Saturday, October 17, 2009

The Final Preparation

So, it is two days before I finally leave for my anticipated trip to Africa. During the entire semester so far, our team of students have been working hard to prepare - from filling out lots of paperwork, getting vaccinated, reading about democracy, contacting people in order to set up interviews, learning how to use the video equipment, and learning Portuguese.

The other day, Michelle El-Hosni and I met with Julie Malacusky and Adriano at Camp Ticonderoga to get to know a little bit more about The Dream Project and how she became involved with the organization. Basically, when she was an undergraduate student at Wayne State, she was not sure of what she wanted to do with her life. So, she prayed and was called to becoming a physician assistant. Afterwards, she visited India and witnessed the street children who were living in unspeakable conditions. She said that she cried for months...however, she was able to use that passion to do incredible things. Julie later went on to Brazil in order to get trained for ministering and reaching out to street children. Then, she was finally asked to be a medical expert for orphanages in Mozambique, which became the Dream Project.

The main Dream Project location is in the northern part of Mozambique. Fortunately for us, the Dream Project is beginning another site in Ponta D'Ouro on donated land, which is approximately 3 hours from Maputo.She explained that she wanted to have a family style structure for the children instead of the typical orphanage. Therefore, there are many small homes in which the children who are affected by HIV/AIDS can stay with. In these homes, the Dream Project is able to provide treatment and raise awareness through prevention by building relationships with the children. As Julie said, the "children are the future of the country".

As far as the national health care system goes, it is very limited. Even though it is government sponsored, the reach of the health care does not go very far especially in the rural areas. She explained that the individuals at the highest risk are the street children. When mothers cannot afford to keep their children or when children run away, they become street children and live their lives without any purpose. I plan on reaching out and learning their stories and witness their conditions while I am in Mozambique.

It is so frustrating for me to see so many people in the world who are living without the basic necessities. While we all try to give and donate money to charities, I feel like there is always something more that we can do. I once heard a quote somewhere and it was "Sympathy is never a substitute for action". I think we are all a little guilty of this quote...we all feel sympathy, but we take relatively little action. My personal goal is that with our documentary on the HIV/AIDS epidemic in Mozambique, we can inspire people back at Wayne State and in Michigan to take action.

The next day, we met with Dr. Johnathon Cohn, an infectious disease specialist at Wayne State who worked with Health Alliance International. His work focused mainly on the implementation of anti-retroviral medications in order to treat the HIV/AIDS patients. He was very knowledgeable about the structure of the current Ministry of Health in Mozambique as well as the various private organizations in the country. The Ministry of Health is composed of a limited staff and overshadowed by the big foreign agencies that have much more money. For example, he explained that St. Agnidio, the Italian group that oversaw the peace relations in Rome, plays a role in treating HIV/AIDS patients in the city of Maputo. He explained that their methodology for treating patients is very high-tech and utilizes highly paid workers. However, this type of "upper-level" treatment facilities is not realistic for the rest of the country due to limited resources. Other groups such as the CDC, World Health Organization, and American universities such as Columbia University and Vanderbilt University have set up extensive networks and staff sources in the country to address the health crisis.

This raises the question of what Frelimo and Renamo are doing in order improve the situation. When I asked Julie and Dr. Cohn, they were not too sure about the two political parties and what they were even up to these days. I am curious to see - if the foreign workers are not that knowledgeable about the presidential elections, are the Mozambicans going to be knowledgeable?

Dr. Cohn also cited a statistic. Of the 1.5 million people who are infected with HIV in Mozambique, approximately only 130,000 people are being treated with ARVs. While this seems like a pretty insignificant and unimpressive statistic, relatively speaking, it is very impressive. Mozambique, a country that used to be at war constantly, and considered to be the world's second poorest country - has been able to allocate its foreign aid resources and energy to provide medicine for the infected population. In the short period of time, they were able to achieve some pretty significant benchmarks. However, the work is not even close to being done.

Dr. Cohn suggested that we visit Maputo Central Hospital to gain an understanding of the national health care system, visit St. Agnidio to look at an upscale foreign sponsored clinic, visit some of his colleagues who are operating clinics within the city, and observe a clinic that is running on minimal means. In addition, Julie and the Dream Project said that we would be welcome to visit Ponta D'Ouro and visit the orphanages and speak with the children.

While this trip is called the African Democracy Project and deals primarily with learning about the presidential elections in Mozambique, my personal goal is to learn how government agencies in foreign countries are affecting the health of their people. I see myself not only as a physician in the US, but also as an international doctor who provides medical care to the poorest in the world. Through ADPM, I have already gained so much insight into the political structure and history of Mozambique, which I know will play a vital role in trying to influence government leaders in terms of health care.

Honestly, I have a feeling that this trip is going to be hectic and spontaneous. However, I think it will all be worthwhile because everybody's goals are in-sync.

P.S. If you are on skype, let me know!

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