Mozmed Project 2009-2014
In the Moma District in collaboration with KMAD
Report for 1 March 2014 to 31 August 2014
Summary
The Mozmed Project (Missão Betesda) has been a constant factor in the health care in the
District of Moma for the last five and a half years. It has quite clear that the presence of the
Mobile Clinic Team (MCT) of the Mozmed Project has made an impact on medical care and
the dissemination of health information in the target area. This has only been possible due
to the close collaboration between Missão Betesda and main partners; namely, the District
Health Department of Moma, KMAD (Kenmare Moma Associação de Desenvolvimento) and
MAF (Mission Aviation Fellowship). This final report mentions the activities of the MCT
during the period extending from 1 March until 31 August 2014.
Preface
end The work
More than five years of Mozmed Project in the Moma District has come to an end.
accomplished in close collaboration with KMAD, MAF and the
the Mozambican Health
Authorities, and with the financial and logistical support of SAM (Support African Mission),
Mission)
will leave its stamp on the communities as well as individuals in the area that was targeted.
This final half-yearly report, sheds some light over our activities during the last part of the
second phase of the project. We have been able to achieve our main goal during the last five
years. This has been, serving those in the remote parts of the Moma District with quality
medical care.
Experiences of Dr. Pieter Willem de Lijster (doctor) in a nutshell
It is no secret that many parts of Africa have a hostile climate to work in. That we, as Mobile
Clinic Team (MCT), have encountered various difficulties over the last five years in our work
setting, remains a fact. However, as the Mozmed Project draws to a close, I would like to say
that every effort has been worth it. We have been able to make a difference in the lives of
many people in the Moma District; having seen close to 17.000 medical cases and almost
6.000 dental cases at the various clinics. Besides these clinic consultations we made
numerous home-visits in the various communities together with our volunteers. More than
numbers and statistics, I am thankful for opportunity we had to help numerous individuals
who would otherwise never have had the chance to access the quality of medical care they
received over the last five years. I wish to thank all our partner, namely, KMAD, MAF and the
District Health Authorities for their cooperation in making this work possible. I also wish to
thank my MCT colleagues Dr. Ida, Dr. Hanneke and Dr. Sarah for their dedication and
compassion with which they have worked over the last couple of years. And above all, I wish
to thank my Heavenly Father for the health and stamina He has given us over the past years
in completing this task. There is no doubt that I will look back at the Mozmed Project in
Moma with many fond memories.
Experiences of Dr. Ida de Carvalho – Capela (dentist) in a nutshell
Five and a half years have passed since the start of the Mozmed Project in the Moma
District. I can still remember the first contacts we had with the communities in which we
worked. They were years of mutual learning; as we taught and learned at the same time.
Thus our emotions, on ending our project in this district, are two sided. On the one hand we
are sad to leave, but on the other hand we are satisfied to see that our communities have
developed a better understanding of various health matters through the work of our health
volunteers. Another reason to be cheerful is the new Mtiticoma Clinic. Besides it being a
beautiful construction, the health staff that work in the clinic have done a great job at
attending to the community.
I would like to thank the Moma District Health Authorities, Kenmare (KMAD), Mission
Aviation Fellowship and the health volunteers for their tireless support of our project.
Without them the work would not have been possible. I thank Dr. Pieter for his friendship,
his leadership and partnership in this project and above all, for having the vision for this
work. I also thank Dr. Sarah and Dr. Hanneke for the good work they have accomplished in
the years in serving the communities. I would also like to thank my beloved husband for his
understanding and support during the years. His trust and love were fundamental in the
accomplishment of my work. Above all, I thank God for strengthening us in difficult
moments, for encouraging us when we had thoughts of giving up and for protecting us till
now. To God be all the honour and glory!
Cinco anos e meio se passaram desde o início do Projeto Mozmed no Distrito de Moma.
Ainda posso lembrar de nosso primeiro contato com as comunidades com as quais temos
trabalhado. Foram anos de mútuo aprendizado, pois tanto ensinamos como aprendemos.
Os sentimentos que envolvem o término de nosso projeto nesse Distrito são ambíguos pois,
se por um lado nos sentimos tristes por sair, por outro lado, temos a satisfação de ver nossas
comunidades desenvolvendo um maior conhecimento sobre assuntos de saúde através de
nossos ativistas. Outro motivo de alegria é a unidade de saúde de Mtiticoma. Além de ser
uma bela construção, a equipe de saúde que tem trabalhado nessa unidade tem feito um
ótimo trabalho junto à população.
Meus agradecimentos são para as autoridades de saúde do Distrito de Moma, Kenmare,
através da KMAD e Mission Aviation Fellowship e aos ativistas de saúde pelo incansável
apoio ao nosso projeto. Sem vocês esse trabalho não seria possível!
