Mozambique is a country in southeastern Africa that is slightly less than twice the size of California and has a population of 19 million. The capital city is Maputo, which is located close to the border of South Africa. The official language is Portuguese.
Three hundred miles north of Maputo is a small fishing village along the Indian Ocean called Chicuque. Despite being a small community, Chicuque is well-known in Mozambique because of its one notable feature - the Chicuque Rural Hospital (CRH).CRH, a project of The United Methodist Church, is a 200-bed health care facility located in a fishing village on the southeastern coast of Mozambique. Serving a population of roughly 500,000 in and around the area, CRH strives to deliver quality health care services in the face of severely limited resources and within a very limited capacity.
History: The rural hospital began in 1913 as a project of the Methodist Church when a medical missionary, Dr. Charles John Stauffacher, founded "Chicuque Mission Station." The hospital remained a project of the denomination until 1975, when the hospital was nationalized and placed under the sole management of the Mozambique Ministry of Health. The United Methodist Church was approached by the health ministry in 1986, amidst government upheaval and a bloody civil war (1976-1992), and invited to forge a new partnership with the government of Mozambique to jointly manage and support the hospital. The partnership successfully continues today.
The reception is the patient's first point of contact upon arrival to CRH. The hospital provides a range of primary and preventative health care services comprising women's health, general medicine, surgery, ophthalmology, pediatrics, tuberculosis (TB) and malaria treatment, HIV testing, a laboratory, a pharmacy, an emergency room, as well as a health and wellness education program.
In addition to malaria and TB, the most common ailments encountered at CRH include malnutrition, HIV, hernias and Caesarian-sections. CRH is considered a premier reference hospital and is one of three teaching schools in the country. It also serves as a model in the national plan to reduce maternal and child mortality in Mozambique.
Currently, the service delivery system at CRH operates through the efforts of five doctors, including two German missionaries, one an internist and the other a pediatrician. It also consists of a number of medical technicians and nurses and non-professional clinical staff.
CRH is not typical of a rural health clinic within the health system. First, most rural referral hospitals in Mozambique do not have access to physicians or medical specialists. CRH, in contrast, boasts five doctors: three sponsored by the government, two provided by the UMC. One result of this high-caliber staff is that CRH serves as the only rural hospital to offer surgery and an operating room.
CRH is also the only hospital in the whole country that is managed by a hospital administrator. His name is Jeremias Franca. In most hospitals, the head physician doubles as the administrative as well as the medical director.
In addition to five doctors and the hospital administrator, 13 medical technicians and 48 nurses work to meet the needs of CRH's many patients. Medical technicians are mid-level medical personnel that assist doctors in all areas of care- from the operating room and maternity ward to malaria treatment and HIV testing. Day in and day out the technicians and nurses, many with less than eight years of formal education, are called to perform the work of professional physicians in order to meet the significant demands of CRH's patients. These mid-level clinicians are given little real medical training and must learn on-the-job how to properly care for patients. With such a dependence on mid-level medical providers, it is no small feat that CRH provides a level of care that is recognized as being equal to if not better than the central hospital in the capital city of Maputo.
The staff at Chicuque truly are miracle-workers. To read more about some of the amazing doctors, clinicians and nurses at CRH, visit the "Meet the Staff" page.
The hospital remains limited in its capacity to meet demands for service. First and foremost, there is a severe shortage of trained technical staff. As funding has tightened at CRH, more and more clinicians and nurses have been let go because the hospital cannot support their salaries. This has left a heavy workload for the remaining staff, which is required to work overtime hours. Professional development and continuous training is not an option for CRH's personnel.
Fundamental supplies such as sutures, needles, gauze and gloves are inconsistently supplied to the hospital and CRH struggles to provide the daily meal of rice and vegetables to the patients. There is insufficient funding for essential medical equipment for the maternal ward, laboratory, operating room and eye clinic. X-ray service is currently at a standstill as the machine is broken and finding the correct parts for the outdated piece of equipment has proven to be difficult. The ambulance that serves the hospital is old, unreliable and frequently breaks down.
To say the least, the culmination of such staffing and funding issues has created a challenging environment for CRH and the need for increased assistance is urgent.
The Hospital Revitalization Program assists Methodist churches in Africa and Asia, including Chicuque Rural Hospital in Mozambique, to assess the needs of their health-care facilities. It then works with the hospitals to improve standards of care, ensuring always that the effort will be part of a larger strategy of community-based health education and development.
Contributions to Chicuque Rural Hospital may be sent through a local United Methodist church, Annual Conference or by mailing a check to: The United Methodist Committee on Relief (UMCOR), Room #330, 475 Riverside Drive, New York, NY 10115. Call toll-free 1-800-554-8583 to make a credit card donation. Write checks out to UMCOR. Be sure to include Chicuque: Hospital Revitalization, Advance #982168 on the memo line. One hundred percent of your contribution will go to Chicuque Rural Hospital.
UMCOR's everyday expenses are funded primarily by gifts to One Great Hour of Sharing (OGHS). You may give to OGHS during the annual offering in Lent or any other time of year. If you are not using the special offering envelop, be sure to mark on your check that your donation is for the OGHS.
Photos: 1. Fish market in Chicuque, Mozambique. Credit: Anya Nawrocky, 2003. 2. Patients and visitors must wait in the courtyard at Chicuque Rural Hospital before being checked into the hospital or allowed to visit with firends or family. Credit: Anya Nawrocky, 2003. 3. A young man's broken arm is set. Credit: Shannon Trilli, 2003. 4. A hospital nurse administers a sonogram. Credit: Anya Nawrocky, 2003. Click on any photo to see a larger picture.