Long Read: On Development in a Developing Country

(Above: a vendor’s shop along the coast in the city of Pemba in the province of Cabo Delgado in Mozambique)

The clouds above begin to close in on the remaining sky. He approaches from across the road, and while we haven’t spoken much before, today he wears an inquisitive look as I hand-wash my laundry in the quickly fading, morning light.

“Good morning, Benjamin,” I say, arms deep inside a bucket filled with soapy water. “How is work today?”

“Normal,” he responds, sitting down next to me with seemingly more to say. If I were to guess, I would say he is about 17 or 18 years old. After a couple minutes in silence, he continues. “What is like in America?”

“Well, what do you mean exactly?” I respond.

“Do you have a lot of work there?” he asks, his eyes locking on to mine, revealing a little more about the concerns that seem to be clouding his thoughts.

“Yeah, of course,” I reply quickly. “We have lots of jobs and opportunities there.”

He seems to process the response like someone receiving information she or he already knows. He nods his head and lets out a soft “hm” before returning to silence.

“Why do you ask?” I say, sensing that he isn’t satisfied with the answer to his question. “Do you think that there is a lot of work in Mozambique?”

“No,” he responds quietly. “I went to school here as a child and a teenager, but now there is nothing else for me to do but work in the store.”

“What do you want to do?” I ask.

“I want to be a geologist,” he responds, lighting up a bit. “I want to study rocks and the land, but where am I going to study this? Mozambique doesn’t have the opportunities, and I can’t afford to go to another country. Also, I have family here. I want to do more.” He says this with elbows on his knees, leaning forward in his seat and looking beyond my fence to the neighboring shop where he works. “But there’s nothing more to do here in Mozambique.”

By this point, I have lifted my arms from the soapy water and rested my elbows on my knees, turning my attention toward his worries. I know what I am supposed to say: Try hard and you can accomplish great things…push through the barriers and you can accomplish great things…search out the opportunities and you can accomplish great things.

Instead, we sit together in silence as the light fades away, the sky closes, and it is replaced with dark clouds. The rain begins to fall, splashing inside my bucket.

More Research is Needed

The team is silent as they type away on their keyboards in our office, entering statistics about the abandonment rates of HIV treatment, the number of children infected with the disease through vertical transmission, and how many people were tested during the past year. As the new guy, I’m relegated to the position of fly on the wall.

They are preparing for a meeting with the rest of the members of the ICAP team in our province’s capital the following week. Since it is the end of the year, they are required to submit the statistics to show the current progress of the program in the country.

“Our numbers are a little worse compared to other ICAP programs in the country,” Santino says to the rest of the group. “But they’re looking a little better from last year’s numbers.”

ICAP is an international non-governmental organization (INGO) from Columbia University’s Mailman School of Public Health with one main goal: “to improve the health of families and communities” (About ICAP). They’re accomplishing this by addressing major health challenges and working to improve health systems in more than 3,300 sites across 21 countries. In Mozambique, they work to reduce the burden from HIV and AIDS.

The team works with the local health system to identify patients who have abandoned treatment, search for them in the community, and successfully re-integrate them into the health system with ongoing treatment. Usually, the problems occur during the latter.

“We’ll improve them for next year,” Cristobal says. “We have to.” Cristobal is a trained psychologist from Maputo. He lives here – more than 1,500 km from his family, including a new daughter – with his team members, a doctor and a monitoring and evaluation specialist who also have families and friends in Maputo.

While the rest of the team returns to silence, I open my computer and start to search through years of research into HIV interventions, behavioral trends, and health statistics for the country. Much of the research comes from other INGOs that are scattered throughout the country: USAID, Elizabeth Glaser Pediatric AIDS Foundation, and World Vision, to name a few.

Since the country gained its independence from Portugal in 1975, organizations and researchers have worked tirelessly to improve the overall health of an already weak and damaged system, especially following a decade-long civil war that left the country in pieces. This work is evident through countless articles on piloted health programs, quantitative and qualitative findings regarding health improvement, and insights into behavioral trends that are preventing the adoption of healthy behaviors, especially for children.

