People as partners: Empowering communities in Mozambique

19 Aug 2023

Médecins Sans Frontières/Doctors Without Borders (MSF) has been supporting and running medical projects in Mozambique for almost three decades. 

In the Nampula province, our programs focus on providing care for people with neglected tropical diseases (NTDs). These are a diverse group of viral, bacterial, fungal, and non-communicable diseases including Chagas, dengue, leishmaniasisscabies, and sleeping sickness, that cause devastating health, social and economic consequences to more than one billion people globally

The Meluli river

The Meluli River, flows alongside the town of Nametil in the Nampula province, and is the main water source of the region. People come here to wash themselves, their clothes and sometimes even their cars and motorcycles. Using the river water puts the community at risk of contracting schistosomiasis (bilharzia), an infection caused by parasitic worms living in fresh water in subtropical and tropical regions. Credit: MSF/Pierre-Yves Bernard

In this interview, Stéphane Foulo the MSF country director and Dr Ana Gabriela, an MSF medical doctor offer insight into the medical work with NTDs in Mozambique.

How is MSF addressing the health challenges relating to NTDs and the climate crisis in Mozambique?

Mozambique ranks as one of the two most at-risk countries of NTDs in Southern Africa and is among the top 10 globally for extreme climate shocks (unpredictable weather events affecting a community’s sustainability). Every year, cyclones become more frequent, and the population fears the dry season, which has become unpredictable both in intensity and duration. 

Mozambique ranks as one of the two most at-risk countries of NTDs in Southern Africa and is among the top 10 globally for extreme climate shocks (unpredictable weather events affecting a community’s sustainability). Every year, cyclones become more frequent, and the population fears the dry season, which has become unpredictable both in intensity and duration. 

Nampula is a region with extreme climate shocks, high poverty rates and some of the country's lowest access to education and healthcare. The area experiences a high prevalence of NTDs, which currently lack targeted medical care.

Since 2022, in collaboration with the Ministry of Health, MSF teams have run a project in Mogovolas district in the province of Nampula. This project aims to address gaps in the prevention, diagnosis, and treatment of neglected tropical diseases like lymphatic filariasis (also known as elephantitis) and schistosomiasis, and vector-borne diseases, such as malaria and dengue. MSF teams work with health workers from the Ministry of Health and with the community, which plays an essential role in implementing the project.

MSF is actively participating in national initiatives for surveillance and prevention of epidemics, such as the National Cholera Elimination Plan. Our team is also engaged in preparing for disasters, particularly extreme weather events like cyclones. 

How does MSF's approach in Nampula ensure holistic and patient-centered healthcare?

The project is designed to be comprehensive, providing medical assistance, water and sanitation, and health promotion activities in the communities we serve.

‘People as partners’ is also an integral strategy in our project. This approach allows us to discuss and organise services together with the community, including through a steering committee.

Our teams are working to improve the monitoring and reporting of NTDs in the district. With the data available, we have mapped and tried to select the communities with the highest burden of these diseases. A strategy was implemented to provide a full package of health promotion, medical, water and sanitation activities by engaging the main community representatives and local leaders in the steering committee.

Engaging the community means members actively work with MSF teams to evaluate their healthcare needs, identify barriers, propose adapted and sustainable solutions and monitor activities.

Eufrasie, an MSF health promoter, conducts a health promotion session in front of the Muepane health post

Eufrasia, an MSF health promoter, conducts a session in front of the health post with people from the village of Muepane. She explains how consultations will be conducted and provides information on how to prevent and recognise symptoms of the neglected tropical diseases. Credit: MSF/Pierre-Yves Bernard

What is MSF's strategy on inclusion, locally hired staff empowerment, and training in the context of your work in Mozambique?

Our project in Nampula is based on a patient-centred approach and engagement with local communities. Inclusion is a key element of our work – our teams work with patients as partners, viewing them as part of the team.

Empowering locally hired staff is another priority. As a responsible employer, MSF is committed to providing new opportunities and challenges to enable our teams to build capacities and develop new skills. 

Founded in 1971, MSF is a global movement with staff from over 160 countries. The active participation of MSF staff in defining the Nampula project orientations and activities is crucial. We facilitate spaces for dialogue, debate and reflection at the project level to gather everyone's views, reach a common understanding and agree on the way forward through workshops and meetings.

Additionally, MSF offers a broad range of training opportunities for the teams, both online and in the project, including coaching, mentoring and detachment. Ensuring our staff are well-trained guarantees the quality of care provided. Moreover, entrusting teams with responsibilities guarantees the sustainability and continuity of that quality care. 

If you're interested in learning more about MSF and who we recruit to work overseas, see our medical and non-medical jobs below.