Agradeço ao Dr. Pieter por sua amizade, sua liderança e parceria neste projeto e acima de
tudo, por termos a mesma visão deste trabalho.
Agradeço a Dra. Sarah e Dra. Hanneke pelo bom trabalho que desenvolveram nesses anos
em que serviram as comunidades.
Agradeço também ao meu amado esposo por toda compreensão e apoio nestes anos. Foi
fundamental sua confiança e amor para que eu chegasse até aqui.
Acima de tudo, agradeço a Deus por ter nos fortalecido nos momentos difíceis, ter nos
encorajado quando pensamos em desistir e ter nos guardado até aqui. À Deus toda honra e
glória!
Experiences of Dr. Hanneke Dekker (doctor) in a nutshell
Sandy roads, a blue ocean at the horizon. Warm climate and 2 bottles of water a day. A
camp full of containers surrounded by small local houses. A few chickens, goats and many
children along the road. A plane, car, boat, bicycle as transport. All small memories fixed in
my memories. This is Topuito... the place where the Mozmed team worked for 5 years.
My own memories started 2,5 years ago; I see the different health workers and volunteers
that worked with us, I see the KMAD team that supported us - thanks too all of you, I am
thankful for our work together!
I see so many faces when I look back; the happy face of a man with paralysed legs; the
anxious face of a woman with the unbelievable amount of ascites in her abdomen; the sad
face of a woman whom lost her child; the expressionless face of a patient that does not
understand my explanation; the crying face of a young girl with a HIV positive test; the
desperate face of a man that asks help for his child; the friendly face of a chronic patient; the
suffering face of an old women with pain and the fearful face of a small child that is afraid
for the white doctor.....
I hope that our work has contributed somewhat to the development of the health care in
the clinics and community. I wish KMAD, the District Health Authorities, all the health
workers and the health volunteers in the Moma District success with the continuation of the
work.
Experiences of Dr. Sarah Scofield Moreira (dentist) in a nutshell
When I came to Mozambique for a five month long voluntary experience, I never thought I
would still be here after two years. I believe that God had a plan for me, and meeting Dr. Ida
Capela at Marrere Hospital (Nampula) was part of this plan. I fortunately had the
opportunity to take part in this unique project, with a fantastic team; always willing to help
others. I am certain that I gained more than that I was able to give and the last 20 months
with Missão Betesda will remain in my memories forever. I hope that the health in
Mozambique, especially in the Moma District, will improve and that other community
projects will come about to aid the most needy within the community.
Quando vim para Moçambique para uma experiência de voluntariado por 5 meses, nunca
pesei que passados 2 anos ainda cá estaria. Acredito que Deus tinha um plano para mim e
ter conhecido a Dra. Ida Capela no Hospital de Marrere fazia parte desse plano. Felizmente
tive a oportunidade de fazer parte deste projeto único, com uma equipa fantástica, sempre
disposta a ajudar o próximo. Tenho a certeza que ganhei muito mais do que dei, e estes 20
meses com a Missão Betesda ficarão para sempre guardados na minha memória. Espero que
a saúde em Moçambique, em especial no distrito de Moma, melhore muito, e que mais
projetos de ajuda comunitária possam surgir, sempre a favor dos mais carenciados, aqueles
que realmente precisam!
Target Area
The MCT’s target area has remained the same over the last few months. The only change to
the time-table from week 28 onwards was that the Monday morning Mtiticoma clinic had
been moved to Friday morning due to transport problems (see Logistics).
The present roster is as follows:
Monday a.m.
Mtiticoma (Tibane)
Monday p.m.
Pilivili
Tuesday a.m.
Tuesday p.m.
Tuesday night
Wednesday a.m.
Wednesday p.m.
Thursday a.m.
Thursday p.m.
Friday a.m.
Larde
Education health volunteers women
Meeting with female sex workers
Mecane (once a month)/Mtiticoma (Topuito) (once a month)
Briganha
Mtiticoma (Topuito) (once a month)/Moma-Guarneia (once a month)
Community visits with health volunteers men (once a
month)/Guarneia (once a month)
Community visits with health volunteers men (once a month)
Clinic Visits
The MCT continued to make fortnightly visits to the target area.
During the period of 1 March – 31 August 2014 a total of 13 visits to the target area were
made. The first clinic during this period took place in week 10 of 2014 and the last in week
33 of 2014.
There were four planned variations made to the regular visits to the clinics, namely the
following;
• Week 18 – 1 May – Labour Day - The MCT used the morning to work on the clinic car
and to do stock taking. The team flew out of Topuito at 12h00. Community visit on 2
May was cancelled.
• Week 24 – 13 June - Tibane was visited by the theatre group during the morning. The
MCT was not present during this activity and no home visits were made due to an
early departure from Topuito on request of Dr. Pieter.
