In the Pazimane neighbourhood, in the Maputo district of Marracuene, an area far away from great cities, there is who in the midst of the Covid-19 pandemic, abandons the comfort of their home early in the morning to care for those who cannot go to a health unit on their own.

Beneath the scorching sun, dust on her feet, and the risk of becoming contaminated by Covid-19, Anilça Macuacua (34), a Community Health Agent (APE) living in the Pazimane neighborhood, travels more than five kilometres to care for the sick and put into practice the lectures that aim to make users aware of prevention of health problems.

On her way, Macuacua speaks to communities about the need to do family planning, as well as alert them on the need to use mosquito nets and prevent diseases such as malaria and others.

The pain of the distance that should be of other people (patients), she undertakes it for herself, once a week.

“I do this for love. I like to help people who cannot go to health units because they are far from health centres.”

But in this activity, says Macuacua, not everything is characterised by good times. There is also unpleasantness.

“This year a family kicked me out. They not let me to enter their house. I got sad. I am saddened because despite everything, I take all precautions for prevention and do long distances. It was the first time I went to that house and the doors were not opened to me.”

In Pazimane, the nearest health unit is nine kilometres away. With access roads in degradable and precarious conditions, and with a lack of transport, hundreds of people look to Macuacua as the first and sometimes the only solution.

“Last week, at dawn, people came knocking on my door. A few streets away, a woman was giving birth to a baby, “she says, adding that,” she ended up giving birth on the street. People helped her, but didn’t know how to deal with the umbilical cord.”

So, “I had to leave my bed and go to the mother to be. Fortunately, everything went well. I cut the cord. Then we took the woman to the health facility.”

 On the night in question, says Macuacua, expressing her enthusiasm for helping the delivering woman, “I saw part of the fruits of my work reflected on other people in the neighbourhood, everyone helped the delivering woman. I was overjoyed when a neighbour, a professional driver who normally charges 1,000 meticais (about 14 US dollars at the current exchange rate) for his services, did not charge us from transportation costs. I was happy and amazed.”

Over time, she started to create a habit, “saving money to help people who need to go to the hospital. There are complicated moments. At those times, we need a car. So, I decided that I should save some money to get people to the health unit. Nowadays, due to the pandemic, for a trip to the health unit and return home, the minibus taxi drivers charge a thousand meticais.

With less than 4 years working as an APE, Macuacua ended up getting to know and perfecting her work strategy.

“At harvest time, for example, since people here live on agriculture, I make visits and do lectures in the afternoons. Otherwise I do them in the morning.”

“With Covid-19 I reduced the number of visits”

At the end of 2019, the press reported the outbreak of Covid-19. At the time, with no cases recorded in Mozambique and Africa, Anilça Macuacua was almost indifferent. Like many, she thought Covid-19 would not reach Mozambique. However, a while later, the first case of a contaminated Mozambican was officially announced.

“This disease has changed everything. Some people are more apprehensive. I myself am afraid of becoming infected. Since I started I never got contaminated, thanks to God”, she adds, regretting that “I only received protective equipment once”.

In Macuaua’s house, in this new context, there are chairs scattered around the yard with the aim of enforcing the distance between people who pay visits looking for first aid services.

“Now, with Covid-19, I have reduced my visits. Without protection, it is complicated. Before I used to make at least two visits a week, but now I only do one,” she said.  

The source also added that before Covid-19, she used to visit more than five houses during the two visits, but currently she visits only two.

“I’m happy when a patient

tells me that they were well cared for”

One of the greatest happiness of Macuacua is to receive people and then refer them to the health unit.

“When people return from the hospital, they come to me. And they tell me how it went. But what makes me most happy is when they inform me that they have been well attended.”

She stressed that “it is I the link between the hospital and the communities, so when the opposite happens, and people are poorly served, and it saddens me.”

* This interview took place a week before vaccination started at the national level. On Tuesday, the source called the Observatório do Cidadão para Saúde (OCS) to report that she had received the first dose of the Covid-19 vaccine.

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