A Glimmer of Light—Tzu Chi Free Clinics in Mozambique

Tzu Chi doctors conducted home visits to households in the countryside of Mozambique and witnessed how Cyclone Idai had made the already hard lives of local people even more difficult. The families were so poor they were not even able to eat regularly.

Even though the help they could provide was limited, the Tzu Chi medical team did what they could to bring a glimmer of light to the lives of the underserved.

In mid-March 2019, Cyclone Idai struck Mozambique. The heavy rains brought by the storm led to devastating flashfloods and mudslides. Houses built with sun-dried mud bricks simply dissolved and people and property were swept away. The storm took the lives of over 600 people, injured 1,600 others, and caused heavy losses of property.

In May, I traveled with a Tzu Chi medical team from Taiwan to Mozambique to provide free clinics to survivors of the disaster. My duty was to record the events I witnessed there. As our airplane descended to land in Beira, the capital and largest city of Sofala Province, central Mozambique, I looked out the window to try to find evidence of the cyclone. The local Tzu Chi volunteers had described areas ravaged by the storm as if they had been rolled over by bulldozers. However, what greeted me instead when I looked out was a beautiful expanse of clear blue sky. Only when I looked down did I notice the extremely muddy water in local rivers. The coconut trees on the riverbanks were all bent in the same direction, and the ground was a picture of disarray with tree trunks scattered haphazardly around. It was not hard to imagine how strong the winds had been when the cyclone hit.

Many international news reports focused on the devastation in Beira, but the Nhamatanda District, also in Sofala Province, was dealt a severe blow too. The village of Lamego in Nhamatanda suffered from the highest floodwaters among all affected regions in Mozambique. The village was located near the bend of a river. Mudslides triggered by Cyclone Idai rushed down from upstream, blocking floodwater and wreaking havoc in the area.

Beira has better communications systems than outlying areas, so its residents were alerted to the cyclone and could prepare for it in advance. Nhamatanda, on the other hand, is poor and backward; few people there own cell phones or have access to the Internet. In addition, the floods came so quickly that local residents were caught completely off guard. Those who were luckier managed to escape to higher roads or climb up into trees for safety; the less fortunate ones were pitifully washed away along with their houses. Submerged in floodwater in the aftermath of the cyclone, Lamego was cut off from and lost all communications to the outside world. Almost every road in the area was too damaged to be used; the only one that was still serviceable was National Road No. 6, which runs from Beira to the boundary of Zimbabwe—though even that road was damaged in many places. As a result, even though aid supplies from the international community were able to reach Beira, there was no way of distributing the supplies to areas in need. Nhamatanda was still without aid, even up to two weeks after the storm.

Floods brought by Cyclone Idai destroyed farmland and mud-brick houses. It will take time to rebuild. Public health was also a concern after the disaster.

Tzu Chi volunteers in Maputo, the capital of Mozambique, quickly sprang into action to help survivors after Cyclone Idai. About a week after the disaster, a team of volunteers that had traveled over 1,200 kilometers (745 miles) from Maputo arrived south of Nhamatanda. They assessed damage and distributed emergency aid in Grudja and Dondo in Sofala Province, and Dombe in Manica Province. In early April, volunteers moved on to help residents of Nhamatanda. From early April through May 20, distributions of food, daily necessities, farming utensils, building materials and tools, seeds, and school supplies were held for survivors in the villages of Tica, Lamego, and Nhamatanda. Guara-Guara in Buzi District was also included in this round of distributions.

The assistance from the distributions flowed seamlessly into the medical assistance in May. Free clinic services for survivors started on May 19, just a day before the relief distributions were concluded.

The customs area at the Beira International Airport was small and ill-equipped. Tzu Chi medical volunteers from Taiwan, America, and Australia waited for over two hours there but were still unable to receive their landing visas. Coupled with that inconvenience was a scanner that refused to work. Finally, customs officers in the airport decided to let the volunteers go, allowing them to return some other day to complete the procedure.

The medical team, including the superintendents of four Tzu Chi hospitals in Taiwan, conducted three large-scale free clinics for cyclone survivors from May 19 to 21 in Tica, Lamego, and the Catholic University of Mozambique in Beira.

Tzu Chi volunteers unload building tools to be distributed to cyclone survivors to help them rebuild their homes.
Cyclone survivors return home with building tools and rice distributed by Tzu Chi.

Distribution of building tools hastened reconstruction

Manuel was a Mozambican who lost family members to Cyclone Idai. His house was damaged in the disaster too. He was a college graduate and served as an interpreter for the Tzu Chi medical team. “I told myself I must volunteer for Tzu Chi,” he said. “When I help others, others are helping my own family.”

