My typical week here in Mocambique

Starting Each Day New
I’m a morning person, but far from the stereotype of morning person that you see in the movies. I’m not the scary person we try to avoid until they get their first cup of caffeine, nor will you catch me whistling or singing at the break of dawn. I should be completely honest and say that although I could (and do) make it happen, its still a struggle to get up to practice any form of movement before the day has really begun (well, almost any form). I still think that sleep is one of the best things in life we tend to take for granted. That said, I believe mornings to be the most sacred (not necessarily in a religious sense) and most forgiving time of the day, and particularly when I can greet the morning quietly and with reverence.

I know that to some degree, it depends on where you rest your head, but the early morning is the time of the day when there’s a certain stillness in the world around me that allows me to see things differently, more clearly. It’s a time when I realize I actually give my attention to the creaking of my zinc roof, the varied sounds of birds greeting the morning, the rustling of leaves through the mango trees, and sometimes even the anchoring sound of stillness. It’s when I notice new things about my surroundings that were always there, but weren’t previously given my time and attention – because other sights, sounds, and my own constantly playing reel of thoughts are what often overtake my senses and become my priority throughout the day.
Mornings are also the opportunity I am granted to begin fresh – new. It’s the time of the day, before my head fills with everything I “have to do”, when I can set an intention of what “I would like to do”. It’s a chance to enter the day with the disposition of someone who is thankful to wake up with full breath and sincere gratitude before my body even makes it’s first move into waking.

A Few Minutes For Meditation
I don’t like to rush (says the native New Yorker). Sometimes I’ll get up two hours earlier than when I actually have to begin getting ready for work – just so that I can take my time to make my hot cup of goodness, read the words of the day in Daily Meditations for People of Color, catch up on what happened in the world while I was asleep, and set my intention for the day which I reinforce with a guided meditation. Up until now, I’ve been practicing reclined yoga poses in my bed before going to sleep, and standing and sitting poses that I can manage to do with just a capulana on my hard cement floor. I’m hoping, however, that the esteira (hand-woven bamboo mat) that I asked my colleague about three months ago might finally come to pass this week, so that I can transfer into a more complete practice in the morning. Again, because sleep is a beautiful thing, I would prefer to practice when I get home from work or before I get ready for bed, but something about anticipating a 90-95 degree practice in my room in the evening is the best kind of motivation to get my boody up and moving before the morning sun has a chance heat things up.

My Daily Role as a Health Volunteer
One of the things that I love the most about my time here and this role that I currently have, is that every day is a just a little bit different. I’m serving as a Community Health Educator, and here in my town I’ve been paired to work with the District Hospital as well as the Community-based Organization (CBO) Tsinela, primarily in the areas of HIV, Malaria and Tuberculosis education and prevention. Mondays and Thursdays are the days I’ve been assigned to work in direct support of hospital efforts, and the other three days of the week I give my time, effort and energy to CBO activities. The role of the health volunteer at a site like mine, is to serve as one of the links/liaisons between the systems, staff and efforts of the hospital and those of the CBO, as they work in partnership to serve the community in these critical areas of public and community health.

The Hospital
Up until now, Mondays have been a mix of several different opportunities. During my first couple of months, I spent Mondays in the Psychosocial Support office where almost all patients show up for a consultation no matter the reason for their visit, and there I would enter consultation dates into log books, look for missing patient records (its like an ongoing form of hazing for the health volunteer in Moçambique), and sit and observe consultations conducted by nurses and technicians…mainly in the local language (Xitsua) which is the primary language of most of the patients who are seen at the hospital.

Recently, in order to branch out and learn more about the hospital and it’s sectors and services, I connected with the SAAJ (Youth Clinic), which is a separate building catering to the health needs of youth up to about age 24, so that they are in an environment that has services delivered with their unique needs in mind. After several weeks of spending time observing and participating in consultations with youth at the SAAJ, the nurse has agreed that having me there to work together with another nurse and a community health educator from my organization, would be a feasible plan for the coming year (or until the end of service as needed). I’m currently in the process of thinking through the details and drafting a plan for us to deliver activities related to Family Planning, HIV prevention and treatment, Gender and Empowerment, Malaria prevention, and any other topics that youth might find interesting about their own mental, emotional, and physical health.