• Week 26 – 25 June - Independence Day - The usual clinics, namely, Mecane and
Briganha were postponed to the following day (Thursday). The Mtiticoma clinic,
usually on the Thursday was set for the Friday.
•
Week 28 – 7 July – Due to transport problems (see Logistics) the Monday morning
Mtiticoma clinic was moved to Friday morning and will continue so until the end of
the project.
During the last 6 months there were two late arrivals on the Monday morning at our first
clinic (Mtiticoma). In week 12 the delay was caused by a MAF technical problem. In week 24
the delay was caused by weather issues at Topuito. These delays resulted in a late arrival at
the Mtiticoma (Tibane) clinic (usually 08h00):
Week 12: 08h20
Week 24: 08h50
Consultations
We have continued our MCT visits on a regular basis throughout the past six months.
Attendance at the clinics in general has been stable, fluctuating somewhat with the amount
of medication present at the clinic at the time. We have however noted a concerning
increase in absenteeism amongst the clinical staff at various clinics. We have seen that more
educated staff is frequently absent, either in Moma or Nampula for work or personal
reasons. At times their absence is unaccounted for. The unstaffed clinics, unfortunately do
not help in improving the community’s confidence in the medical care.
At present, the situation is such;
-Mtiticoma clinic has been functioning well over the last one and a half years. The opening
of this new clinic has made an enormous impact on the Topuito communities. The technician
(nurse) working at the clinic together with the three clinical aids make a good team. At
present the maternity is also functioning with the presence of a maternity and child health
nurse;
-Briganha clinic as always, is a well structured clinic thanks to the two very dedicated health
volunteers that keep the clinic running. We will miss this clinic and the good relationships we
have with the community and the volunteers. Unfortunately the qualified technician has
continued disinterest and conveniently makes sure not to be around the clinic on our arrival;
- Larde clinic is mostly run by the efforts of one health volunteer, Mr Selemane. The nurse
technician in Larde shows interest in our work, but is unfortunately not always present
during our visit. A new hospital is being built behind the present clinic as Larde received that
status of District only a short time ago. This will mean that the medical care in Larde will be
lifted to another level including overnight admission. This will be a great improvement to the
medical care for the local communities especially when one takes note of the geographical
remoteness of this town from the referral hospitals of Moma and Angoche;
- Pilivili clinic continues with the same medical nurse, who is usually present during our
visits. This clinic is also aided by two very dedicated volunteers;
- Mecane clinic remains to be one of the less organised clinics. Both the dentist, as well as
the medical doctor make use of two very dedicated volunteers at this clinic;
- Guarneia clinic has been one of the most organised clinics over the last few years. Patient
lists are well organised and patients are often present. The nurse technician has been absent
frequently during our visits and the clinic is usually run by a group of very dedicated
volunteers.
Patient contacts during 13 clinic weeks (medical doctor) and 13 clinic weeks (dentist)
(March - August 2014) (Annex A):
Tibane
Pilivili
Larde
Guarneia
Mecane
Briganha
Topuito
Community
Total:
Doctor
478
127
293
159
165
300
321
17
1860
Dentist
159
130
156
66
75
108
85
2
781
During this 6-month period a total of 243 ultrasounds were made (Annex B).
Education and Training
The MCT continues to transmit medical/health knowledge to the local staff at the various
clinics. Besides the informal bedside teaching we continue with various protocols which are
presented to the staff and tested at a later stage. Unfortunately this aspect of the project
has suffered slightly due to the increase of absenteeism amongst the staff as well as
disinterest shown by others. The nurse technicians at the Mtiticoma and the Pilivili clinics
have continued to show interest and eagerness to increase their medical knowledge. Some
of the topics covered over the last 6 months were the following:
• ABCDE of Trauma
• Trauma in Pregnancy
• Neurological Trauma
• Trauma in Childhood
• Burns
• Preparing for Hospital Transfers
• Chronic diseases (diabetes, hypertension)
• HIV counselling
Sr. Mário who used to work as a medical technician in Larde has received
a 7 year scholarship from Missão Betesda to study medicine at the Catholic University of
Mozambique in Beira. He started the 1st year of medicine at the beginning of February 2014
after having successfully terminated his propaedeutic year. He passed all six subjects at the
end of the 1st semester which ended in July (see Annex D). He will continue to report to the
Missão Betesda Board each 6 months.
The new health educational team made three visits to the 5 schools in the Topuito area in
the last 6 months. The visits took place in weeks 12,22 and 28. The activities were specifically
targeted the sexually active group amongst the scholars. Their focus during their visits was
on HIV/AIDS, Sexually Transmitted Diseases and sexual health in general. All in all, 1716
scholars at the Topuito, Naholoco, Thipane, Nathaca and Mtiticoma schools were reached
with these messages during the three visits. More detailed reports on this work are available
on request.