However vast the amount of research and findings I read, they all come to the same conclusion: more research is needed. I’m familiar with this phrase after two years in a public health program that required an intimate knowledge of research prose. Basically, information has been collected, certain battles are better understood, but the war rages on.

I excuse myself from the silent typing session to walk around the grounds of the hospital. Across from my team’s office is the maternity ward, where each day a large group of women arrive early in the morning to receive much needed access to HIV testing, nutrition support, and medication. Technical staff leads palestras (health talks) each morning in front of the interested women, usually including a true-to-size model of a penis, a condom demonstration, and an abundance of laughs and gasps from the crowd.

Today, I find myself standing at the back of the open-air waiting room for patients who are receiving service, collecting medication, or waiting for a family member. The waiting rooms in Mozambique are notorious for their long wait times and crowded spaces. This one is no different.

I sit down in the back on a long bench that holds a mother and her child on one end and a man who has his arms folded across his chest and his head down, apparently in mid-sleep. I allow the environment to surround me. I lean forward, rest my elbows on my knees, and run my hands through my hair and wonder to myself what my role will be in this system. The research comes to mind. More research is needed. More…is needed. More…

Força da Familia (Strength of the Family)

“Wake up, Aleksi,” she says with a soft, warm voice from behind me. “You are sleeping in too late.” She pokes her head in through my bedroom door (or her bedroom door) and waits until I start to move about before closing the door.

It takes me a few seconds to remember where I am. I look around the room and see the familiar blue table with one chair that my host father carried in from the main living area when I first moved in. The shiny, metallic cylinder that filters my water for drinking is set up on top of the table with the spout hanging just slightly over the edge. On the cement floor is a tin pot with a lid containing boiled water from the night before, since cooled.

I leave my room to find my host mother clearing the dishes and pans from the dinner the night before: fish, rice, and fresh bread from the town’s bakery. She is handing the dirty dishes to her daughter, Helen, who will carry them outside to wash them.

“Take Aleksi with you,” she says to her daughter. “He needs to see how to clean plates.”

Helen leads me outside into the bright, morning light of Namaacha, a small town located two hours outside of the country’s capital of Maputo. The town is known for its cool weather and gorgeous views of rolling hills, dotted with homes and small shops. It’s home for two months as we prepare to live on our own at our permanent sites.

“Aleksi! Good morning!” my host father yells from across the yard. “Do you want to help me make some blocks today?” He stands feet deep wearing swimming shorts and a tank top in a pile of cement-sand mixture used for creating blocks for construction. Standing next to him, collecting his breath, is a young-looking man holding a shovel in his gloved hands.

“I want to learn,” I yell back to my host father, “but first I need to help Helen with the dishes!” Helen is still standing next to me, a pile of dishes in her hands as she smiles.

“Okay! After!” he replies.

Using two buckets, one with soapy, bubbly water and the other with clean water, Helen demonstrates the Mozambican process of putting the dirty plates in the soapy water, scrubbing them with her hands or a sponge, and resting them in the clean water. She checks for understanding. I nod. She demonstrates again. I nod. One more time.

During this time, my host mother has already started a fire to heat the water that we will all use to bathe ourselves, collected and lit the charcoal on the stove to start preparing breakfast, started to cut the vegetables in her hands used to flavor the meal, and filled three buckets to prepare to teach me how to wash my dirty laundry.

First, I join my host father who is in the process of making cement blocks that will be used to expand his family’s home. Using a shovel, he collects a large pile of the mixture, places it inside a hollow, metal container set atop a short stump until the mixture overflows over the top, and he uses the flat side of the shovel with much force to flatten the cement block into place. He demonstrates this a few times and hands the shovel to me.

I take a few swings at the mixture, which ends up flying through the air and collecting on the clothes of everyone in a small radius of the stump. A couple more attempts, and he smiles as he reaches for the shovel and says the water is ready for my laundry.

