back in the USA

made it back, safe and sound, after a pretty brutal set of flights and layovers. glad to be home, glad to be reunited with my jeans! and eric too, of course. :)

last day in mozambique

things are closing out really nicely. or, as nicely as they can be. i have everything i need, i think, and all seems fairly tidy. the sad news is that professor v's daughter died while i was in catandica. she was 42 and professor was understandably distraught. i was so sad for him. despite this, he still met with me, managed to make a few truly nice remarks about fernando torres' goal for liverpool on tuesday (he saw my picture of torres on my computer's wallpaper which launched us into a 2 day discussion of football when we were in chokwe!) and some other niceties. he's a really sweet man, and he was truly a pleasure to work with.

it's amazing: he's must be in his late 70s, he used to be vice-minister and minister of health in mozambique (he had some amazing stories of the 80s and early 90s when there was a terrible civil war here), yet he's still working hard to equip mozambique's countryside by training cohorts of tecnicos of surgery. i'm really glad i had a chance to make it all the way out here and meet some truly good people.

everything is packed and i'm ready to head back home tomorrow! here is my lunch today for you foodies: it's a spicy seafood soup and something i had for lunch a lot all over mozambique, though gussied up because this is the big city, it's called prego.

thanks for all your comments and keeping tabs with me here. the interweb is a great, great thing.

lengthy car rides

i forgot to mention the ride to catandica was almost 6 hours! there were 11 of us, crammed like sardines in an ambulance from beira to chimoio (where we made a brief pit-stop) and chimoio to catandica. it was suprisingly fun! 8 of the 11 were patients who'd had VVF (fistulas) repairs in beira that were too complicated for the rural hospitals. mostly we were chatting and they were all pointing things out to me in the countryside. hooray for no motion sickness (i cheated, i took the dramamine)!

the ride back to chimoio from catandica yesterday was great! it was just the driver, tecnica and i (she just wanted to make sure i made it to the airport in chimoio safely), and i got to see the whole agricultural area (sugar cane, tobacco, maize) and mountain range. it was gorgeous. i was really glad to have seen it during the day time; i didn't get to see it on the way to catandica, because by the time we got to that part of the trip, it was already pitch-black and i didn't see anything. beyond that mountain range is zimbabwe!

birthday hernia

no, i didn't have a hernia (though i easily could have with what my documents-stuffed bag weighs now), but now i know what one looks like! what started out as an expectedly busy day collecting information from the hospital ended with tecnica inviting me to her house for a little surprise birthday celebration. she'd made some cookies and had some cherry cordial and soda laid out for me. her son sang me happy birthday in protuguese and then....she received an emergency call from the hospital! a patient with a hernia was vomiting and the suspicion was that his hernia had become incarcerated (pinched) and needed to be operated immediately. she asked me if i wanted to tag along, and i thought, "what the hell! i can do this!"

she lent me some scrubs, i helped her scrub up (i just poured water while she did the whole handwashing routine) and calmly observed from a corner in the operating room. ok, so i'm lying. i wasn't calm at all. even though the operating room was very nicely air conditioned and cool, i had a cold sweat sitting on my brow for the entire procedure. the first bit was tough for me to watch, but after a while it was so interesting to see it all! she did a great job of explaining it all to me (not easy to do with a mask over your mouth and speaking a language that i really need to concentrate to understand) and pointed out things of interest. i won't gross those of you out there with a weak stomach (like mine), but it was one of the neatest things i have seen. any surgery is probably interesting to everyone at some base level, but to see someone who is very poor, in a lot of pain (i was with her when she did the initial assessment at the ward), out and open on the operating table, and then recovered the next day, walking around, animated and eating, is truly amazing. in these remote places, people like the tecnica are very literally life-savers. that was cool to see.

i also got to watch her do a skin graft of a 17 year-old patient with piomiositis (a disease of the developing world where there is a severe infection of a large group of muscles) and that was equally amazing, for the same reasons. i never thought i'd find the actual witnessing of the operations so interesting (i like cold hard numbers on the computer screen!), but i did. definitely a birthday i'll remember!