The educational sessions with the female health volunteers have continued on a regular
basis. Since PSI, the partner NGO that helped train this group, left at the beginning of this
period, the number of the volunteers attending the sessions has dwindled. Fortunately
KMAD has stepped in and recruited new volunteers. This does mean that the new recruits
have not received the same educational information as the rest of the group over the last
couple of years. However KMAD has committed to provide further educational sessions as to
reinforce the health education given over the last couple of years. An average of 29
volunteers were present at the sessions over the last 6 months. This was a significant
increase from the average of 14 we had before the new volunteers joined. The module on
HIV/AIDS and Tuberculosis was completed in week 14 with a post-test on the matter. We
were pleased to see that the average score in comparison with the pre-test had risen by 14%
(see Annex E). Despite the enthusiasm of a few of the volunteers we remain concerned
about the performance and motivation of a large part of the group. Unfortunately we have
found that the increased attendance is mainly motivated by the subsidies the volunteers
receive from KMAD.
Some of the topics that were covered over the last few months were the following:
• History, Transmission and Prevention of Tuberculosis
• Leprosy
• Bilharziosis/Filariasis
• Sexually Transmitted Diseases
• Dermatological Diseases
• Ophthalmological Diseases
• First Aid
The visits to the various communities in the Topuito area together with the male health
volunteer group continue on a regular basis. This group has now become a mixed (male and
female volunteers) group mainly presenting theatre pieces on health in the various
communities. This activity has been coordinated together with the KMAD staff over the last
6 months and will continue under KMAD supervision.
The fortnightly meetings with the ‘ladies of the night’ (female sex workers), which were
started in the Topuito area in August 2012, have continued over the last 6 months with an
attendance of an average of 7 women at each session. The following topics were discussed
over the last 6 months:
• Gonorrhoea/Chlamydia/Syphilis
• Vaginal Discharge/Menstrual Cycle
• Use of Condoms/Condom Negotiation
• Herpes, Genital warts and other Sexually Transmitted Diseases
• Finances/Savings
• Impact of Work on Family Life
Logistics
The collaboration with both the District Health Authorities and the Moma District Hospital
are better than ever. It is our opinion that the health services in Moma have certainly
improved over the last couple of years. The surgical section and the technicians presently in
Moma performing surgery are very capable at performing their tasks. This has given us the
opportunity to refer more patients in need of surgery, directly from the outlying clinics to
Moma instead of Nampula. The logistical impact on patient and guardians is much less when
they are referred to the District Hospital of Moma which is more easily accessible .
The supply of medicines to the clinics and hospitals at provincial level have improved slightly
over the last 6 months. The last months we noticed an improvement of medical stocks at the
various clinics. Unfortunately some medicines remain out of stock which make the
treatment of some simple diagnosis difficult at clinic level.
The clinic at Mtiticoma has proven to be a great asset to the Topuito area. The clinical team
have shown great dedication in the effort of improving the health care in this area. The MCT
has enjoyed working together with the team at this clinic. Unfortunately there have been
various issues with the community ambulance, supplied by KMAD. Once again the
ambulance has been out of service for a number of weeks, awaiting parts from abroad. This
has caused a negative impact on the transfer of critical patients from the Topuito area to the
District Hospital of Moma.
MAF (Mission Aviation Fellowship) has played a very important role in the Mozmed Project
over the last few years. Unfortunately, MAF’s activities suddenly came to a halt when their
certification to perform flights in Mozambique was cancelled. At present MAF is in the
process of renewing its certification and we hope that their services will be available once
again in the near future. The MAF transported the MCT to and fro to Nampula until the end
of June. They evacuated 14 patients (during this period) that needed specialised care only
available at the Central Hospital in Nampula. Five more patients were transferred by clinic
car from the outlying clinics.
Success and less successful stories
Case 1: On arrival at the Briganha clinic we found a young 9 year old girl who had just been
brought into the clinic, half an hour before our arrival. As Sr. Pinto the local nurse had
disappeared once again, we were the first to see the child. The child had fallen from quite
high, after climbing a mango tree in search of the last mango of the season. On examination
she complained of severe pains of the abdomen. On examination I could not find any sign of
fractures, but she did have a very tender and tense abdomen and anaemia. Sonography was
performed and free fluid was found in the abdominal cavity. We immediately new that this
would be a matter of life and death. Right there we decided to pack up and rush of with the
patient to Moma. We arrived in Moma an hour and fifteen minutes later and Dr. Celestino,
the surgical technician was present to receive the patient. He agreed that the child needed
urgent surgery, but as they had no anaesthetic technician, they would be unable to perform
the surgery and thus the young girl would have to be sent to Nampula (six hours down a
terrible road). The MCT pleaded that we would operate as the girl would not survive a trip to
Nampula. We agreed that the MCT would assist in the operation and giving anaesthetics.
