Cycling the Rice Patties around Beira

I went biking this morning with Peter and Bob. (Bob is an FP from England, who with his wife, Anna, is coordinating the curriculum at the medical school.) We headed north from town , past the airport and out to the mouth of the River Maria. Although Beira is not as oppressive as developing world cities can be, it was good to get away from the concrete and the noise.

Beira is pretty much built on a few sand dunes at the mouth of the Pungwe river, and is surrounded by a big swamp (which makes this a hotbed for malaria). Villages are situated in a few areas that are a few feet higher, and drier. The juicy areas are used to cultivate rice, and as we rode through them, we could see people harvesting by hand.

In the higher areas, we would rode past dirt compounds of thatched roof houses made of sticks. What struck me was the large numbers of people walking along the roads. We passed women carrying everything on their heads, chickens scurrying out from underfoot, and occasional young men on large, black, Chinese-made bicycles.

Cursed with too-long legs, my seat was too low, so I had to work hard to keep up with the other two, who were in it for the exercise. This had the effect of keeping me tired, and humble. Still, I managed to sneak in a few pictures which I have posted.

After, we went to the part of the city near the market on a special quest: Peter´s car side mirror was stolen the other day, and it cost him 1300 Meticals, (about $40) to replace it (probably with one stolen from another car). To discourage this happening again, we tracked down a guy who works from the median strip of a major street downtown, and etches the license plate number on the mirror. You pull up onto the median strip in the middle of the road, oblivious to any traffic that has to stop and pass around you, he pulls out his tools, powers them from the car battery, and gets to work.

Then we went to a small shop to have little steel bands strapped over the side marker lights, so that they wouldn´t be stolen too. The area we were in is thick with thieves, and Peter says about once a week, a thief gets caught in the act, and lynched by a mob.

En-route to Africa... & first impressions

Hi everybody, Greetings from Mozambique.

In case you are wondering, Moz is on the bottom right hand side of Africa, to the east of South Africa and Zimbabwe, and south of Tanzania. I left on Wednesday, May 19th and I am working with a group called AIHA (American International Health Alliance) at a medical school in a city called Beira.

I wanted to come here so I could get a taste of Africa, learn more about tropical medicine, and experience again the "special pleasures" of living in the less developed world. The Catholic University of Mozambique has money from US AID to open a primary care clinic here, with the idea of combining HIV care with the care for other chronic diseases, like hypertension and diabetes. They were looking for FP's to work with the Mozambiqean medical students, as there are so few MD's here that they staff the medical school with many foreign doc's.

Nothing special to say about the trip, except that it was long: 6 flights, as long as 15 hours. I had a stopover in Washington DC to meet the AIHA folks, and another in Johannesburg. My bags got lost somewhere between Atlanta and here. 15 hours in a pathetically tiny seat,but I bonded well with my personal movie machine- about 40 movies at my disposal to ease the pain- watched Avatar, Invictus, Juno and Michael Jackson while sucking on aspirin to prevent blood clots. And I pretended to sleep for a few hours.

My brief glimpse of Johannesburg was of a big, spread out and un appealing city. It looks surprisingly developed, with a cozy blanket of smog. Numerous mines were visible from the air. My stay was punctuated by a mercifully brief episode of angst-ridden excitement when, while registering for the hotel, I discovered my passport was gone. I had to go back to the airport and found it at the money change desk. That's the hazard of travelling with a sleep-deprived brain that doesn't know what time it is and what it is supposed to do.

Onward to Mozambique!
The flight into Beira was beautiful- high, brown, dry and sunny over S Africa, but it became cloudy and green over Mozambique. Very undeveloped- I saw no roads or towns for most of the way, just a few small villages. Although Beira is a city of 500,000, it doesn't look very big from the air. It's perched on the banks where two rivers flow into the Indian Ocean. It is ringed by little villages of huts and palm trees surrounded by rice patties. The central part of the city is pretty dilapidated, but supposedly on the rebound. Looks like old communist era apartment buildings. Old abandoned hotels have been taken over by squatters. The airport was a sleepy, crumbling affair, with rusting old planes from the civil war strewn about. Nothing moves too fast.

I'm staying for now with Peter and Emily. Peter is the one who put this all together. He used to direct a residency program in Bangor, Maine. They have a nice 3BR apartment 2 blocks from the beach and 5 blocks from the clinic. Peter is a laconic Mainiac, reminds me in his mannerisms of Bill Gerencer. They are both very nice.

Our apartment Is only about 100 yards to the water's edge, but the fact that the sewage canal dumps into the ocean about 5 blocks south of here is a little discouraging. In spite of that, it is pretty pleasant, especially around sunrise and sunset. I went for a run on the beach early this morning. Nice and cool. Egrets fishing at the tideline. Young men working handheld gillnets in chest-deep water shouted out greetings to me. Felt good to get exercise.

In true, developing world style, we have a maid here. She is an awesome cook. We come home from the clinic at mid-day for lunch, and she cooks up spicy malaysian inspired dishes. Miuto bien!

Tuesday was a special day- my bags arrived, and I finally got to change my underwear. Even though they spent 2 days in the Johannesburg airport, which is supposed to be full of baggage thieves, they arrived intact with nothing missing.

For the first few days, my brain did not know when to sleep, and I lay awake all night sweating on the sticky mattress. You can hear the muslim call to prayer at sundown and sunrise (mosque down the street), listen to the night noises (rats in the trees?) and roosters stirring in the early morning hours.

I will be moving into a different apartment on Sunday. It is not as nice, more like student housing, and noisier, but nice view of the beach. I will share it with two med students (form US). The internet connection is better there, so maybe Skype will work. Just made arrangements for a maid to come twice a week and clean/wash, since I don't know how to do that myself

Clinic is busy: We arrive at 7:30, have a conference with the medical students, then start seeing patients. There is usually a crowd of 50-100 patients waiting when we get there in the morning. Lots of typical primary care stuff, punctuated frequently by the big three: HIV, TB, and malaria. Lots of pussy abceses to drain. Treatment options are limited. Many of the diagnoses are death sentences, especially cancer. HIV can be treated if they can negotiate the HIV clinics: that should improve when we start treating with anti-retroviral meds in a few weeks.

Portuguese is starting to make a little more sense but what comes out of my mouth is still gibberish.