The remainder of the day on Mondays are currently used for planning and working on my comprehensive community assessment. Although I could go back to the hospital after leaving the SAAJ, by 1pm the patient traffic has typically slowed down tremendously in the office I am in, so while I previously used that time to just chat and get to know others in the sector, I now use it to work on writing my assessment which requires time for planning, active researching, and writing (in Portuguese).

Thursdays, although I’m at the hospital, my day looks completely different. Thursdays are an earlier start for me, and I honestly find it really difficult to maintain the same routine that I do on most other days. I still manage to prioritize a short meditation and the reading, and my cup of something good, but that’s all I have time for since I have to be out of my house no later than 7:20am in order to make it to the hospital for the Comité TARV (Tratamento Anti-RetroViral). This committee is a national effort in health centers across the country, and is a cross-team effort within the hospital (and includes partners such as Peace Corps and FHI 360 here at my site in Inhambane) to share information, successes, and challenges in order to improve services related to HIV testing and treatment (TARV), and patient care.

After the hour-long meeting which ends at 9am, I’ve recently been taking the 10 minute walk over to the District Health office which is where the Mobile Brigades that travel into the community originate. As I did with the SAAJ, I started to go in order to get a sense of the flow of other hospital sectors and services, and particularly what was offered to community members in bairros (neighborhoods) far from the District Hospital. The district I live in is the largest district in terms of total area, however it is not the most populous. The majority of the population is located in the eastern portion of the district, within 15km of the main central highway and the sea. It’s the conditions of the side roads, however, and the lack of resources regarding transportation which make access an incredible barrier for most. The district does have smaller health centers scattered throughout the bairros, but they are still sparsely resourced with staff and materials, and access on these roads that are essentially made completely out of sand, make it close to impossible for regular access for the average individual needing medical consultation or treatment.

Mobile Brigades (Joint Initiative between Hospital and District Health Office)
The Mobile Brigades were initiated to begin to address challenges related to access, by bringing services of the District Hospital out into the community to those for whom access remains a significant obstacle. I’ve been on three brigades so far, and each site has been different. The first one, about a 40 minute drive from the hospital, served roughly 30 women and their children. Medical staff weighed babies and checked nutritional status, consulted on minor symptoms for cold and flu, and tested about 3/4 of those over the age of 5 for Malaria (due to symptoms they were experiencing), and referred patients to the hospital for those concerns that needed further attention. The third site I went to, approximately an hour and a half from the hospital, served approximately 300 community members who received the same types of consultations as those at the first site – due to the limitations of the brigade. I plan to continue travel out into the community with the brigades twice monthly on Thursdays, because this is an opportunity for me to work with the health students and other technicians to implement health talks and related activities while community members are waiting for their consultations. These sites, unlike the district hospital, do not have a regular presence of Activistas (community health workers) who begin each morning at the hospital with palestras (health talks) on various topics. In terms of identifying a significant gap in services, this is definitely an area that could use more support.

Community-based Organization (Associação Tsinela)
Tuesdays, Wednesdays, and Fridays I dedicate my time to activities that directly support the organization. The walk takes me 40 minutes each way – longer if I peek my head into my host family’s quintal (cluster of homes) to saudar (greet) them and find out how their previous day was and how the morning is treating them. Everyone always says that I should take a chapa (mini-bus or open-back pick up truck) the 5 minutes it would take from the main market to my org, but I would still have to walk down to the market to get one, so I just figure I might as well take advantage of the exercise and the time to think (or not).

At the beginning, the org was in the process of working with a large international organization (CARE International) to do a community mapping activity as a part of a grant they were awarded, so in the first few weeks when I arrived, we were busy going out into the community, meeting with community groups and local leaders, and mapping out strengths and needs in communities as per the perspectives and experience of the community members themselves. Since that time, the org has entered into its second year of the four year grant, and after receiving feedback from the first year evaluation from this funding partnership, this org has a lot to do in terms of improvements with program implementation and evaluation as they move forward. Needless to say, finding time to involve me meaningfully in the organization’s day to day so that I can get a sense of where I can learn and support the process – has been a significant challenge, because everyone is so busy with their primary responsibilities under this grant-funded project.