Although the patient was unstable she was operated on successfully. More or less an half a
litre of blood was found in the abdominal cavity and a laceration and haematoma of the
spleen. The next morning we visited the child, who already looked quite somewhat better
than the previous day at Briganha.
Late afternoon operation (Dr. Celestino and assistance
of MCT)
Case 2: This young man presented his case to us for the first time at the Mtiticoma clinic.
According to him the tumours in his face and elsewhere on the body had started only four
months ago. On opening the mouth a large violet coloured plaque was found on the palatum
durum. An HIV test was done and found to be positive. Most probably the presenting
tumours are Kaposi Sarcoma in an AIDS patient. The patient will need to start with antiretrovirals before we can transport him to Nampula for chemotherapy. Unfortunately this
patient, despite the urgency, never came back to our clinic for follow-up.
Kaposi Sarcoma
Case 3: No medical staff was present at the Guarneia clinic on our arrival. Both nurses had
left the medical care in the hands of the clinical aid (cleaner). On arrival at the clinic, two
maternity patients were brought to my attention. One young girl, was undergoing a
spontaneous abortion whilst the other lady had been in prolonged labour and was not
progressing at all. On examination, and with the help of our ultrasound, I found that the
child was in a breech position and that the child was in distress due to a cord prolaps. An
urgent call was made to Moma to evacuate the mother and child for a Caesarean Section in
Moma. Unfortunately no ambulances were available and we decided to take the woman to
Moma in our clinic car (a one and a half hour drive). On arrival an ultrasound was repeated
and the child was found to have died. A Caesarean Section was planned to diminish the risks
to the mother.
Hours Worked
During the period 1 March – 31 August 2014 the MCT worked the following amount of days
(Annex C):
Dr. Pieter/Dr. Hanneke:
77 days
Dr. Ida/Dr. Sarah:
70,5 days
Acknowledgement
We would like to thank all those that have made our work possible over the last five years.
We would like to start with thanking Dr. André Elias (Director of Health of the Moma District)
for his support over the last few years and for his staff that have often shown the capability
of working in very difficult settings in the various clinics of the district. We would also like to
especially thank the Kenmare/KMAD staff that have aided us with their logistical support
over the years. Without their support the work would certainly have been more strenuous.
MAF has also played a very important role in the Mozmed Project in the last five years.
Without their support many patients
p
would not have had the opportunity to get to the
quality of care they needed. MAF’s moral support has also been an encouragement over the
years.
We would also wish to thank «Missão Betesda» in Brazil, «Support African Mission» in the
Netherlands and many more organisations, churches, friends and family that have supported
our work in some or other way during the last 5 years. Without this support it would have
certainly been a more difficult task.
Annex A
Patients seen by MCT from 1 March – 31 August 2014
March
UNIDADE SANITARIA
3-7/3/2014
Mititicoma
Pilivili
Larde
