Da esquerda para a direita: Manuel Cochole Paulo Gomane, doutorando em Filosofia pela UFBA; Jonas Baltazar Daniel, doutorando em Saúde Coletiva do ISC; Edson de Andrade Nhamuave, mestrando em Saúde Coletiva do ISC

After being affected by cyclone Idai in March this year, which killed more than 1,000 people and affected more than 3 million, Mozambique was again hit by another weather phenomenon in April: cyclone Kenneth. Since then, the African country has been experiencing cholera outbreaks caused by the floods and has raised awareness of known problems. Sensitized by the situation, Mozambican students from the Federal University of Bahia (UFBA) held a seminar at the Institute of Collective Health (ISC) last month to discuss the country’s main health challenges.

The event was coordinated by UFBA Vice Rector Paulo Miguez, who lived 11 years in Mozambique. “I enjoyed the generosity, the welcome, the affection of Mozambicans, but I also followed a terrible epidemiological problem that was war, violence. Hunger was also by my side, ”he said at the opening.

During the seminar, students presented an overview of the geography and history of Mozambique, which gained independence 44 years ago, and faced a long civil war until 1992, the year the Peace Agreement was signed. . We are a country where the greatest epidemic is war, ”said student Manuel Cochole Paulo Gomane, PhD student in Philosophy at UFBA. He also drew attention to the instability that the war imposed on the country. “We can resist human phenomena, but we become fragile about natural disasters.”

Health scenario

Since the 1975 Constitution, revised in 2004, “all citizens have the right to medical and health care” in Mozambique. In recent decades, the numbers show growth in the population’s quality of life. From 1990 to 2018, the Human Development Index (HDI) rose from 0.209 to 0.416. Despite this, the country is still considered low in HDI, occupying the 180th position in the global ranking.

Already the life expectancy went from 43 years to approximately 59 years. “We have had a slight improvement over other African countries,” noted student Jonas Baltazar Daniel, a PhD student in Collective Health at ISC. But he also points out that the numbers are more favorable for the population living in urban areas of the country.

There was also a reduction in the incidence of malaria for children under 5 years, which fell from 53% to 42% between 2012 and 2016. Jonas also highlights the participation of traditional medicine in this context, which is no longer marginalized by government actions. The Mozambican Ministry of Health has even set up an Institute of Traditional Medicine to bridge the gap between the hospital and the “healers”. “Experience has shown that rather than expelling, you need to bring them into the system.”

Since 2014, the country has also approved the decriminalization of abortion, in addition to the decriminalization of homosexuality, considered a crime in much of the African continent.

Obstacles

Mozambique is among the countries with the highest rates of HIV in the world. In 2017, the prevalence of the AIDS virus was 12.5% ​​among adults aged 15 to 49 years. Of these, 55% are treated with antiretrovirals. For student Edson de Andrade Nhamuave, Master’s student in Public Health at ISC, there is a clear underreporting in relation to men. “Most of them don’t look for services. In addition, when they are diagnosed, they do not reveal their HIV status to women. ”

Edson also points to the submission of women to men, something widespread in the country, responsible for their greater vulnerability to infection. An example of this is the rituals, which although in disuse, continue to be practiced in some regions of Mozambique. In the North, women undergo sexual mutilation soon after their first menstruation. In the Center and South, there is a ritual that forces the widow to have unprotected sex with her brother-in-law, or someone rented by the deceased’s family, to purify her. If she refuses, the widow may lose the property.

Male initiation practices can also be found in the country. Through the “unhago”, Yao’s most important celebration in the Mozambican province, boys aged 5 to 10 are circumcised with knives without sterilization, collectively, which increases the risk of HIV infection. To combat rituals, the Mozambican Ministry of Health tries to make people aware of the risks of initiation. “There are people who leave and there are people who support as a defense of the people’s identity.”

Faced with this scenario, Edson highlights the need to create in Mozambique a database system that allows researchers access, which would increase the number of health research. For him, it is also necessary to expand the health network, reducing the distances in the search for care. “We still need to overcome the lack of medicines, chronic malnutrition, and early pregnancy,” he concluded.

Campaign

Since April, UFBA has been promoting a campaign to raise donations to the country. Through the UFBA MOÇAMBIQUE account – Banco do Brasil, Branch 3832-6, current account 37248-X – students, technical and administrative staff and teachers, like everyone else, can help the thousands of citizens affected by cyclones.

The idea of the campaign came after meetings between a group of students from Mozambique and Vice-Chancellor Paulo Miguez. The proceeds will go to the Red Cross and the Fernando Leite Couto Foundation, chaired by the Mozambican writer Mia Couto.