the photos are the view of the hospital through her vegetable patch in her backyard.

catandica

catandica was the place where i was both, the most amazed and comfortable and the most skittish! it was a fantastic place to end my data collection experience. i became good friends with the tecnica of surgery there and her 8-year old son (who calls me tia ana--so cute!), but the remote location in the mountains and gorgeous environment makes it the perfect place for absolutely ginormous insects and arachnids to flourish. i spent my last night there terrified that a spider the size of my palm (ok, half the size of my palm, but that's still really big!) would jump onto my face during the night. i was right to worry! the morning i left, i opened my eyes to see one of the scary, hairy and striped fellows crawling directly above my head on the ceiling. i shot out of bed, got ready in record time, and scooted out the door. i'm just not good with creepy crawlies that are as big as rodents.

but, that aside, catandica was simply awesome. it's a sleepy little town in the mountains with no bakery (my tecnica friend has to buy bread in bulk from chimoio, some 2 hours away by car), one restaurant, one gas station and a huge street market with vendors selling all kinds of goods in little stalls. it's incredible. the hospital was wonderful. the tecnica runs it with ruthless efficiency (she's a very caring clinician, obsessively making the rounds through all the wards) and doesn't take any crap from any of the nurses, clinical assistants, administrative people and aides she has to manage. i was amazed by how much responsibility she has. she's the only clinician trained to perform surgical procedures in the entire northern half of the province of manica (usually these hospitals serve a district but she serves 4 districts: a huge, remote area), and all emergency cases in the area get brought down by ambulance for her to treat. she also has to maintain all the hospital records, data, and deal with human resource management issues. makes my head spin.

so i'm very motivated to doing a good job documenting the rural hospital's surgical caseload and costs so we can get our reports and papers out and distributed to the health ministries of the countries we're studying! the idea is that the personnel at these hospitals are overworked and underfunded yet have good outcomes for their patients. that's certainly true in catandica.

beira

it's raining like crazy, and i'm waiting for my ride to start the 5 hour trek to cantandica. ug, if i thought i hated long car rides at home (road trips are the stinks!) i really don't enjoy car rides over here. i get too car sick. thank god anna gave me a good supply of dramamine.

i keep expecting my good luck with internet connectedness to run out. i thought for sure i wouldn't have any in this sleepy beach town, but here i am, blogging away. i am *for certain* not to have any in catandica though. everyone keeps correcting me when i ask about the town, saying "no, no, it's not a town, it's a village." so there you have it.

i'll be back in maputo on wednesday, and counting down the days until i get home! although it's been an amazing month, i'm sick of the turtle, 'house-on-my-back' life. i think i will put the 4-5 outfits i brought with me on a year-long hiatus from wardrobe rotation. if i don't see or wear another pair of linen pants in my life.....sigh. is it weird that i really, really miss wearing my jeans?

maputo nightlife

last night lene (norwegian lost baggage buddy) and i went out to costa do sol (a popular seaside seafood place) for dinner and out to listen to some live music and dancing at a place called the africa bar. the food was great, and the music and dancing even better! although, the caipirinhas at costa do sol are a bit too strong...i had a hard time getting up early this morning to meet with professor v. and finish up our remaining chokwe data issues.

lene is a great going-out partner, so in hindsight, i'm glad our luggage was lost and we had a chance to bond. the funny thing is that she works on health sector projects for NORAD, so we're professional colleagues here too. we chatted a lot about the work i'm doing here and we shared some information that we each found useful (she coming from the top-down, me working from the bottom-up so we could cross-reference our facts).

i fly to beira tomorrow morning and then head by ground transport to cantandica on sunday. apparently cantandica is in the mountains so i'm hoping for some really pretty views. it's also very close to the border with zimbabwe. i'll see if i can post anything from there, though i doubt i'll have access (i've been pleasantly surprised about my access before though!). i'll be back at the hotel in maputo next wednesday, so i'll definitely update by then.

time to pack!