So currently, on the days I go to the organization, I make sure that I haul my laptop with me so that I can work on writing my community evaluation. I always sit and chat with activistas before getting to work on the computer, as it’s a nice way to remain connected with them and learn about what’s going on in the community (when it’s translated for me, because all conversations are typically always in Xitsua). I’m hoping that I will finally get to the local primary school with one or two of the activistas before schools gets under way again, in order to discuss a plan for implementing prevention and education activities with the oldest of the students there. Although my hope was to be working more with mothers and young children during my time here, it seems as though the universe keeps bringing me right back to youth – at least in these early months. If this plan works out, I hope we can be at the primary school twice a month to implement activities with the group on my org days, and set up the same type of plan with an older group of girls (only) at the Secondary School that sits close to my house in my own bairro.

When the Work Day is Over
Most days of the week I am back in my house by 4-4:30pm, as long as I haven’t made a stop at the market or my host family’s house, or if I’m not coming back late from a brigade trip. I have to start cooking right away, as everything takes longer on the little 2-burner stoven (stove+oven) that I have. While the food is cooking, I’ll typically take a bucket bath and check in on social media to see what friends and family have been up to share some updates or photos now and again. I’m usually eating by 6pm, if not a bit earlier, and after cleaning up I’ll read, talk with friends here in-country, and/or write for a while before starting to get ready to go to bed. Like so many volunteers, I’m typically in my bed no later than 9pm, but will take another bath (this heat!!!), read for an hour or continue talking with friends until I’m ready to sleep.

Weekends
The weekends are a whole mix of different activities. Typical weekends involve “sleeping in” until 7am, and then going through the same morning routine as I do during the weekdays. Depending on how (un)motivated I feel, I’ll either do my washing or leave it until Sunday. Recently, I’ve been highly motivated to just leave it until Sunday. On the day I wash, I’ll also clean up the house, sweep both rooms to get rid of dust and sand that accumulates literally overnight, and organize my table – which tends to become the catch-all for just about everything.

Saturdays or Sundays are my main market days, and I constantly get scolded for going out at the hottest time of the day (I just can’t sacrifice my quiet, early morning time for the hectic movement of the market in the early morning). So I do suffer, but it feels like such an accomplishment when I get back home with a basket full of good stuff to prepare. Not only do I enjoy what I reap from the market run, I appreciate the time I get to chat with the friends I’ve made at my main market stalls. We catch up on my work, on their days, on family, on food prices and the weather, and unfortunately on illnesses and deaths that have taken place since we last made time to talk. Depending on the friend-vendor, this is when I’ll also get in my impromptu Xitsua lesson for the day.

In the past few weeks, I’ve been using my Saturdays as time to read non-health related books, which I’ve really missed. It reminds of when I was living back in Brooklyn, and I would take the train early Saturday or Sunday morning into Manhattan to The Strand and then walk over to Barnes and Noble, just to sit for hours and read travel journals, biographies, and get lost in so many other types of life stories. Most recently, I’ve begun to use time on weekends to write entries to share my story with you all reading this blog.

That’s a typical week for me – although every day and every week looks a little bit different. I didn’t even mention the random events that I am sometimes invited to….such as graduations, a lunch at someone’s home, or a trip offsite to visit other volunteers or just to passear for a day (get out and stroll with no real destination or plan but to be seen and to be social). I realize, though, that my plans are just that – plans. They are typically something I put together to create some kind of safety through structure and the order that I’m used to. And then I have to let it all go because apparently that wasn’t the universe’ plan for me. It’s getting easier for me to take a deep breath, relax, and just be open to what comes. Some days it’s harder to do than others (and heaven forbid I haven’t eaten for hours when a significant change comes up), but for the most part it’s a nice lesson and reminder that my days are shared with my community, and despite everyday changes and challenges, I’m really privileged to be living these opportunities.