The day before the first Tzu Chi free clinic, Manuel took some members of the medical team for a visit to Tica. When the group arrived at the village, they saw João, along with other local residents, rebuilding his home with tools distributed by Tzu Chi not long ago. João told the volunteers that the tools had greatly helped to speed up their building process. An area of 30 square meters (323 square feet) could be built up in just two weeks.

“If Tzu Chi hadn’t given us the tools,” João declared, “we wouldn’t have known what to do after being hit by such severe floods.” Residents usually chop wood or use locally collected materials to build their homes, but without the aid of tools, no rebuilding would have been possible.

Locals normally build their homes with sun-dried mud bricks. After Cyclone Idai, they rebuilt their houses with this kind of brick too. Those who could afford it used fired bricks to rebuild, but those bricks were still not hard enough; should another flood hit, those houses would very likely collapse again. Even tribal chiefs, with their elevated status, lived in houses that did not stand much chance against strong winds and severe flooding.

Another group of volunteers, including plastic surgeon Ye Tian-hao (葉添浩), from Kaohsiung, Taiwan, conducted house calls in Lamego village. During their visit, they saw just a couple of houses with cement walls. All the others were new structures built after the disaster. Mud bricks, tree branches, hay, and plastic tarps were the typical building materials they saw.

Villagers brought their children out of their homes for the doctors to examine when they saw them coming. A five-month-old baby girl, apparently suffering from malnutrition, had developed a cough and runny nose. Another one-year-old sported a head smeared with toothpaste. He was diagnosed with a possible case of folliculitis, a skin condition in which hair follicles become inflamed. Pediatrician Lin Yu-ying (林玉英), from Changhua, Taiwan, advised the mother of the child through an interpreter to wash her child more regularly. But limited water resources, exacerbated by the recent cyclone, had made regular washing more difficult for the villagers. It was doubtful if the mother could follow the doctor’s instructions.

A cluster of local children followed close on the heels of the visiting volunteers. Those who were older carried younger ones on their backs, while the younger ones held the hands of those even younger. Some wore tattered pants slipping down their hips; others had adult clothes. As the volunteers proceeded, the procession grew longer and longer. At one point, a six-year-old girl hopped toward Dr. Lin. An adult explained that the girl had had chapped soles for three years. Blood could be seen seeping from her heels. That was bad enough, but Dr. Lin noticed another problem. The girl’s worn-out shirt revealed a protruding belly button. The physician involuntarily stretched out her finger and pressed on the belly button. Her preliminary diagnosis was umbilical hernia. Shaking her head, she asked with a sigh: “Does her family know about this?”

Lin had participated in Tzu Chi free clinics in Jordan and Nepal before, but this was the first time she had volunteered her services in Africa. Seeing how many local people here were plagued by poverty and illness, she couldn’t help but think of the abundant medical resources enjoyed by people in Taiwan. People in Mozambique and Taiwan both live in the same global village, and yet their worlds are so different. Thinking of that made her feet grow heavy.

In a tent area, the volunteers saw an old man who was a polio victim and who had been getting around on all fours almost all his life. An elderly woman had an eye condition; all that she could see was very weak light and black shadows. Her eyes looked clouded, and her family told the doctors that she had had lazy eye since she was small. Dr. Ye Tian-hao gave her a bottle of artificial tear drops and told her to apply them in the morning and at night. The medical professionals couldn’t help but deplore how little help they could provide for these needy people.

Illness aside, almost every family was so poor they couldn’t eat regular meals. However, hope emerges even in the most poverty-stricken places. The volunteers caught sight of some corn seedlings near a hut; the freshly emerged leaves kindled hope in the volunteers’ hearts. They decided that even though they couldn’t do much for these people, they would strive to bring a glimmer of light to the lives of the local underserved.

An abundance of malaria cases

The three free clinics Tzu Chi held in the disaster areas offered treatments in internal medicine, surgery, neurosurgery, urology, rheumatology, gastroenterology, dentistry, OB-GYN, pediatrics, and traditional Chinese medicine (TCM). The clinics were like smaller versions of a hospital. Every clinic swarmed with people seeking medical help.

There was extensive media coverage in Taiwan on the four Tzu Chi hospital superintendents personally leading the free clinic mission in Africa this time. The four superintendents, however, were under a lot of pressure. Mozambique is, after all, a country that severely lacks medical resources. The prevalence of AIDS and a surge of cholera and malaria cases after Cyclone Idai further compounded the challenges they faced. Aware of all this, the superintendents felt a weighty sense of responsibility leading this free clinic mission. At the same time, they also knew that their work was very meaningful and necessary.

