF 2011 for Mozambique and some from the USA to compare. If you want more information just visit UNICEF website.
It is well known that maternal conditions are the leading causes of death and disability among women. 99% of these deaths occurs in low resource countries especially Sub-Saharan Africa.
Nearly all maternal deaths are preventable through availability of contraception, timely prenatal and postnatal care, skilled birth attendance and ways to reach emergency care to deal with complications. To obtain all these improvements women have to fight poverty and inequality.
Most of the pictures were not mine but taken from the Internet:
We must help them have a better future.
.jpg)
Women in Mozambique work the land, but tradition strips their rights of ownership and inheritance
.jpg)
Women have the right to contraception to empower them, to decrease death by septic abortions, maternal hemorrhages.
Mozambican women must unify and fight for their rights.
Rape, sexual violence are common and specially growing is the harassment of girls students by teachers and fellow students.
Most of the population is still in rural areas where polygamy, early forced marriage remain widespread. Early marriages lead to girls be taken out of school by their husbands, increase illiteracy, and causes high number of pregnancies: 24% of women ages 15 to 19 already have 2 children. Remember most of these are unwanted pregnancies because destitute women have no access to contraception.
Believe or not despite the Mozambican Family Code reads that marriage is "monogamous", polygamy is still very prevalent in rural areas.
Rural women for whom land is the source of their live hoods have no rights to ownership. The houses belongs to the husbands who holds the assets. The husbands can get rid of their women simply throwing them on the streets with no warnings or rights... I know nurses who went through hell because of this tradition but slowly rebuilt their lives. By the way a good nurse from the hospital wants now to find an American husband, she heard they make much better husbands then her ex- Mozambican. If you know of any available American man just let me know...
On top of all the inequalities there are a lot of widows in Mozambique due to the civil war and HIV/AIDS high rates. These are vulnerable women whose traditional customs strip them of their rights specially ownership and inheritance.
The single-parent household led by women have the highest rates of extreme poverty. It's very unheard of single-parent men in this country.
Although Mozambique has ratified the International Women's Right Protection measures violation of these rights is common: persistence of discriminatory laws, violence against women, limited access to property, education and health care as well obstacle to access to justice " African for Women's Right" March 2010
Here are some statistics from UNICEF 2011 for Mozambique and some from the USA to compare. If you want more information just visit UNICEF website.
- Total population: 23.930. 000
- Life expectancy at birth= 50 years USA= 79 years
- Total literacy rate= 56%
- Adult literacy rate female as % of males= 61
- Urbanized population= 31%
- Percentage below international poverty line (US$ 1.25 per day) = 60%
- Maternal mortality ratio lifetime risk= 1/43 (USA= 1/2,400)
- Contraceptive prevalence = 12% ( USA= 79%)
- Child marriage by age 15 = 21%
- Child marriage by age 18 = 56%
Today I say tears to these women who do work very hard, for whom pregnancy and delivery is still a death sentence. I wish them a way of becoming stronger and find their freedom status in the society to give themselves and their children a stronger and more equitable life....
But there are good news in the horizons: Mozambique has eliminated maternal e neonatal tetanus from its statistics and I do have large number of female medical students in my classes.
Sunday, June 16, 2013
African adventures at Gorongosa National Park
Gorongosa National Park is in the heart of Mozambique. It has over 4,000 square km of valley floor and some surroundings plateaus. The rivers spread over the area originating at Mont Gorongosa.
Three main vegetation types support the Gorongosa ecosystem's wealthy of wildlife: savanna, woodlands and grasslands.
During the long civil war the number of animals specially mammals was dramatically reduced as Gorongosa was one of the battle fields of the war.
Elephants were slaughtered for their ivory, lions and other carnivores died of starvation when their prey zebra, antelopes, wildebeest, buffalo were eaten as bush meat by hungry people. Many of the park large herbivore populations were also reduced by the war and poaching. However more than 400 kinds of birds and reptiles survived.
Since 2004 the Carr Foundation's Gorongosa Restoration Project, a U.S. non profit organization is helping the Mozambique Government to protect and restore the ecosystem of the park. Animals are being reintroduced to their land.
Bob and Flavia and their friends Eric and Alison, Nick and Annie got into their 4 x 4 wonderful 1998 Toyota Land Rover Prado Active Vacation and headed over to this beautiful land. Of course it took us a while to get there (about 5 hours) because neither the potholes nor the police let you speed in this part of the country.
We had a great time. As money is short now in our lives we opted to camping over staying in one of the fancy and must say beautiful but very expensive roundale guest houses. The camping facilities were great with a very nice hot shower.
