“Maryangela. how are you?”

“Maryangela. how are you?” she is asked. With a very pensive look, she delays her response, contemplating all the adjustments from morning till night she has had to undergo in the last two months. Immediately she wants to reply the token polite answer of “ I'm fine, thank you.” But to herself she wonders how she is doing after two months of transition. She no longer smiles when friends have said that she is crazy. She understands why her mother told her go for a few weeks and come home. She honors her children for being proud of her, but worries if the voyager gene has been passed to them. Maryangela seriously wonders why after being raised and cultivated in the northeast of the United States of America, now she sits in Africa and wonders what she can make any difference....

Independence Day: Mozambique on June 25^th celebrated it's 40^th Independence Day. Patriotism and pride was widespread from children to their parents. There are few in the age range of 55-75 (5% of the population) who remember the revolution starting in 1962 that finally ended in 1975. But celebration started days before, a torch symbolizing freedom was pasted throughout the country and my site of Magude, close to the capital, was delighted to be a stop.

I took a look at this countries history in the last fifty years and I understand why the celebrations is deserved. Even after the country's independence from Portugal, political and social unrest remained. In 1976 a rebel political party developed and started a civil war against the one party Marxist-Lenin doctrine. That civil war lasted till 1992 – 16 years - one million lives lost to war and famine. I can totally respect the verses in the national anthem; “Rock by rock we construct a new day”.

I still am not sure how my small rock influence a new day, I'm hoping I'll find some direction once I settle in.

Two of the three weeks of my visit have passed quickly. Introduction to my work place – Magude District Health Center – has been interesting. This morning I went over to the pediatric unit to observe how things are done. There was a group of perhaps 75 mothers and infants. At first I was brokenhearted because I could not get one baby to smile with me – unusual but I dismissed being rejected – I then helped with the infants weights. Well after that I too could not smile, I actually started to tear the weight gain was so low. The majority of the infants with such a low weight gain fall into the moderately to seriously malnutrition. The technician – not a physician, there is only one at this “big” hospital serving 66,000 population – tried to quickly ask about the number of times the baby was breast-feeding (here the health system promotes breast feeding for 18 months, higher in nutrition and the options are seriously limited – no Gerber's here). When one mother responded “twice” because she works - I had to quickly catch the reaction on my face as I looked at the slight curve on the baby's weight card. Another mother was also having her baby drink water. Another baby was sick and lost weight. Another mother missed three months of visits for her 8 month old, so the weigh card had gaps.

Can one small rock even put a ripple in this small pond?

Okay, think, what can I do? One possibility is to try to explain the weight cards and have the mothers understand the importance of weight gain for infants, then expand to nutrition. I also have to get them to attend the infant check-ups.

Did I tell you that the public health system here does not have check-ups? I'm sure that private doctors have patients that get preventative services, but for the 90% of the population who can't afford it they go when they get sick. When it comes to HIV everybody is promoted to come and get blood tests, Mozambique is #5 on the global charts for HIV/AIDS, after South Africa, Nigeria, India, and Kenya. The United States is #9.

“Maryangela. how are you?” she is asked. She responds, “My family and I are in good health.” And she means it with that “Attitude of Gratitude.” ........xo