The dental departments at the Tzu Chi free clinics were extremely busy. Many patients were seeing a dentist for the first time in their lives.

Many people who showed up at the clinics complained of chronic aches and pains, work-related injuries, or geriatric conditions. There was also a significant number of malaria cases. An extremely weak female patient came to Superintendent Chao You-chen (趙有誠) of Taipei Tzu Chi Hospital. A rapid diagnostic test (RDT) showed that she had malaria and needed to take antimalarial drugs right away. The young interpreter who was assisting the superintendent said nonchalantly, “They are all familiar with this kind of medicine. They just can’t afford it.”

Chao prescribed antipyretics and antimalarial medicine for the woman and told her she would regain her health after taking the medicine for a few days. The treatment provided at the free clinics was like timely rain for an extremely thirsty field. However, coming face to face for the first time with such gravely underserved people, Chao couldn’t help but lament the arid medical landscape of this African country.

On the morning of the first free clinic, seven malaria patients came for treatment. A woman collapsed onto a chair upon arriving at the venue—she was as feeble as could be. A medical student who was interpreting for Superintendent Lai Ning-sheng (賴寧生) of Dalin Tzu Chi Hospital suggested that the patient be given an RDT for malaria; she tested positive. Dr. Lai said, “One can be a doctor for an entire lifetime in Taiwan without ever once coming across a single malaria patient. This is quite an experience for me.”

Superintendent Chao said that what they experienced in the free clinics in Mozambique was very different from what they had experienced in Southeast Asia before. In addition, they encountered many medical conditions that they had never encountered in Taiwan and that they were unable to treat on-site. This was a country that would require long-term care.

Traditional Chinese medicine and dentistry

At the free clinic sites, one could often witness the consequences of scarce medical resources and inadequate healthcare knowledge. For example, a young mother showed up one day with a baby in her arms—the little one had had a fever for three days. After examining the baby, a pediatrician immediately gave the little one some antipyretic medicine, and he suggested to the mother that she take her child immediately to Maputo Central Hospital for further treatment.

The mother apparently did not understand the severity of the situation. A volunteer did her best to explain the situation to her and said that she would accompany her to the hospital. The woman eventually understood that her child was probably very ill. With her eyes red with tears, she followed the volunteer to the hospital.

With local medical students interpreting for him, Superintendent Chao You-chen of Taipei Tzu Chi Hospital sees a patient.

It wasn’t all gloomy news at the venues, however. Cheerful news emerged again and again too. For example, a nine-year-old boy visiting the clinic couldn’t raise his left arm. After Dr. Ho Tsung-Jung (何宗融), vice superintendent of Hualien Tzu Chi Hospital, administered acupuncture on his elbow, shoulder, and arm, the boy was able to raise his arm with ease. Dr. Ho said, “In fact, he just had a joint dislocation. Because he couldn’t see the doctor, he had no clue what was going on.”

Off to another side, Dr. Cheng I-che (鄭宜哲), from Taichung Tzu Chi Hospital, was treating a patient’s back pain with a chiropractic gun. Cheng had first participated in an international Tzu Chi free clinic held in Sri Lanka in 2018. At the time, he had pondered what else he could do for patients besides giving them acupuncture. That’s why for this trip he brought a chiropractic gun and a massage gun to help him. He said there weren’t many medical conditions a TCM doctor can treat in a free clinic; such doctors mostly help relieve body aches. However, if TCM doctors give patients tui na massages with their bare hands to soothe their body aches, they soon get tired. That’s why he needed the tools. “Even though I had to fork over some money for these tools, the money was well spent because they could be used to help many people.”

A lot of people had their teeth pulled at the three events. Patients came in an endless stream to Dr. Hsia Yi-jan (夏毅然), of Taipei Tzu Chi Hospital. Five local dentists from Maputo Central Hospital volunteered at the events too. Some of them were department heads or professors, but they all used this opportunity to learn from Hsiao how to better pull a tooth.

Hsia said that though it had been five years since some of these local dentists graduated from medical school, they didn’t seem to have much practice in treating patients. Therefore, the way they held the tools wasn’t quite correct, and that slowed down their speed in extracting a tooth.