Mecane
Briganha
Mititicoma
Comunidade
Total
Medicina
22
9
26
17
25
14
1
114
Medicina
17-21/3/2014
Mititicoma
Pilivili
Larde
Mititicoma
Briganha
Guarneia
Comunidade
Total
11
11
17
12
0
26
1
78
SERVIÇOS
Pediatria Maternidade Cirurgia Estomatologia Ortopedia
24
1
0
2
6
7
0
40
1
2
2
0
0
2
0
7
1
0
0
3
0
0
0
4
6
10
12
15
10
8
0
61
Fisioterapia Outros
2
0
0
0
0
0
0
2
Pediatria Maternidade Cirurgia Estomatologia Ortopedia
13
1
1
11
1
1
1
29
2
3
0
0
0
0
0
5
2
0
1
2
0
2
0
7
17
11
10
7
1
15
0
61
0
0
0
0
0
0
0
0
0
1
1
1
4
0
0
7
Total
56
23
41
38
45
31
1
235
Fisioterapia Outros
0
1
0
0
0
1
0
2
0
0
0
0
0
0
0
0
2
1
1
4
0
3
4
15
47
28
30
36
2
48
6
197
April
UNIDADE SANITARIA
31/34/4/2014
Mititicoma
Pilivili
Larde
Mecane
Briganha
Mititicoma
Comunidade
Total
SERVIÇOS
Medicina Pediatria Maternidade Cirurgia Estomatologia Ortopedia Fisioterapia Outros
19
9
19
13
21
19
5
105
20
2
4
1
5
17
0
49
2
0
2
1
2
1
0
8
1
1
1
4
0
6
0
13
15
14
13
14
15
13
0
84
2
0
0
2
0
1
0
5
0
0
0
0
0
0
0
0
Total
5
1
3
2
5
3
0
19
64
27
42
37
48
60
5
283
0
1
2
4
1
3
0
11
44
18
25
37
27
39
4
194
1
39
Medicina Pediatria Maternidade Cirurgia Estomatologia Ortopedia Fisioterapia Outros
14-18/4/2014
Mititicoma
Pilivili
Larde
Mititicoma
Briganha
Guarneia
Comunidade
Total
21
5
15
17
14
27
1
100
9
0
1
2
1
0
0
13
0
0
2
3
1
0
0
6
4
2
0
1
3
0
1
11
10
10
5
10
7
9
2
53
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Medicina Pediatria Maternidade Cirurgia Estomatologia Ortopedia Fisioterapia Outros
28/42/5/2014
Mititicoma
16
1
3
3
14
1
0
Pilivili
Larde
Mecane
Briganha
Mititicoma
Comunidade
Total
3
17
16
17
0
0
69
1
0
2
4
0
0
8
0
0
1
0
0
0
4
1
0
3
1
0
0
8
15
7
9
11
0
0
56
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
3
0
0
4
20
24
31
36
0
0
150
May
UNIDADE SANITARIA
12-16/5/2014
Mititicoma
Pilivili
Larde
Mititicoma
Briganha
Guarneia
Comunidade
Total
Medicina
23
5
18
15
15
22
1
99
Medicina
2630/5/2014
Mititicoma
Pilivili
Larde
Mecane
Briganha
14
11
16
17
19
SERVIÇOS
Pediatria Maternidade Cirurgia Estomatologia Ortopedia Fisioterapia Outros
6
0
3
16
4
1
1
31
0
1
0
3
0
1
0
5
2
0
0
3
1
0
0
6
Pediatria Maternidade Cirurgia
14
2
0
5
4
3
0
0
1
0
14
9
15
10
12
10
0
70
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
1
2
0
1
1
0
8
Total
48
16
38
47
33
35
2
219
Estomatologia Ortopedia Fisioterapia Outros
3
0
0
2
1
8
13
15
10
11
0
0
0
0
2
0
0
0
0
0
2
1
2
4
3
44
27
33
39
40
Mititicoma
Comunidade
Total
15
4
96
14
0
39
2
0
6
3
0
9
8
0
65
1
0
3
0
0
0
4
0
16
47
4
234
June
UNIDADE SANITARIA
9-13/6/2014
Mititicoma
Pilivili
Larde
Mititicoma
Briganha
Guarneia
Comunidade
Total
Medicina
13
12
18
8
15
22
0
88
Medicina
2327/6/2014
Mititicoma
Pilivili
Larde
Mecane
Briganha
Mititicoma
Comunidade
Total
17
4
26
18
19
3
0
87
SERVIÇOS
Pediatria Maternidade Cirurgia Estomatologia Ortopedia Fisioterapia Outros
3
2
2
6
1
2
0
16
2
3
1
2
0
0
0
8
4
1
0
2
2
1
0
10
Pediatria Maternidade Cirurgia
12
3
3
1
4
2
0
25
5
0
1
0
0
14
0
20
12
8
12
5
7
10
0
54
0
0
0
1
1
1
0
3
0
0
0
0
0
0
0
0
1
1
1
1
0
0
0
4
Total
35
27
34
25
26
36
0
183
Estomatologia Ortopedia Fisioterapia Outros
1
3
1
0
0
0
0
5
11
12
11
7
4
6
0
51
0
0
0
0
4
0
0
4
0
0
0
0
0
0
0
0
6
0
1
3
0
0
0
10
52
22
43
29
31
25
0
202
July
UNIDADE SANITARIA
Medicina
SERVIÇOS
Pediatria Maternidade Cirurgia Estomatologia Ortopedia Fisioterapia Outros
Total
7-11/7/2014
Pilivili
Larde
Mititicoma
Briganha
Guarneia
