First full week in Maputo

So much has happened this week that I hardly know where to begin. I began at the lab on Monday morning and met 4 wonderful new friends. I had already met Jose Paulo Langa, the most senior of the lab staff, last Friday. On Monday I also met three young women assigned to the lab, Anisha, Charlotte and Lena. Everyone speaks pretty good English except for Lena. I am still struggling with Portuguese, but the lab folks are determined to help me improve that. We shall see, as languages have never been my strong suit.

This week I have been given a tour of the Central Hospital of Maputo clinical lab, the lab at the Jose Macamo Hospital as well as the Immunology Laboratory at the Central Hospital of Maputo. I have also been driven with Jose Paulo and Charlotte to the warehouse of the Ministry of Health where equipment and supplies are received and distributed. We went to the warehouse to request delivery of a biological safety cabinet that had been in storage since 2007.

The two hospitals had hundreds of people waiting in lines or groups at the entrance to the Urgent Care sections, and we needed to walk through the people to access the labs. It is clear that there is much human suffering in Maputo and people in need of care need to spend a lot of time waiting to see medical personnel. We are so fortunate in the US!

The labs appear to be well equipped to do relatively modern bacteriology but closer examination shows that much of what is done is more like good bacteriology the way we were doing it 40 years ago. I did see one Bactec machine at the Urgent Care laboratory at the Central Hospital but later learned that it was the only machine, and it was placed in the Urgent Care lab because that was the only lab that is staffed on 24 hour shifts. I didn't see any instrumenttion at the Jose Macamo laboratory.

The Immunology Lab is a state of the art facility for all manner of HIV immunological evaluation with 3 FACS machines and new closed system PCR machine that is still in the validation stage. They are capable of doing cell culture, ELISA, PCR, FACS analysis and are currently setting up a virus isolation lab to expand beyond HIV services. They are currently undergoing evaluation for certification by the WHO. This is said to be the most advanced clinical laboratory in Mozambique.

At the Central Hospital Lab I was introduced to Dr. Oraima Garcia, a consultant contractor from Cuba who has been there assisting with upgrading clinical labortory operations. I never would have had an opportunity to meet her if I hadn't come away from the US because of the ban of travel to and from Cuba imposed by our country. She has also been helping the lab staff that I will be working with by advising them.

When we traveled to the MOH warehouse we traveled through some suburbs of Maputo which gave me a flavor of the "real Mozambique" with many people engaged in daily life in poverty trying to squeeze out a living by selling wares along the street. Everywhere someone is selling something. When they see a foreigner they become quite persistent so as not to miss the opportunity to sell something to a person of means. I am told to expect to pay about half of the initial price, although I haven't done quite that well as yet.

On Friday Jose Paulo presented the first section of a 56 slide presentation on laboratory biosafety. He is a good teacher. Next week I will begin to teach basic microscopy to the lab staff when they have free time in their schedules. Friday afternoon Anish, who is of Indian extraction, walked home to pick up some leftover basmati rice and chicken from a family dinner, and we all had a nice lunch together in the office area. Next Friday we plan to go out for pizza.

I leave the lab for the CDC office every day at 3:15 PM to spend the last two hours there. My CDC supervisor has been away all week, so I haven't had any significant time with her. Next week should be better. I did manage to establish a regular Friday morning with Dr. Ilesh Jani the Director of the Mozambican NIH beginning next Friday. This should help a lot with understanding what budgetary support we can count on. There is a need for immediate investment of approximately $10,000 to make the lab minimally operational.

During off-duty hours I have been traveling about and taking meals with the other 4 short-term TDY folks from CDC. We are becoming good friends, and have developed a support network of sorts so that none of us is lonely or needing to travel about alone which feels unsafe. This weekend we have already spent a day taking a Maputo City tour on a cute little train that rides around on the streets and then had lunch together at Zambia, a nice restaurant. The tour starts at the Maputo train station and does a circuit that visits various attractions. Some photos will be attached if I can figure out how to do that.

Well, I managed to attach a number of photos, but their placement is a bit unfortunate, and I can't figure out how to move them. At the top of the page is a picture of my 4 CDC colleagues with whom I travel about. From left to right is Jasmin Minaya, Rhondette Jones, Rebecca Miller and Terry Njoroge. Terry is from Kenya, and the rest of us are lifelong residents of the USA. They are all wonderful friends and I don't know what I would do without their company.

The next two pictures are a street scene near the central marketplace and a scene of a Mzambican wedding party stopping at the local "lover's garden" for photo ops. Next is a section of the central "wood market" which has a lot of wood crafts, but also many other craft items. The other photo is of the Maputo train station where we began out tour. The tour cost $20 each and travels around the city for 2 hours letting us off for 5-10 minutes to take photos at each stop. Now that we know where things are, we can spend more time at sites of interest.