In the waiting area for dental services, a local young man, Richard, was showing people how to properly brush their teeth with a dental model and a toothbrush. He looked so good at it people thought he was a dental student. (In fact, he was a student of finance.) Richard said that there were many ways to help your own country become better, and sharing your knowledge with others was one of them. He felt he was doing something very meaningful by sharing his oral hygiene knowledge with his fellow compatriots.

 Dentist Liao Jing-xing (廖敬興), from the U.S.A. chapter of the Tzu Chi International Medical Association, asked the dental team at the free clinics to be sure to help local people understand the importance of oral health. “Rather than give them candy, it’d be better to teach them how to brush their teeth,” he said.

Dentist Li Yi-bang (李彝邦), of Hualien Tzu Chi Hospital, was responsible for cleaning patients’ teeth at the events. He had taken part in many Tzu Chi free clinics before. He pointed out that people in different countries present with different dental problems. In the Philippines, for example, tooth decay was prevalent because people there drank a lot of sugary beverages. In Mozambique, people were poorer and so they didn’t have many opportunities to eat sweets—which was a good thing for their teeth. “It will therefore be easier for them to enjoy good dental health as long as they develop good dental habits,” said Dr. Li. “That’s why we’re doing our best to increase their awareness of oral hygiene.”

Next step—education

After the three free clinics in the disaster areas, the medical team moved on to Mahotas, Maputo. They held a Buddha Day ceremony and a free clinic for families receiving long-term aid from Tzu Chi at the Tzu Chi Home in Mahotas. This free clinic, along with the three earlier ones, served a total of 4,951 patient visits. The medical professionals were all very happy to have done what they could for the underserved. Denise Tsai (蔡岱霖) and her husband, Dino Foi, two core Tzu Chi volunteers in Mozambique, were more than grateful that the medical team could come to Mozambique to help cyclone survivors and other needy citizens.

Denise Tsai, from Taiwan, settled in Mozambique after marrying Dino Foi, a Mozambican. She said she once wanted to leave the country, in 2012, but that Master Cheng Yen’s encouragement changed her mind. As a result, she decided to stay and serve the people there.

Because of Cyclone Idai, many residents’ hard lives had become even more difficult. Tsai, originally from Taiwan, reflected on the challenges she and other local volunteers had encountered when they worked to help survivors after the disaster: “Beira [one of the hardest-hit areas] was still relying on gas-powered generators for their electricity supply at the end of March. We couldn’t even find a place to stay. I had serious doubts about how far we could go in providing aid to survivors.”

Tsai and her husband practically made the disaster areas their home after the cyclone. Foi was responsible for com­munica­tion and coordination with government agencies and for finding resources; Tsai, on the other hand, led volunteers to assess damage and care for survivors. The couple knew how badly the survivors needed help, and that pushed them to work as hard as they could.

The shabby, crude building behind these children contained two classrooms. After Cyclone Idai, Tzu Chi volunteers visited this school to distribute school supplies and assess the needs for further assistance.

With the magnitude of the devastation caused by Cyclone Idai, it was impossible to rely on just a handful of people to deliver aid. Fortunately, the couple was helped by a large group of native volunteers. Tzu Chi volunteers wearing their uniforms became such a common sight in the disaster areas that when they traveled along National Road No. 6 to deliver aid, traffic directors would let the Tzu Chi vehicles pass first.

Foi choked up when he said that two months earlier, when he arrived at Beira, the city was a picture of ruins. But now, two months later, because of Tzu Chi’s love and help, he could see hope in the city. “This is a miracle,” he said.

Foi is a Mozambican. He came from an impoverished family, and it wasn’t until he was eight that he put on his first pair of shoes, drank his first mouthful of tap water, and used electricity for the first time. When he went to Lamego, Tica, and other Idai-hit villages after the disaster, he seemed to be able to see a younger version of himself in the local children. “Though I can’t say I have been really successful in life,” Foi said, “having been able to receive an education has made a real difference in my life. I believe that if we provide the people with educational assistance, they will have a better chance to make it in life.”

Though Tzu Chi had finished its emergency aid to survivors of Cyclone Idai in Mozambique with the completion of the free clinics, their work there wasn’t at an end. It was only just beginning. Foi said he would work to provide the people with more educational resources to help them transform their lives. “Mozambique is ready, I’m ready,” he said. “I’ll continue to stay here and contribute what I can.”

Tzu Chi volunteers went to Mozambique after Cyclone Idai to help with disaster relief efforts and hold free clinics. Tzu Chi’s emergency aid to cyclone survivors in the nation came to an end in late May. The foundation is now planning mid- and long-term assistance projects.


July 2019