It was Eric's birthday. We had a wonderful barbecue with vegetables
(otherwise Flavia would have gone hungry), t-bone steaks, potatoes and grilled pineapple. The delicious meal culminated with a birthday cake baked by Flavia ( sorry Eric as Flavia is not a good baker, but at end the cake was a success). Our feast ended with smores. Alison was able to find pink marshmallows at the supermarket in Beira. They were pink but according to the human carnivores in our group tasted really delicious. The weather was pleasant and even a little hot during the day but chilly and comfy at night by our fire.
Here are some of the pictures of our great adventure. Gorongosa is one of the most beautiful places that we had visited so far in this side of the world.
Three main vegetation types support the Gorongosa ecosystem's wealthy of wildlife: savanna, woodlands and grasslands.
During the long civil war the number of animals specially mammals was dramatically reduced as Gorongosa was one of the battle fields of the war.
Elephants were slaughtered for their ivory, lions and other carnivores died of starvation when their prey zebra, antelopes, wildebeest, buffalo were eaten as bush meat by hungry people. Many of the park large herbivore populations were also reduced by the war and poaching. However more than 400 kinds of birds and reptiles survived.
Since 2004 the Carr Foundation's Gorongosa Restoration Project, a U.S. non profit organization is helping the Mozambique Government to protect and restore the ecosystem of the park. Animals are being reintroduced to their land.
Bob and Flavia and their friends Eric and Alison, Nick and Annie got into their 4 x 4 wonderful 1998 Toyota Land Rover Prado Active Vacation and headed over to this beautiful land. Of course it took us a while to get there (about 5 hours) because neither the potholes nor the police let you speed in this part of the country.
We had a great time. As money is short now in our lives we opted to camping over staying in one of the fancy and must say beautiful but very expensive roundale guest houses. The camping facilities were great with a very nice hot shower.
 |
| Poor Eric the picture was not good and the cake was not pretty, but was delicious. |
(otherwise Flavia would have gone hungry), t-bone steaks, potatoes and grilled pineapple. The delicious meal culminated with a birthday cake baked by Flavia ( sorry Eric as Flavia is not a good baker, but at end the cake was a success). Our feast ended with smores. Alison was able to find pink marshmallows at the supermarket in Beira. They were pink but according to the human carnivores in our group tasted really delicious. The weather was pleasant and even a little hot during the day but chilly and comfy at night by our fire.
Here are some of the pictures of our great adventure. Gorongosa is one of the most beautiful places that we had visited so far in this side of the world.
 |
| The entrance and our great car ACTIVE VACATION perfect for the occasion |
 |
| This was the first wildlife we saw as soon as we entered the park. After that Flavia's desire for camping went down the drain, but Bob and Flavia managed to sleep inside the car very comfortably. All the sits unfold nicely and we had 2 comfortable beds. |
Monday, May 20, 2013
in between....
Dear friends and family,
This will be a different post. It is the one I promised myself I was never going to write. But life changes and emotions don't follow many rules. I have decided that my blogs would have lots of pictures and less "talking". Yeah!!! things definitely changed.
This last weekend Bob and I had the great surprise to receive our supplies that we have shipped from the USA in December. Great, because I had giving up on them coming at all to the way here to Beira. However much to my dismay they came and and indeed, intact. We were so anxious waiting and even had forgotten what we had shipped.
Much to my surprise some of the stuff were well needed here but most was just a waist of money. We do not need all the clothes we sent down. It was nice to see also the small gadgets we got that we cannot even use here because the electricity is 220 Volts and it costs a lot of money to buy devices to change from 110 to 220V. At least it is nice to know that our 13 year old alarm clock made safely......
What I was not prepared was for all the emotions that came together with the boxes. The items that came felt my heart with nostalgia and a strong desire to be back with family and friends in Texas. Bob and I had a bless reading the farewell books and picture card we got from you all. Thanks so much Pat, Yvonne, Patty Young and all the Women's Clinic friends for this wonderful "recuerdo". It means a lot to us.
We closed our eyes and made believe that we still lived in the States ant that we were going out to eat at our friends Pat and Yvonne' house as we did many times. That the next day I was going to work back to the Women's Clinic and visit and see all my patients, friends and co-workers . You cannot even imagine how much we miss all of you.
