In Mozambique, Poverty Takes Toll On The Young

This summer, All Things Considered will air a series looking at women and childbirth across the world. Melissa Block has been in Mozambique for the past two weeks reporting for the upcoming series. Michele Norris speaks with Melissa about what she has seen in the country in southeast Africa.

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ROBERT SIEGEL, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Robert Siegel.

MICHELE NORRIS, host:

And I'm Michele Norris.

This summer, we'll be launching a series on women and childbirth. We'll bring you stories from China, Egypt, France and, of course, from all over the United States. And we'll be reporting on everything from the latest science to cultural trends, to the many challenges that pregnant women face around the world.

And that's why my co-host Melissa Block has been in Mozambique, in southeastern Africa, for the past two weeks. And she joins me now from Mozambique.

Hello, Melissa.

MELISSA BLOCK, host:

Hey, Michele.

NORRIS: Where exactly are you right now?

BLOCK: We are in Nampula province. It's in the northern part of the country. Mozambique is a former Portuguese colony, hugging the Indian Ocean, just north of South Africa. And we came here for the women and childbirth series because it illustrates some of the terribly daunting challenges that women and children face in the Third World.

And think about these numbers, Michele. This is a country where about one in seven children will not reach the age of 5, where the lifetime risk of maternal death for a woman is one in 45. And if you consider that 82 percent of the population here lives on less than $2 a day, I think you start to get a sense of the conditions here and just what those challenges are that these women face.

NORRIS: Steep challenges, indeed. Tell us about some of the stories that you've seen, some of the people that you've met.

BLOCK: Well, let's set the scene, Michele, with a little bit of music that we gathered here.

Unidentified Group: (Singing in foreign language)

BLOCK: Michele, we're listening to a church service this past Sunday, a Zionist Pentecostal service in the village of Meliisse(ph), that's in Gaza province in the south of the country. And there are women in brightly colored skirts coming up and dancing around church members who are coming forward for healing.

Now, the reason that we went to Gaza province is that it has the highest HIV infection rate in Mozambique, and the numbers are really staggering. Thirty percent of the women in Gaza between the ages of 15 and 49 are infected with HIV.

So one of the stories that we've been reporting on is about programs here that are trying to prevent the transmission of HIV between those mothers and their babies using antiretroviral drugs and education. If the drugs are used properly, they say they can reduce the risk of transmission to the baby to virtually zero.

But here's the catch: The drugs are free, but there are frequent shortages in the drug supply. And so instead of getting a one-month supply of pills, maybe a woman gets only a week's worth. And then she needs to go back to the clinic or hospital. And I cannot emphasize enough just how hard that can be, how impossible that can seem in remote areas where these facilities are many, many miles away from the villages. And people have absolutely no means of transportation, except their own two feet.

NORRIS: You mentioned how poor this country is, and Mozambique, more than 80 percent of the population, as you said, living on less than $2 a day. That really does paint a very vivid picture there. That has to also have all kinds of ramifications for the health care system and for women's health in particular.

BLOCK: It does. And there was a huge brain drain in Mozambique when the Portuguese left, after the country won independence in 1975. Factor in on top of that 17 years of a brutal civil war, and the country was really left in tatters.

So we've been looking at some of the ways they're trying to bolster the medical system. For example, this is a country that still has very few doctors, so they've been training nurses to perform emergency obstetrics surgery, things like cesarean section. So they hope to improve outcomes for women that way. And we've also been visiting a number of programs that are engaging with traditional healers or curandeiros and traditional birth attendants, trying to link them with the existing medical system, encourage them to send women to the hospital when they are in trouble rather than treat them in the villages.

NORRIS: Well, we miss you, and we look forward to your return. And we really look forward to hearing some of these stories. Get back safely, Melissa.

BLOCK: OK, Michele. See you next week.

NORRIS: That's our co-host Melissa Block wrapping up a reporting trip in Mozambique for our upcoming series on women and childbirth.

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