“…and I’ve never seen a traditional dance like THAT!” Caroline (the PC Health Program Trainer here in Mozambique) explained to the group of PC health trainees as we discussed our observations regarding some sexual references during a local dance performance we had just witnessed. In fact, what had caught people off guard was not the repeated pelvis thrusts that occurred throughout the dance (typical in many traditional African dances), but rather the culmination of the song where the lead dancer put his hand down his pants and stuck his finger out of his undone zipper. Even though some of the moves were notably influenced by African culture, the show resembled a hiphop dance scene from the movie “Step Up” more than anything else. The performance by the group of young men, as Caroline pointed out to us, actually gave us a lot of insight into the generation of young Mozambicans that we will be working with who are currently experiencing a huge transition of cultural influence in their society.
Even though many European countries carved up and forced themselves upon most of Africa in the 1800’s and 1900’s, I believe that the western cultural influence which is now penetrating African society is arguably greater than ever before. While colonialism forced new languages and social structures on many African tribes, the local languages and customs persisted and were highly prevalent in everyday life. Now, on the other hand, although the current generation of Mozambican youth continues to get certain aspects of their culture from their Zulu and Shangana (here in Namaacha) heritage, there is a huge amount of influence from foreign sources that extends beyond the realms of government and economy to profoundly influence family life. This influence, in the case of my host family for example, most often comes in the subtle and seductive form of Brazilian and Portuguese television programming, American and European movies and music, and a general influx of ideas from organizations and individuals from all over the world who set up camp in foreign countries. Although one might argue that this influx of knowledge and culture greatly benefits the upcoming generation of Mozambicans, it has a detracting side to it as well. Of all the 6 children in my host family, for example, only one, my oldest brother Lissaio, can actually speak Shangana. To combat this trend the government has implemented programs to revitalize local culture by teaching native languages in schools, but these programs are few and far between.
On a personal note, after having been in Mozambique for a little less than 2 months, I’ve already started to question the presence and motives of international NGO’s and ex-pats (not excluding myself) who come to Africa to help build infrastructure and/or address public health problems, but who often bring with them their own agendas and end up causing a lot more problems than providing solutions. I am not saying that we should stop offering aid to people in developing countries, but instead I am trying to make it one of my foremost goals to not push my agenda when serving the people of my future community. We’ll see how well I hold true to that one…
Friday November 20th, 2009
I have a blog entry for this day that I'll be sending out to people on an individual basis because of its sensitive content. If you would like to see this entry, please email me at mtudeen@gmail.com and I'll try to email you the entry ASAP.
Saturday November 21st, 2009
It was only slightly drizzling (a significant improvement in recent weather patterns) as I stepped out of my house and started up the hill towards the city center of Namaacha. It had been raining the night before though, so the roads were pretty muddy and it was battle with every step I took, having to tug on my sandals just to get them back out of the matope (shangana for “mud”). I was running a little late and wasn’t sure where I was going exactly, but I knew that PC had scheduled a visit with a curandeiro (a traditional healer) somewhere in Namaacha so I was pretty ready and willing make the early morning trip, even in less than ideal conditions, to have the new experience.
A look at the mountains from Barrio 25 during a quick lull in the rains.
After the initial confusion, I found myself with my language group being led down a wet, rocky mountain side, whose dirt had been scrapped away by the wind and rain, towards the curandeiro’s house. Although the path looked especially daunting, the rocks were actually not very slippery, surprisingly easy to walk on, and sort of functioned like an paved, albeit uneven road for the barrio.
When we finally arrived at the house of the curandeiro, another PC language group had just started their visit so we had to stand outside the consultation room (a circular mud-block hut, about 10 feet in diameter, topped with thatch roofing and completely separate from his actual house) under a crammed covered patio and make small talk while waiting our turn. When the other group finished their visit after 30 minutes or so and we were finally able to enter the consultation room, the curandeiro asked us to take our shoes off before entering and then sit on the straw mat stretched out on the floor in front of him. The curandeiro was a middle-aged man, probably somewhere in his early 30s, whose dark black skin dramatically contrasted the white and red capulana that he wore around his waist. Luckily for us, he spoke Portuguese very slowly and clearly and I was able to understand most, if not all, of what he told us.
Our visit with the curandeiro started with him explaining to us the preparation that goes into a consultation and how a typical consultation happens. As we sat there star struck, he rapidly pointed out items hanging from the walls of the room that play important roles in the consultation: differently designed capulanas he wears in accordance to the type of consult, head dresses that that patient must wear, various jars of herbs and animal skin, etc. He then went on to tell us how, when a patient arrives for a consult, they are not supposed to tell the curandeiro what’s wrong. Instead, the curandeiro takes a small cup filled with coins, shells, and other materials, shakes them, and the releases them onto the floor to make a pattern. He didn’t explain exactly how he reads the patterns that they make, but apparently it tells him why the patient is visiting and they move on from there with the appropriate ritual or herbal remedy. On a normal day, he guesses that he’ll see anywhere between 10-15 patients. And to me that’s very interesting because here, in a relatively urban area (like Namaacha) where access to the hospital is relatively easy, the cost to find transportation to the hospital is minimal and the care at the hospital is, most of the time, free. On the other hand, a curandeiro always charges a fee. So even when almost everyone in the area is strapped for cash, you know that money isn’t the most important factor in many people’s health decisions.
