Nampula — A year after the opening of the Mutava-rex Health Centre, located in the outskirts of the city of Nampula in the north of Mozambique, inhabitants of the Mutava-rex district continue to face problems in accessing health care. Residents are dissatisfied with the services offered locally. For residents of neighbouring areas, such as Namutequeliua in the Nampaco district, travelling to this hospital in the case of illness is a waste of time.

The people of Mutava-rex travel long distances to receive medical treatment, heading for the 1st May, Namicopo or 25th September health centres more than 10 kilometres from the city centre, or even to the Nampula Central Hospital.

@Verdade has confirmed that the main illnesses affecting residents of the district are malaria, cholera and headaches. Besides a lack of humanised service, users of the health centre are constantly faced with disruptions to the stock of medicines. The alternative has been private pharmacies.

Money extorted from patients

When asked to comment for our Report, residents of the Mutava-rex district accused the centre's employees of poor service and lack of rapport with the patients. Those who wish to receive a better level of service are obliged to pay. Those who do not submit to this extortion are given a lower level of priority. Women giving birth at the centre are the greatest victims.

The residents of Mutava-rex also complained about the semi-public transport which does not allow them to arrive at any hospital on time.

Health workers work twice weekly and do not respect working hours

At the Mutava-rex Health Centre, @Verdade observed that the employees only report to their posts twice weekly, on Mondays and Fridays. Users suspect that they have taken on other commitments with non-governmental organisations. Consequently, medical services at this centre are only provided on these working days. At the weekends and on public holidays, it is impossible to rely on them. In the case of illness, the population must fend for itself.

According to our interviewees, health workers sometimes arrive at work at 12.00 and, when they arrive, they attend few patients. There are reports of orderlies replacing nurses. Indeed, one of the orderlies confirmed the doctors' lateness for our Report.

Mariamo Vicente, aged 31, is a citizen who we met at the centre, accompanied by his son who was suffering from malaria. "The provincial director of Health, the city president and the governor already know about this, but unfortunately, their intervention has yet to come", he complained.

A lack of water

Besides the aforementioned problems faced by the Mutava-rex Health Centre, there is also a lack of water which affects the district as a whole.

Cleaning in this health centre is carried out with a great deal of sacrifice. @Verdade observed that the tank of water which is supplied by rainwater was dry, as it has been some time since it has even drizzled in this part of the country. Meanwhile, residents use wells because there is no conventional system for supplying the precious liquid.

Muatala: a neighborhood in Nampula where poverty rules

Abandoned to its fate, Muatala is one of the oldest suburban districts located in the south of the city of Nampula, with an estimated population of 45,412 inhabitants. The unemployment rate in the district is higher than 60%. A large number of the inhabitants work in the informal sector, amongst whom many are women who produce and sell traditional alcoholic drinks, such as cabanga, as well as sugar cane wine and cashews as part of their daily routine. Many also work in agriculture.

Muatala is bordered by the districts of Mutauanha and Central, and it is made up of 10 Communal Units, 198 blocks, of which the majority do not possess basic services. Amongst its main problems are a serious lack of land planning, substandard environmental sanitation, a deficient sanitation network and provision of drinking water and an intermittent and poor quality electricity supply.

The district only has informal markets, with the most important being the 25th June, also known as Matadouro. It benefited partially from renovation public works under the first mandate of the mayor Castro Namuaca, which also consisted of the construction of a bathhouse and a small refrigerator, neither of which ever became functional. The surrounding wall is another issue, as only part of it was built.

Water drunk from rivers and wells

Muatala may be considered to be a district which has been hard hit by the problem of drinking water provision, since more than 65% of the population obtain drinking water from rivers and wells. It is only the urban area which benefits from piped water. The further one walks into the district, the further the basic services are from the population, making access more complicated.

