Boundaries - Anne-Marie Graham

August 2010

 

Mozambicans spend so much of their lives outside that there is little division between the inside and the outside world. Almost all the architecture, from the simplest reed home to the physical buildings that make up the hospital and the Massinga Health Training Centre where we spend the majority of our time, have a natural flow into the fresh air and sunshine. The lack of boundaries between the inside and the outside world is also seen in the families visiting sick ones in the hospital where many gather to sleep and cook under the shade of a large mango tree in the space between the hospital buildings. This is also reinforced when we travel to Tevele, a rural community with whom the Massinga Health Training Centre has a well-established working relationship.

Here in Tevele one gets a glimpse of the well-defined gender boundaries that exist between men and women. Here on the small machambas women arise at 4:30 AM to tend to their families, animals and crops on the farm. They sweep the farmyard with coconut branches before starting on a 1-2 km walk to fetch water for the day’s laundry, cooking and bathing. Given my inability to carry a 10-gallon water jug on my head empty or full I was handed the coconut branch and asked to sweep while the women headed on down the path.

I observe the constant rhythm of the women’s lives, never seeing them rest until 10:30-11:00 at night. There are few options for women. If they don’t plant their children will not eat, they have large families and are mainstays within their communities. Given my own boundary of language I am relegated to observer. In Massinga my poorly conjugated Portuguese verbs are passable, but here in Tevele they speak Xitswa, so I am limited to non-verbal means of communication. My offers to help are well received by the local women but I soon become acutely aware of my own limitations as I try to help serve matapa in a small-crowded kitchen over an open fire in the dark.

Another boundary the people of Mozambique face is access to health care, one of the determinants of health. Over 50 percent of the population of Mozambique cannot access the health care system and if they can often have to overcome transportation barriers to reach the services that are only available in the larger centers.  Here in Tevele there is a small health post that is staffed by someone with six months of training. They are able to to address only a small number of common health concerns, but this is much more than many communities have access to. The role of tending to the ill also falls to the women of the community. Women do not always have choices when caring for themselves and the health of their families.

I admire the women of Mozambique a great deal. They fulfill three vital roles in the communities they live in: productive, reproductive and community contribution. They accomplish this through constantly working in their anonymous, humble way for the benefit of those around them. Their voices may not always be heard but the impact of their contributions can be felt throughout the community and their work is a huge determinant of community health. They do all this with unshakable patience and a quietly joyful manner. I will not forget them. They are an example that joy can overcome many boundaries.