According to the curandeiro we visited, between 60-70% of Mozambicans have visited/still visit a curandeiro for medical treatment. People seek out medical treatment from curandeiros for various reasons. Even though the public health care system here in Mozambique is free of cost, there are still plenty of barriers to entry and oftentimes a visit to the local curandeiro is the more practical option. For example, with over 20 million people in Mozambique and less than 900 doctors, compared to over 15,000 curandeiros, it is safe to say that there is a significant deficiency of health care professionals, resulting in very long wait times at the hospitals. Additionally, hospitals are only located in district and provincial capital cities, so if you need to receive treatment, you may need to travel very far just to wait in those long lines. Another important aspect of visiting curandeiros is the emphasis on spiritual and emotional healing which oftentimes the official medical system tends to put less emphasis on or ignore completely. Discussing it a little more, some PC friends and I have hypothesized that maybe paying something for health-care services gives the patient a sense of comfort in knowing that the service rendered is “valuable” and the patient literally and figuratively has bought into the treatment method.
The curandeiro we met with is the district secretary of AMETRAMO, Association of Traditional Healers of Mozambique, and thus he was very sensitive in the wording of his explanations regarding the struggle between traditional healing and western medicine. While sidestepping some of the more direct questions regarding this struggle, he portrayed the current health care situation as one with shared responsibilities between both entities. He recognized that some problems are indeed biologically based, but that curandeiros have many herbal solutions that they can use to treat them. He also conceded that there are some diseases are biologically based that curandeiros haven’t yet figured out how to treat them (ie HIV) and instead they refer these patients to the area hospital. However, he was insistent that many physical illnesses are actually rooted in emotional and spiritual issues that curandeiros can best treat through particular rituals.
One must take all of that with a grain of salt though, because a patient doesn’t typically walk into a curandeiro with a hospital diagnosis. In fact, as I mentioned earlier, the curandeiro usually won’t even permit the patient to tell him what’s wrong with him. Instead, the curandeiro relies on their collection of shells, coins, and other spiritual items to help determine what the patient’s illness is. In the end it’s tough to say if a curandeiro will always refer a patient with a biologically-based problem that they can’t treat to the hospital. An omnipresent force of conflict in western medicine is the influence of money. It’s no different in traditional healing. Curandeiros are not typically ultra-wealthy members of the community and thus they need to earn money just like everyone else. As one can easily infer from this situation, there is a significant incentive to holding on to patients instead of referring them to the hospital.
That all said, there is a saying back in the States among general practitioners that 70% of acute patients will get better without the intervention of the doctor. Yet, not only do we continue to still see all of these patients, but we even encourage most people to go to the doctor more often. This seemingly insinuates that the illnesses stopping are directly related to the doctor’s interventions, but this is not always the case. So I ask, in this instance, is western medicine and traditional medicine really that different? Just a thought…
Sunday November 22nd, 2009
Since arriving back from site visits over a week ago it has been overcast and rainy every day, minus a 3 or 4 hour interval one afternoon. It’s been so bad that I’ve actually been called out by my host family for acting sad or depressed. And you know what? They were right! I’m a Florida boy and I was pretty bummed out by the weather. To give you a better picture of how intense the rain has been, two days ago it was so bad that 3 houses in Namaacha actually caved in and were destroyed because the rain eroded the mud “mortar” that held the houses’ stone exterior together. (As a side note, it’s amazing that I didn’t even notice the collapsed houses until my brother pointed it out to me! I can be so absorbed in small things that I notice the huge ones.)
That all said, after a week of rain, I woke up this morning singing to myself, finally…. it’s gonna be a bright (a bright), a bright, a bright sun shinny day! I took the opportunity to wash and dry clothes (I had been getting a lot of jabs from my host family about having worn the same pair of pants for the past three days), get mud off shoes, and, most importantly, get out and have some fun!
Check out the photos below from my long anticipated hike to the waterfalls with my PC friends and our host families:
Walking in the shade to the waterfalls just outside of Namaacha.
A better look at the scenery while walking to the waterfalls.
Yokho, Roselia, and Noemi with our host brothers and sisters at the upper waterfalls.
Me joining in on the photo action in front of the upper falls.
Josh feeling me up from behind in front of the big waterfall.
Roselia and my brother, Ramadaan, chilling on a rock in front of the big fall.
Amanda's brother and my brother, Ramadaan, climbing a tree in front of the big fall.
Yokho, Noemi, Roselia, and Josh with our host family members enjoying the sunset as we walk back to Namaacha.
Wednesday November 25th, 2009
Happy Thanksgiving everyone! I miss you all! I’ll write more about my Thanksgiving experience and such later, but I just wanted to let you all know what my site placement is! **drum roll please** I will be spending the next two years in the rural town of Nauela in the northern part of the Zambezia province partnered with the international-NGO Friends in Global Health working with People Living With HIV/AIDS (PLWHA). My site is located in northern part Mozambique, close to the Mt. Namuli (the second highest mountain in the country, I think). Go check it out on google maps or something J! Now I know where I’m going and what in theory I’ll be doing, but once I get to sight we’ll see how everything pans out. Either way, I’m really excited!
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