When I first started filming for my documentary, Sick in Africa, I had a vague notion of what I wanted to capture and how to go about it. Now, 8 months later, I've wrapped up principal filming and start the process of trying to weave a story together. My intention is to create an authentic narrative in which the Yawo themselves tell their stories, open up their homes and share their lives and struggles with the outside world who so rarely gets to see what life and health, or the lack thereof, looks like for a subsistence farming community steeped in tradition.
I've leaned heavily on my friends and neighbors who live nearby; the real, ongoing, long-term residents of a Yawo Muslim community near Mandimba in Mozambique's northern Niassa Province. I'm just a visitor of 13 years among the Yawo and I know I see through a glass darkly when trying to make sense of a Yawo worldview. So I've asked a lot of questions in the past 8 months focusing on the whos, whats, wheres, whens and whys. My aim is to keep this a story straight from their mouths without an overlaying foreign explanation that could be very, very wrong despite one's best intentions.
Now that filming is mostly over (it doesn't really end until I either get rid of my camera or hop on the plane, whichever comes first) I'm able to sort and organize just whose paths I've crossed in the course of this exploration into the Yawo mindset.
The HEALTH PROVIDERS vary widely and break down into the FORMAL and INFORMAL/TRADITIONAL sector.
FORMAL HEALTHCARE PROVIDERS
Baba Awali and his wife Amina, already parents to 7, head across the border to the Malawian government hospital in Mangochi to see if they can find help in their desire to have two more children.
Abiti Bakali, one of our informal healthcare providers (an herbalist), has a husband who is complaining of undiagnosed pain in his chest and stomach. We head to the private Catholic hospital of Muli Bwanji across the border to see if they can tell us anything.
Of course most folks just rely on the closest and easiest solution: the Mandimba government health post. Sergio's wife carries on a successful pregnancy and birth at the hospital. An elderly lady with an ongoing pain in her shoulder also tries to find relief there. And on one occasion we join healthcare workers in the village of Che Issa where a vaccination program is underway.
Strangely, I even ran across a Chinese herbalist clinic called TIENS that recently opened up in Mandimba. Part of a massive conglomerate, this is yet one more option that some have begun to turn to for help and hope.
When illness strikes, the Yawo tend to try to guess at its origins whether physical (of God) or spiritual (from a curse). There are often signs and symptoms that allow them to attempt to diagnose (swellings, taboos, etc.). Often the first place they go to is family who can help make medicine using local roots. Abiti Bakali is one such herbalist who shows us what it's like to look for roots and how to boil them up into medicine.
Che Mandutu is a popular local African traditional doctor who uses magic and natural medicines for diagnosis and treatment. A natural storyteller, I got more than I bargained for as he not only showed me how he treats patients but also explained his understanding of the local history of Mozambique from colonialism to present day. He also talked about invisibility, how people can turn into animals using sorcery and many other fascinating topics I know nothing about. Or rather knew nothing about.
Amina is a young woman and mother of 5 who was sick for 3 years until finding out that the spirits wanted her to become a healer. Upon acceptance of her new task, she got well and has now been treating patients through knowledge she believes the spirits give to her.
Other healers I met included an elderly Muslim sheikh who is sought out to create talismans using Arabic from the Quran. When written in ink on paper and shaped into small pillow-like fashioned into charms, many believe that healing will come.
Apart from medicine obtained through roots and leaves, many villages have their own informal injection providers and small shops that sell basics to help with headaches, stomach ailments, malaria, etc. A private pharmacy (far out of reach for most Yawo in terms of cost) is also available if the local health center is unable to provide quality medication. But most seem to use traditional medicine and nearly every African market will feature traditional African doctors who sell their homemade medicines. Another major issue frustrating both donor nations and locals who feel cheated comes from medication sold illegally from government health posts by health workers and resold by unscrupulous businessmen.
Back in April when I started filming, I had planned to follow two friends of mine: Sergio (who lives in town) and Candulu (who lives 10KM away in the village). I expected that numerous health issues would come up with their immediate or extended families and that I would be able to be there to film the decision making process and journeys to healing respectively. But that hasn't really materialized like I thought it would and instead I ended up following numerous health cases that came my way through those I know (and a few new friends).
- Baba Awali and his wife Amina are struggling to have more children (see their photo above).
- Abiti Bakali's husband has an ongoing illness preventing him from eating well (photo above - "It's not sorcery?").
- Sergio's wife Mayingina uses the local health center for a successful delivery (photo below)
- A family with epileptic twin teen girls talks about their struggles for help
- Candulu's uncle tells us about his sudden illness and recovery; we later visit another family member's home just hours after their baby dies after severe seizures
- Lucia is an older lady (she doesn't actually know her own age) who complains of upper arm pain that has made her nights sleepless for too long. She wants an X-ray from somewhere, but will she succeed in her mission?
- Mama Laura is a mother of 7 who recently went through a harrowing experience as she nearly lost her most recent baby. She recounts what happened and how she found help as well as shares what she is currently doing to try to help her young son find healing from his slow development possibly caused from birth complications.
It's been a fun journey and I'm so glad to have embarked on it. I had hoped to hit on many relevant issues such as the following:
- illnesses common to the Yawo
- special illnesses the Yawo suffer from (often related to taboos)
- taboos dealing with birth & sexual practices
- beliefs and practices surrounding injections
- an overall government approach to health care
- what variety of informal health care providers exist (religious, spiritist, herbalists, etc.)
- how the Yawo feel treated by health providers
- how traditional African doctors treat
- misunderstandings that arise when taking medication
- problems of transportation to adequate health care
- witchcraft, jealousy and fear
- Chinese herbal medicine
- Islamic folk charms
- the spirit world and interaction with the living
- natural vs. magic illnesses
- prenatal and postnatal care
- corruption/bribery at government health posts
Curiously, one issue did not really come up though it's one of the top three things most outsiders would think of when it comes to healthcare in Africa: HIV/AIDS. I'm very interested to know why, but haven't yet explored the answer.