My host mother demonstrates the correct method of cleaning laundry in Mozambique. Using three buckets, one with soapy, bubbly water and two with clean water, she uses her hands to rub the dirty laundry with her knuckles in the soapy water. Once she feels she has covered all surfaces, she rings it out, puts it in the next bucket, rings it out again, puts it in the final bucket, rings it out, and places it on the clothes line to dry. I’m impressed with the sheer force of her arms and hands as she washes the clothes.

My host father finishes building the blocks, and he enters the house to take a bath. He will rest for the remainder of the day. My host mother continues the day by finishing breakfast, carting water on her head and a wheelbarrow from the pump in the next neighborhood over, washing the clothes of her family, preparing lunch then dinner, and ending the day with dinner with the family, a hot bath, and finally rest.

At dinner, I acknowledge the amount of work they both do during the day. “You both work very hard,” I add to the conversation. “I have a lot of respect for both of you.” I fumble through the Portuguese, but they understand.

“It’s nothing, Aleksi,” my mother responds.

“It’s our lives here,” my father adds. “We have to work hard to take care of our family and our community. We cannot sit around and do nothing. We have to help however we can.”

My host sisters, including Helen, and host brother are all sitting on a bench near the dinner table eating along with us. They nod along with their father’s statements, seemingly seeing a similar future of hard work and giving back to the family and community they love.

A Lesson in More

I lean back against the bench in the waiting room of the hospital where I had been sitting for the past thirty minutes. The mother and her child have since left, and the man is now awake, talking and joking with another man seated next to him.

I look around the waiting room once more and see the faces of the patients. It’s difficult not to see the faces of my host family in each person with whom I interact. They’re the ones, after all, who taught me everything I know about Mozambique, its culture, and its core.

While research is plenty, the more I was looking for lay in the faces of the people surrounding me. I decide to focus my attention on having conversations with as many people in the community as possible, to both learn more about health in the community but also to better understand the mindsets and beliefs of my new home.

The following day, using the training and experiences I gained during the completion of my public health program, I create a survey that I will use out in the community to collect information on the health of Namapa. The survey has ten questions, complete with demographics, thoughts about health issues, and ideas about where people receive health information in the community.

It’s a warm, sunny day, and I walk onto the main street of Namapa, where people are passing in plenty. I understand that this moment is the first of many that will guide me and direct me throughout the next two years at site.

With the research and the strength of my host family in mind, I approach the first person.

“Good morning!” I say as softly and warmly as possible. “How are you today?”

Moving the Immovable Wall Forward

Benjamin and I are still silent as we sit outside my house, but the overhanging roof now covers us. The rain continues to fall, but the clouds are starting to dissipate. I’ve abandoned the task of washing my clothes and instead think of how to best address his concerns.

“Benjamin, I don’t know what to say,” I tell him. “I have no answer for you.”

“It’s okay,” he says. “I am happy that I am able to work here. I have family. I have friends here. All is well. But I do like having conversations with you. I hope we can talk more.”

“Of course we can,” I respond. “That’s really all I can offer, and I’m always able to talk.”

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This post is in response to a friend’s request to write up an article or post about my thoughts on development in Mozambique. While the way in which I describe my experiences is meant to require interpretation, I also want to direct interested minds to other articles and research on the idea of development in a developing world, especially in regards to Peace Corps and foreign aid:

Peace Corps Website

• Provides Mission, Fast Facts, History, and Reports

“Reconsidering the Peace Corps” from the Brookings Institute (December 2003)

• An older article about improving the Peace Corps, but it provides a good overview of the history of the program, its main goals, and the future direction of the program.

The Divide Between Developed and Developing Countries by The Levin Institute

• A closer look and explanation at the gap between developed and developing countries, including problems of development, case studies, and strategies for the future.

The World Bank Development Indicators for Mozambique

• Hard statistics on the development indicators, current statistics, and global economic prospects

United Nations Mozambique Key Development Indicators

• History of Mozambique, Development Context in Mozambique, and National Development Goals