The communal units of Cossore, Maparra and Namuatho "B" are the most critical in terms of water supply. Inhabitants walk for more than five kilometres to fill a 25 litre plastic container. The 45,000 inhabitants must use just 46 fountains, of which 38 are functional and the rest out of service. The majority of the homemade wells have healthy water. Families can wait for at least a week without seeing the precious liquid gushing from their taps, which forces many to take water from the Muatala river, whose source originates in the drains of the cemented area.

Poor quality electricity

According to data provided by the electricity company EDM in the Operational Area of Nampula, over 2,000 of the 45,412 inhabitants have access to electricity from the Cahora Bassa Hydroelectric Station. In Muatala, the only roads with street lighting are those which are asphalted.

The other situation which represents a headache for the population is the poor quality of the electrical current. For example, in the area of the Muatala Cossore Comprehensive Primary School, the Texmoque factory, and the Micolene and Namavi communal units there are constant disruptions to the supply. Some residents confirmed to @Verdade that the electricity which they consume oscillates constantly.

Two health centres for 45,412 inhabitants

Muatala has two health centres: the 25th September Health Centre, and the one attached to the Psychiatric Hospital. However, due to the distance a large number of the residents of this district turn instead to traditional medicine.

The situation is more difficult for pregnant women who can end up giving birth on the side of the road. The majority of Muatala's residents prefer to travel to the Nampula Central Hospital, after looking for a more local health centre for their appointments.

Substandard environmental sanitation

Muatala is a district which has a core collective to fight rubbish, whose aim is to keep the residential area clean. "We work to leave the district rubbish-free and the cleanest in the city. Our main focus is the Muatala river, where open defecation is a reality and the situation is dramatic", said Agostinho Incaniço, head of the Social Direction of Muatala.

Each year, Muatala has been hit by diarrhea and cholera due to poor sanitation. The building where the Municipal Slaughterhouse is located is a concrete example of the filthiness. The lack of hygiene in this place where animals are slaughtered is glaring. There is a lack of latrines throughout the district, whether locally built or conventional. Many inhabitants resort to the Muatala river to satisfy their biological needs, contributing to the degradation of the area's hygiene. The banks of the Muatala river have been transformed into a dumping ground for human excrement.

Some communal units, despite losing money which they pay towards the rubbish tax, do not benefit from the collection of solid rubbish.

Environmental pollution provoked by a nauseating smell coming from some aviaries and from the snuff factory is another problem which the city council must resolve urgently.

Insufficient access roads

Almost all of the access roads to the Muatala district are in a forlorn state. The only roads in good condition are those of Solidariedade and of Sem Medo, which lead to the Administrative Post of Muatala, and a small stretch on the way to the Mutauanha district. All of the others are dirt roads.

It should be recalled that in the mandate which is about to finish, the "number one plan" of the president of the Municipal Council of the city of Nampula's electoral manifesto was to create habitable conditions and provide basic services in the districts, such as electricity, piped water, rubbish collection, urban transport, the establishing of health services and road improvements. Four years later, almost nothing has been done.

Education: insufficient schools for 45,412 inhabitants

With regard to educational institutions, the district of Muatala has three public secondary schools, one private, five comprehensive primary schools and two of EP1. Besides these schools, there are three community creches.

There is another private creche located on the Filipe Samuel Magaia road.

A district with a dangerous reputation

Muatala is reputed to be a dangerous district. In 2012 alone, more than 1500 crimes were reported, from attacks on homes (burglaries and thefts) , sexual violence involving women and deaths of young girls by strangling. In this district, criminality is on the rise due to the presence of many bars and discos which do not observe the rules and city ordinances, including a high level of consumption of alcohol and drugs.

@Verdade talked to Abel Abreu, aged 37 and resident of the Maparra communal unit. He stated that at night shouts can often be heard in houses or in the streets: these are from people being attacked by groups of criminals. "My district has more criminals than anything else", he revealed.

With regard to the increase in criminality in the Muatala district, some people suggest that the phenomenon owes to the absence of the Mozambican Republican Police. The spokesperson for the police in Nampula, João Inácio Dina, told our reporter that two police posts will be built in the district, in the Muthita and Maparra communal units which are the most prone to crime.