Mititicoma
Total
4
8
18
15
9
9
63
Medicina
3
3
9
2
2
4
23
1
1
2
0
2
0
6
0
3
2
1
2
5
13
Pediatria Maternidade Cirurgia
4
10
17
8
9
4
52
0
0
1
1
0
0
2
0
0
0
0
0
0
0
3
2
2
1
4
6
18
15
27
51
28
28
28
177
Estomatologia Ortopedia Fisioterapia Outros
2125/7/2014
Pilivili
Larde
Mecane
Briganha
Mititicoma
Mititicoma
Comunidade
Total
4
17
11
13
10
10
1
66
0
1
4
4
25
1
0
35
1
1
0
2
4
3
0
11
1
3
1
0
0
1
0
6
8
13
7
5
16
4
0
53
0
0
0
4
0
1
0
5
0
0
0
0
0
0
0
0
0
0
4
1
11
1
1
18
14
35
27
29
66
21
1
193
August
UNIDADE SANITARIA
Medicina
SERVIÇOS
Pediatria Maternidade Cirurgia Estomatologia Ortopedia Fisioterapia Outros
Total
28/7-1/8/2014
Pilivili
Larde
Mititicoma
Briganha
Guarneia
Mititicoma
Total
3
15
8
18
17
9
70
Medicina
0
1
9
1
2
12
25
0
0
3
0
0
2
5
1
1
2
2
2
2
10
Pediatria Maternidade Cirurgia
1
18
8
4
13
10
54
0
0
0
1
0
2
3
0
0
0
0
0
0
0
0
2
1
1
5
2
11
5
37
36
27
39
39
183
Estomatologia Ortopedia Fisioterapia Outros
1115/8/2014
Pilivili
Larde
Mecane
Briganha
Mititicoma
Mititicoma
Total
8
20
21
16
27
0
92
0
0
1
0
22
0
23
1
1
1
0
1
0
4
1
1
1
2
6
0
11
15
15
13
13
11
0
67
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
3
2
1
1
0
7
25
40
39
32
69
0
205
Annex B
Sonography (ultrasound) at various clinics from 1 March – 31 August 2014
2014
3/3-7/3
Thipane
Pilivili
sonography obstetrics
gynaecol. abdominal
3
4
1
2
2
2
Larde
5
2
2
Mecane
Briganha
1
2
Mititicoma
3
4
5
Larde
3
Topuito
Briganha
4
1
Guarneia
3
2
2
2
blad/prost
peripheral
heart
thyroid
scrotum
blad/prost
peripheral
heart
1
1
gynaecol. abdominal
2
3
1
1
1
1
3
1
1
1
1
1
2
sonography obstetrics
17/3-21/3
Thipane
Pilivili
scrotum
1
2
sonography obstetrics
17/3-21/3
Thipane
Pilivili
thyroid
1
gynaecol. abdominal
2
2
thyroid
scrotum
blad/prost
peripheral
heart
Larde
7
2
Mecane
Briganha
2
2
1
2
Mititicoma
2
1
sonography obstetrics
2
3
1
1
gynaecol. abdominal
14/4-18/4
Thipane
Pilivili
1
2
Larde
5
2
2
1
Topuito
Briganha
3
4
3
1
2
1
Guarneia
6
7
1
Larde
3
Mecane
Briganha
3
3
Mititicoma
0
thyroid
scrotum
blad/prost
peripheral
heart
1
1
1
3
sonography obstetrics
28/4-2/5
Thipane
Pilivili
2
2
gynaecol. abdominal
3
1
thyroid
scrotum
blad/prost
3
1
1
peripheral
heart
1
1
1
1
1
1
1
1
1
sonography obstetrics
gynaecol. abdominal
14/5-18/5
Thipane
Pilivili
2
2
Larde
0
Topuito
Briganha
2
0
2
Guarneia
2
1
5
4
Larde
4
mecane
Briganha
5
3
Mititcoma
6
scrotum
1
1
sonography obstetrics
26/5-29/5
Mititicoma
Pilivili
thyroid
peripheral
heart
blad/prost
peripheral
heart
1
1
1
gynaecol. abdominal
3
blad/prost
thyroid
scrotum
1
1
1
3
1
3
1
1
1
2
3
1
1
2
2
1
sonography obstetrics
gynaecol. abdominal
9/6-13/6
Thipane
Pilivili
2
3
2
2
Larde
7
1
1
thyroid
scrotum
blad/prost
peripheral
heart
1
6
Topuito
Briganha
3
1
Guarneia
4
2
1
1
1
sonography obstetrics
2
gynaecol. abdominal
23/6-27/6
Mititicoma
Pilivili
7
3
5
1
3
Larde
5
1
3
1
Mecane
Briganha
4
1
2
1
2
Mititicoma
17
12
sonography obstetrics
1
1
Larde
6
1
Topuito
Briganha
3
0
2
Guarneia
2
2
Thipane
1
sonography obstetrics
thyroid
scrotum
blad/prost
4
4
peripheral
heart
1
1
gynaecol. abdominal
7/7-11/7
Pilivili
1
thyroid
scrotum
blad/prost
peripheral
heart
thyroid
scrotum
blad/prost
peripheral
heart
1
1
1
gynaecol. abdominal
21/7-25/7
Pilivili
1
1
Larde
1
1
Mecane
Briganha
1
2
1
1
Mititicoma
3
2
1
Miticoma
9
4
5
1
sonography obstetrics
28/7-1/8
Pilivili
0
Larde
3
Topuito
Briganha
2
1
Guarneia
4
Thipane
4
