Verdade (Maputo)

3 September 2013

Mozambique: The Tough Life of Mozambican Doctors

Maputo — Eleutério and Rosa believed that, after graduating from medical school, their lives would be better. Disappointment. Out in the field (districts), they found more problems. Far from family and friends, they are trying go on with life, but it is not easy. It is hard to be a doctor in an inhospitable place.

When faith in the health sector falters, how to maintain dedication to patients? "A doctor in the interior district of Cabo Delgado, without electrical power and housing, feels lost in the woods." This is the voice of a young doctor who has always lived in the city center of Maputo and, at the end of the medical school, had to move to an inhospitable place.

Eleutério, a fictitious name, received the mission to go to the district with enthusiasm. Because, he says, a doctor cannot choose the comfort of town to fulfill his job. Only, he says, that does not mean living in degrading conditions. "I left my family behind. I had a baby and I had to leave to go to Maputo to treat people in the countryside. This effort has at least to be respected and valued. Here it is the opposite", he explains.

Asked about the fact that doctors are public employees who have the best conditions, Eleutério responds with many other questions: "What kind of dignity does a doctor have living in a hut? Who is, in your view, the most important for the country: a doctor or a judge? Who saves more lives?"

"You do not have to answer", he says while continuing on with another answer: "It is the physician who earns least and works many more hours.

This is not fair and I think people have to be paid according to the importance and relevance of the work they do. What happens is quite the opposite."

Eleutério has worked in the field where, in addition to treating patients, he has had to take care of party affairs. "In times of elections, doctors have to campaign. Do not ask us if we have party choice. The State party's assumption is that we are all Frelimo. In our view, that is one of the things that has to be changed."

Family Life

Eleutério's loving relationship was interrupted by medicine. The distance between Maputo and Cabo Delgado was too onerous for the love he had with the mother of his child. "The outcome was predictable because we are young.

What hurts, in the middle of our separation, is our son. The only link that's left."

Is the State responsible for the separation? "No." After a pause continued, "the idea is to show what a young man has to give up to be a doctor. My youth was spent reading books to graduate. There was not so much a sacrifice of the country, as it is said, but instead one of my parents. If the country wants to have doctors it is because doctors are needed and it is unfair to treat them like garbage."

The pay is low

Indeed, a doctor earns 15,000 meticais of base salary. The State adds to the wage a kind of technical bonus equivalent to 75 percent of that value.

That's over 11,250 meticais. "There is also the risk of 10 percent," he adds. "If the doctor is in the district, he can earn up to 35 percent of salary. But it depends on where you are. There are levels, and I am a type 1 district and get this bonus."

Rosa

The life of Rosa (not her real name) is different from the life of Eleutério. It is not easy for a young woman to leave the capital to be settled in a distant district.

Rosa feels that during medical school it was more painful, classifying it as slavery. "Look," she says, "even prisoners are not forced to work, but those who are studying in a public institution are subjected to a regime of almost slavery."

"After seven years of studying almost all day, now we work almost for free", she says. Without being able to count on parents' financial support, the young doctor had no alternative and tried to ask for a transfer to a place with better conditions. She waited months and months until she got used to the place. Rosa also complains about the salary and the workload.

She says, without shame, that housing conditions are degrading and agree with the complaints of other doctors.

Asked to talk about the pressure doctors face, she is clear: "Those who overcame shortages of everything will not bow down to a local official or an intelligence boss. Being a doctor in Mozambique is much harder than being pressured."

How to live and work

In the district, where she lives and works, there is not much. "You have to monthly go to the provincial capital, even to get cash," she laments. With regards to work, the doctor did know that at night, when needed, works with improvised lighting.

"Sometimes it's difficult to work in the middle of nowhere. People live near where you find water, especially in the dry season. You need to go out and find patients. On the other hand, we have the problem of staff of Provincial Health who often want doctors to declare certain places affected by cholera. This gives a lot of money by way of schemes that I still cannot understand."

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