Hot, humid and deathly - Writing about health in Mozambique

Posted on May 18, 2010.

The reality of poor health in Mozambique. Credit: Mercedes Sayagues

Life is frail in Mozambique. Credit: Mercedes Sayagues

Guest blogger Mercedes Sayagues

The health page was laid out late at night last week. I had a headache so I went home around 7 pm to lie down. Around 9:30 the editor called: our turn for layout.

It was unbearably hot and humid. The newsroom is in the basement of an old house. The proofreader was sitting on the steps to the garden. “Catching fresh air?” I asked.

Usually the health page is laid out in the afternoon and the proofreader comes in the evening so I had seen Leopoldo Fernandes only a couple times: a small, gaunt man with a balding head and a greying ponytail.

Ponytailed men in their fifties usually have a hippie, musical or artistic past, so I made a mental note to chat to him one day.

Tonight Leopoldo was coughing badly. He pulled out an inhaler from his pocket, like Benicio del Toro in the Che Guevara film.

“I am very sick,” he gasped between coughs. “I have emphysema.”  He lit up a cigarette.

Indeed he was sick. He walked back into the newsroom as if every step was a command he gave to his body. He stared at the computer as if words were vanishing. He had been proofreading the health page when he stepped out and left it open without saving. Someone else used the computer; his work was lost. He cursed and started again. I sat next to him quietly, patiently.

I felt his energy ebbing away word by word but he was set on completing the job. Several times a fit of coughs made him go out again.

At last he finished the health story. I gave it a final read, gently pointed out missed typos and got up. I touched his shoulder: pure bones. “Get well soon,” I said. He looked up and acknowledged. He was too sick to smile. Our gaze locked. Good night.

He died on Saturday. His obit told of an actor and singer, a rebel, a bohemian, “a friend to friends”. Back in 1977, he was sent to a re-education camp - a feature of the post-colonial Marxist regime - to no avail. He was “one of those guys who cannot be re-educated. Luckily some of these exist.” Leo got 50 lashes for smoking pot, fled to the bush, avoided leopards, and returned to the capital to continue a prodigious consumption of pot, tobacco, alcohol and women, said the obit.

I learned of his death on Monday. He was my age.

That Monday, around 7 pm, the reporter I was working with answered her cellphone. Her one-month-old nephew had died. Cause: unknown, she said. Another colleague who sits next to me was teary-eyed: her cousin, aged 28 and just graduated in pharmacy, had died over the weekend. Cause: unknown.  Must have been some bacteria she analysed at work in the hospital. The cousin, she said, “had been weeping tears of blood.”

The way language deals with disease in Africa can be quite poetic. “She had smoke in the lungs,” a fisherman told me, describing his wife’s death. I figured out she had TB. I cannot fathom the blood tears, though.

The following day, I am working with another reporter. “I have to go early for a funeral”, he says. Who died? “Some irresponsible person performed an abortion on my neighbour who was seven months pregnant. The baby lived for a few hours, she died overnight.”

The previous Monday, on the way to a slum to do a story on sanitation, I asked another reporter how was her weekend. “Tiresome,’ she said. Her in-laws had sent an urgent request for medicines for a five-year-old boy. They live in Inhambane province, 800 kms away.  By the time they put together a parcel and found a traveller to take it, the child had died. Would it have been more efficient to send money? The relatives don’t have a bank account and live far from town. What was in the parcel? Vitamins and fortified food. Cause of death? Unknown.

Last year I interviewed an anthropologist who works in a remote valley of the Venda territory in South Africa. The Venda people are known for spirituality, superstition and witchcraft. The anthropologist explained the Venda seldom name a cause of death.  The words may bring the disease or suggest you had something to do with the death.

We kept on chatting. The reporter had fired her new nanny, who is 18, four-months pregnant and feeling unwell.  I thought that was callous until I learned the background. The previous nanny, a sister to this one, was 20 years old and seven months pregnant. She had not told anyone. In December she had a miscarriage in the sitting room, in front of the reporter’s toddler. Her husband came from work to the gory scene. And the problems: finding a car to go to hospital, finding someone to clean the mess.

No wonder my colleague did not want another pregnant nanny in her house.

We arrived in the slum. It was hot, 38 Celsius, and humid. I felt dizzy and nauseous. I sat on the floor and did yoga breathing. My hands went numb, fingers bent into a fist.  I couldn’t open them. I thought I was having a stroke.

I remembered Jean Dominique Bauby, of the Diving Suit and the Butterfly, dictating stories letter-by-letter, blink-by-blink. No, please, no. We dashed to the Heart Institute - the topic of our first story. Hyperventilating, numb hands. I was so scared.

Bless that story and bless the Institute. The director was by chance at the emergency gate and took me straight to the heart unit. Ironically, it was the same area where we did our story, only now I am in a wheelchair. Turned out to be high blood pressure, plus dehydration and anxiety. The doctors gave me pills and left me in observation until 5 pm.

“I will never tell you a sad story again,” said my colleague and squeezed my hand, the one without a drip. She was going back to the slum finish the story. “It made you sick.”

“This is why I am here,” I replied. “This is what we do: we report on health and health care.”

Life is so frail in Mozambique, and death is so much part of life.

Mercedes Sayagues is a Knight Health Journalism Fellow with the weekly Savana, in Mozambique