I spent this summer studying maternal death at Hospital Central de Maputo. The project is centered around maternal death, with a particular focus on postpartum hemorrhaging (PPH) and the introduction of cryoprecipitate therapy at Hospital Central de Maputo (HCM) in Maputo, Mozambique. After working with Dr. Von Drygalsi and Michael Glazier to create data collection forms, I have been spending the summer extracting retrospective cross-sectional data from available maternity charts. Upon introduction of the Cryoprecipitate therapy intervention, prospective data will be collected. The prospective quasi-experimental study will analyze cryoprecipitate intervention implementation for birthing individuals dying of PPH.
I start most of my days around 6:30 or 7:00 a.m. I am typically out the door and making my 30-minute walk to Hospital Central de Maputo at 8:00 a.m. Once at the hospital, I check in with both the Hematology team as well as some Gynecology residents about patients and workflow for the day. I then accompany the teams on patient rounds, to directly interact with and meet the patient population who we are serving through this study. I have gained such a unique insight on what Global Healthcare looks like in terms of working directly in a community, amongst students and physicians who have spent their entire adult lives training to treat patients in these environments. I have learned of pragmatic ways to adapt in situations when trying to best treat a patient in an environment that doesn’t have certain resources. I have learned about patient compassion and care in a way that I could not have learned in any other environment, a practice that I will take with me for the remainder of my career.
Around 10:30am I typically transition into data collection. I have had the pleasure of working with Dra. Patricia Silva, Dr. Virgilio Nanhtumbo, Dr. Momade Correia and other faculty and physician mentors both on the ground in Maputo as well as back home at UCSD to develop 6 new data collection forms in the ACCESS data base, 3 of which I use daily this summer. I have spent the summer analyzing and extracting data from autopsies of women who experienced maternal death at Hospital Central Maputo over the past 5 years. I typically collect data until 2:00 or 3:00pm before heading home. On my walk home I love to stop at a local pastelerias to have some lunch and occasionally a pastel de nata. There are so many amazing foods from so many different cultures, but I must say my favorite traditional Mozambiquan dishes have been Matapa and a vegetarian version of feijoada com Arroz. I could eat them every day…and sometimes I do! By the time I get home I spend a few more hours doing data collection, have dinner and then wind down and get ready to do it all again the next day. However, no one day looks exactly like another.
My time in Mozambique has been not only illuminating but transformative as well. I have witnessed both the frustration and empowerment that physicians feel while working with patients at Hospital Central de Maputo. I have witnessed the numerous ethical dilemmas that physicians and residents are forced to confront when considering how to triage and best treat their patients in a resource deficient environment. I have witnessed these physicians ease the pain and suffering of their patients in more ways than one, even if just for a moment.
I am humbled to be learning from such phenomenal physicians and residents and to have been welcomed onto the team so warmly! It is a pleasure to learn and collaborate on how to navigate healthcare on a global scale and how to best treat patients in whatever environment it is that you are working in.
