Hello again! My final weeks in Maputo have been quite eventful and educational, although they went by far too quickly. Our research has been growing, and more departments are aware that we are looking to identify and help diagnose Deep Vein Thrombosis (DVT). There are many challenges faced within Maputo Central Hospital (MCH) when it comes to medical care, and the ongoing inequities regarding resources effect the physicians and patients daily. Anti-thrombotic agents are not a guarantee, thus patients that remain on bed rest while admitted are unable to start and sustain prophylactic treatment to prevent DVT. This raised our suspicion that many patients may be at risk of developing DVT and possibly progressing to Pulmonary Embolisms (PE), and it is due to a lack of available resources to enact first line therapeutic treatment plans.
There were many cases of patients requiring treatment that was not accessible in Moçambique. We had post-partum mothers that needed bone marrow transplants or immunotherapy for acute leukemia, of which Maputo Central Hospital does not have the resources to provide and the private hospitals nearby charge too much for the patients to receive the treatment. Therefore, the hematology team would attempt to stabilize the patients as best they can – with some receiving more than 15 blood transfusions – prior to transfer to India or South Africa in the hopes of receiving treatment at an affordable price. Additionally, after identifying DVT, the medical team would start patients on anti-coagulation therapy like heparin or LMWH, but the hospital ran out of medication shortly after the increase in treatment.
But work in Maputo wasn’t all challenges. The ingenuity of the physicians and staff at Maputo Central Hospital are unreal! They find ways to treat and operate on patients that are the most in need. The cardiovascular surgical team was kind enough to allow me into their Operating Room for an open-heart mitral valve replacement, and it was an amazing operation that demonstrated the high levels of trust the surgeons, nurses, techs, and patients have for each other.
Maputo and Africa didn’t disappoint either! I was able to go on a walking tour of Mafalala, one of the oldest peripheral neighborhoods of Maputo, riddled with historic inequities and challenges but filled with beauty and character. The homes made of zinc and wood were forced to be built in this manner during the Portuguese control as a means of allowing for easy demolition to grow Maputo. After independence was gained in 1975, the residents of Mafalala began to develop their neighborhoods with what resources they could sequester. Many homes, while still made of zinc and wood, have become reminders of the towns past, along with vibrant artwork that shows the talent Mafalala has shared with the world – names like José Craveirinha, Eusébio, João Albasini, and Noémia de Sousa. Noémia de Sousa was a Moçambican poet who lived through the oppression of the Moçambican people prior to their revolution in 1975, the revolution itself, and the civil war from 1977 to 1992.
Additionally, Mafalala supported and pays tribute to Azagaia, a Moçambican rapper whose songs were about political issues and social justice, prior to his death at age 38.
One of my final stops was in Kruger National Park for a two-day safari in Northern South Africa. This was an amazing and beautiful region filled with parts of Africa that I had only dreamed of seeing. My tour guide used to work as a park ranger and would share stories of how the park rangers will wander through the park by foot looking for poachers while trying to steer clear of the animals.
Moçambique is a wonderful country filled with beautiful culture and kind people. I look forward to the next time I can work with them and learn more.
Cães De Raça – A song about the disparities that exist in Maputo and people live through every day.