gynaecol. abdominal
2
thyroid
scrotum
blad/prost
peripheral
heart
1
2
1
2
1
1
2
sonography obstetrics
2
gynaecol. abdominal
11/8-15/8
Pilivili
2
1
1
Larde
4
1
2
Mecane
5
1
2
thyroid
scrotum
blad/prost
peripheral
heart
1
1
1
Briganha
1
Mititicoma
2
Miticoma
0
1
1
1
Annex C
Days worked by MCT from 1 March 2014 – 31 August 2014
2014
Field
MO Field Dentist Comm.MO Comm.Dentist Admin.MO Admin.Dentist
Week
10
12
14
16
18
20
22
24
26
28
30
31
33
Total
MO Total Denist
4,5
4,5
0,5
0,5
1
0,5
6
5,5
4,5
4,5
0,5
0,5
1
0,5
6
5,5
4,5
4,5
0,5
0,5
1
0,5
6
5,5
4,5
4,5
0,5
0,5
1
0,5
6
5,5
4
4,5
4,5
4,5
4
4,5
4,5
4,5
4,5
4
4,5
4,5
4,5
4
4,5
4,5
4,5
4,5
0,5
0,5
1
0,5
5
0,5
0,5
1
0,5
0,5
0,5
1
0,5
0
0
1
0,5
0
0
1
0,5
0
0
1
0,5
0
0
1
0,5
0
0
1
0,5
0
0
1
0,5
5,5
6
6
6
5,5
6
6
6
6
5,5
5,5
5,5
5
5,5
5,5
5,5
5,5
Annex D
RELATÓRIO DO 1º SEMESTRE DO 1º ANO DO CURSO DE MEDICINA
Importa referir que o 1º Semestre de 2014 iniciou no dia 27 de Janeiro e durou até 04 de
Julho. Nele estavam incorporados 4 blocos que terminam realizando exames em cada 6
semanas com excepção do último que tem 4 semanas que são: Introdução a Medicina,
Metabolismo (Inglês), Interacção e Regulação, e Epidemiologia (Inglês) e 2 exames de
Progresso no qual obtive seguintes resultados:
Bloco/Exame
Resultado
Observação
Introdução a Medicina
20
Aprovado
Metabolismo (Inglês)
14.55
Aprovado
Interacção e Regulação
14
Aprovado
Epidemiologia (Inglês)
10
Aprovado
1º Exame de Progresso
15.56
Aprovado
2º Exame de Progresso
18.20
Aprovado
Exame de Progresso é uma avaliação única que envolve todos estudantes do 1º a 6º ano na
qual é avaliada a progressão de estudantes em relação a tudo que sabem
Foi uma metade 2014 muito impressionante com sucesso apesar de muita pressão mas
parece a vida tem destas temos que correr atras por isso só digo que último exame foi
péssimo apesar de ter passado mas fiquei decepcionado comigo mesmo mas acho eu que é
assim como aprendemos acredito que bons dias virão.
Dificuldades: Bom eu apresentei a 1ª de dinheiro no ano transacto, agora preciso de alguns
livros e alguns materiais que estão acima das minha disponibilidade em relação aos fundos
monetários.
Agradecimento: Quero agradecer a Missão Betesda pela bolsa de estudo e sempre digo eu
farei o meu máximo para não vos decepcionar eu não sei o que seria de mim sem vocês por
isso digo muito, muito obrigado!
Annex E
Results Pre- and Post-test Training HIV/SIDA and Tuberculosis Moma
2013/14
Pré-test 3-9-2013
Maria João
Mariza Graciano Noguiera
Regina Agusto Jorge
Tina Basilo Joao
Johara Dauda Romada
Inês Jose António
Esmilda Usseine Miluco
Maria João
Ligia Ramalho
Suhura Aiuba José
Fatima Ussene Cassimu
Zainabo Selemane Aiubo
Ancha Selemane Ajudante
Zainabo Selemane Ali
Faita Ali Assane
Mimi Marcelino
Gina Ussene
Aninha Rute Armando
Luzina Sozinho
Rate Gómigo
Telma Agostinho Antonio
Fatima Ussene Piquizea
Ofelia Jaime Castene
Mira Antonio
Selma Rodriques Afiel
Lenita Amada Omar
Adelino Agostinho Mussa
Nenita Amade Omar
Fatima Abilio
Albertina Suala
Betinha Momade
Laurinda Tomas
Cecilia Antonio
Cristina Carlos
Mathilde Carma
Quita António
Assinete Mahomubo
Pós-test 1-4-2014
13,5
13,5
7,5
10,5
11,5
12,5
12
14
13
12,5
9,5
14,5
13
12,5
14,5
15,5
16
15
18
16,5
12,5
18
11,5
7
9
13
11,5
16,5
Ancha Omar Amisse
Virginia Montanhe
11
15,5
11,8
59,0%
14,6
73,0%
Aginete Mahamudo
Average