Aparna in Mozambique

Tuesday, August 05, 2008

Pictures from Krueger Park and Swaziland

I have been a lazy picture taker lately, but here are a few from some recent travels. I will try and take more of my day to day life, but I feel a little strange about taking pictures when I am actually working (clinics, research, bairros, etc.) I have some ethical dilemmas about this, but I guess this is what people are also interested to see, not just when I go on vacation or have fun!!

In the meantime, anyhow, here are a few before I get back to work (can you tell that I had my coffee today??)

July 08 Visit to Swaziland

The Boss is Outta Town (Beira)

But that doesn't make me the boss. So, the person that I am working with, who is not necessarily my boss since I am not actually an employee(but who is certainly more senior than me) is gone. I've been trying to run the show to get our research on the markets of Beira and medicinal plants going and it has been going much much faster than I would have thought. On Monday we made all of the preliminary plans.

I am working on this project with 3 men who live in the bairro next to the college and with the man who is working for the project while finishing his master's. They all have a really good grasp of how to get the paperwork done and the actual details of who to talk to, what markets, and things that I would have been a little lost doing on my own. And I was pleasantly surprised to see how quickly things got rolling. Yesterday morning, we started off the day at 7AM meeting with the secretary of the bairro, who then told us to go and meet the Health Specialist for the city. We spent the morning, together, drafting the letters, finishing the proposal, etc. and were there by 2PM. WE met here and sadly, she told us we had to see the president of the Municipal Council first. Oh well, so we have to redraft the letter. We do it, get back on the road, and just as we are about to turn our letters in for processing, the dean of the college calls us back to ask that we please put his name at the bottom of the letter instead of the top. It was important. We had to go back and hopefully today we will have the letter in. And I hope that by the beginning of next week, we are staring at strange roots and plants in the Beira markets.

I've spent a lot of time riding the chapas in the past few days. I wish that I was politically creative, because I think that someone could write a book about how Mozambican politics could be reflected in the rules, regulations and transactions of chapa riding (something like How Soccer Explains the World although I haven't read this either). I pick up a lot more during my chapa rides in Beira because people mostly speak portuguese. This is because in the south, everyone in Maputo (almost) speaks Changaan. In Beira, people speak a mixture of Ndau, Sena, and others, so in the chapas, a lot of Portuguese. Which means, that I get to laugh at jokes, complain with the man sitting next to me about the chapa driver, and pick up little kids that don't fit into other spaces. Things of that nature. Ah, chapas, over 15 chapa rides so far this week will make you really get used to them. But, I digress. Better get back to my preparations for my meeting in an hour.....ate ja!

Friday, August 01, 2008

Culture and Public Health

Last night I was at a dinner with a whole bunch of UN junior staffers....from a handful of countries around the world. My mind started wandering on this question that has been bugging me for the last couple of weeks.

Every time I go to a meeting for one of the research projects that I am doing, I can guarantee that the issue of culture is going to come up. People always say, we have to think about culture. It is really important. What about the traditional healers? What about the traditional birth attendants? What about practices like initiation?

To some extent, I do believe these things are important. But, actually, over the last year and a half, they seem less and less important to me. Last year, I focused solely on looking at traditional birth attendants, in policy and practice. I thought that they were so integral to maternal health care. But, after a while, I started thinking, ah, they aren't really. What matters more is just training more nurses. But, thats not fast, so you just have to devise an interim strategy for the in between times.

Well, that is sort of how I came into the experience here in Mozambique. But, people love to talk about culture here. It is strange. During the post-independence government's reign before the end of the war, traditional practices were banned, to unify and make everyone speak portuguese and be alike in order to build the nation. Well, so after, as you can imagine, there was a surge in the traditional sector. Because of this, there are lots of groups working directly with the traditional practitioners or curandeiros.

So, but how are governments supposed to think about these issues? Yes, the sector is important for most rural, even some urban populations. But, most people agree that if the health systems were strengthened and people had appropriate information they wouldn't go anymore.

It is complex. Obviously it has to do with education and people's belief systems. For example, my grandmother believes that you should put cotton in your ears so that cold air does not enter and make you sick. My parents certainly don't believe this because they have had the benefit of education to no longer believe this. So maybe, in this way, the focus of the effort, should really be on valuing people's cultures, but also urging them to question it.

It is sometimes easier to say that things are hard to change because of culture. But sometimes it is also an excuse. Culture is fluid right? It changes? And it is normal that there should be a "natural selection" in the beneficial and non-beneficial practices. So, how can this start being part of the debate???

Working on this question over my cup of morning ginger tea (cutting down on the coffee sadly....)