Then I remember why we came here. Not to have fun, not to make money but just to follow our dream to help the poorest of the poor. I remember some of the patients that have died on their postpartum period and left behind a family with no mother, no guidance and no love. I remember Lydia Esmeralda a HIV patient, sweat as could be, trying very hard to take her medication to keep herself alive to take care of her daughters. However after a bad infection following a cesarean section she died in one week at the hospital. I still cry when I think about all the mothers in this country that put their lives in danger every time they get pregnant. The odds that they will die from their pregnancy is so much higher than our women in the USA. I told myself that we are very blessed to have such wonderful friends and family that support us in our dreams. In my mind that moment I could see all the students that are learning from me and I had the hopes that I can pass to them the love for my profession and the love I have for my patients. I want to pass to them the importance of caring, the knowledge that a patient is not a bed number but a human being with feelings and a life outside the hospital grounds. If I can succeed at least 50% of the time I will be happy and will never feel that Bob and I are here for nothing. But I need all of your help there from home to give us the strength, the love and the moral support to keep going. Later I will also need some material stuff to help here. You cannot even imagine the lack of supplies. It is hard to believe that one can even practice medicine without all the lab work and studies and medication we have available in the USA. It has been a great challenge but I have faith that we will get there one way or another. I miss all of you but I am happy with myself for the decision Bob and I made to be here and help empower destitute women.
Love and miss all of you a lot
Thanks for always been there for Bob and me.
Your forever friend
FH
This will be a different post. It is the one I promised myself I was never going to write. But life changes and emotions don't follow many rules. I have decided that my blogs would have lots of pictures and less "talking". Yeah!!! things definitely changed.
This last weekend Bob and I had the great surprise to receive our supplies that we have shipped from the USA in December. Great, because I had giving up on them coming at all to the way here to Beira. However much to my dismay they came and and indeed, intact. We were so anxious waiting and even had forgotten what we had shipped.
Much to my surprise some of the stuff were well needed here but most was just a waist of money. We do not need all the clothes we sent down. It was nice to see also the small gadgets we got that we cannot even use here because the electricity is 220 Volts and it costs a lot of money to buy devices to change from 110 to 220V. At least it is nice to know that our 13 year old alarm clock made safely......
What I was not prepared was for all the emotions that came together with the boxes. The items that came felt my heart with nostalgia and a strong desire to be back with family and friends in Texas. Bob and I had a bless reading the farewell books and picture card we got from you all. Thanks so much Pat, Yvonne, Patty Young and all the Women's Clinic friends for this wonderful "recuerdo". It means a lot to us.
We closed our eyes and made believe that we still lived in the States ant that we were going out to eat at our friends Pat and Yvonne' house as we did many times. That the next day I was going to work back to the Women's Clinic and visit and see all my patients, friends and co-workers . You cannot even imagine how much we miss all of you.
Then I remember why we came here. Not to have fun, not to make money but just to follow our dream to help the poorest of the poor. I remember some of the patients that have died on their postpartum period and left behind a family with no mother, no guidance and no love. I remember Lydia Esmeralda a HIV patient, sweat as could be, trying very hard to take her medication to keep herself alive to take care of her daughters. However after a bad infection following a cesarean section she died in one week at the hospital. I still cry when I think about all the mothers in this country that put their lives in danger every time they get pregnant. The odds that they will die from their pregnancy is so much higher than our women in the USA. I told myself that we are very blessed to have such wonderful friends and family that support us in our dreams. In my mind that moment I could see all the students that are learning from me and I had the hopes that I can pass to them the love for my profession and the love I have for my patients. I want to pass to them the importance of caring, the knowledge that a patient is not a bed number but a human being with feelings and a life outside the hospital grounds. If I can succeed at least 50% of the time I will be happy and will never feel that Bob and I are here for nothing. But I need all of your help there from home to give us the strength, the love and the moral support to keep going. Later I will also need some material stuff to help here. You cannot even imagine the lack of supplies. It is hard to believe that one can even practice medicine without all the lab work and studies and medication we have available in the USA. It has been a great challenge but I have faith that we will get there one way or another. I miss all of you but I am happy with myself for the decision Bob and I made to be here and help empower destitute women.
Love and miss all of you a lot
Thanks for always been there for Bob and me.
Your forever friend
FH
Tuesday, May 14, 2013
When it rains it pours
Some pictures for you to have an idea about the rainy season in Beira...
....We though that this was very unusual but with time we discover that when it rains in Beira it pours...
After living in Texas for so long we were not used to see that much rain
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Even though is very hot you better wear boots otherwise you may get stuck in the mud. This is part of my way from my apartment to the Medical School.
If the inside was just like the outside.....
The reality of life in Mozambique is very different. Here you do what you are able to do pending on the donations you get. If the donation is to fix the outside you better do it otherwise you will loose the money. The Hospital Central da Beira faces multiple challenges and it is hard to see the outside improve so much when the inside suffers a lot with lack of equipment, medication, personnel and million more...
This is the hospital entrance by January in the rainy season when I first got here
You had to be pretty good to not get wet or fall in the puddle
Now the entrance has pavement, but the hospital has no Pitocin in L&D...
You can even park your car closer to the main entrance if you are a physician otherwise why bother to have parking slots if most of the people do not have cars any way
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