Mozambique - Beira (EN)
Mozambique was a colony of Portugal and gained independency after 10 years of independence war finally in 1975. But the country had only a short break of violence. From 1977 to 1992 it was plagued by a brutal civil war. The consequences of these long war years can be seen until today.
Today it is one of the poorest countries in the world. According to the current human developing index Mozambique is on position 185 of 191 countries. Mozambique has a population of 32,2 million (2021) with an annual population increase of 3%. 46% of the people in Mozambique live under the national poverty line. The infant’s mortality rate is 80 deaths per 1000 births. The average life expectancy is 58 years and 45% of the population is under 15 years. As with many African countries, the health care situation is different to more modern and better funded Western health care systems. With less than 3 doctors per 100 000 inhabitants (Germany 450, UK 300) there is a dramatic gap in people with the required knowledge to diagnose, cure and advise.
Country/City
Mosambik/Beira
Project Manager
Prof. Dr. med. Nikolaus Haas, Dr. med. Isabel-Sharina Roschatt
Short project description
- Training in echocardiograpy and paediatric cardiology in Beira, Mozambique
- Implementation of a pediatric cardiology outpatient clinic
Project Timeline
October 2022 to March 2023
Cooperation
Universidade Catolica de Mocambique.
- Prof. Kajal Chhaganlal, M.Sc. Clinic, PhD, Associate Professor of Pediatrics
Funding
We would like to express our gratitude to the Universidade Catolica de Mocambique for their reliable and confidential collaboration. The employees demonstrated remarkable dedication to this project, providing invaluable assistance in addressing any challenges at the public-led central hospital.
- Generous fund from the Else Kröner Fresenius Stiftung of 61.000 €
- Own funds of the department approx. 50.000 €
Local Project Manager
Prof. Kajal Chhaganlal, M.Sc. Clinic, PhD, Associate Professor of Pediatrics, Pedagogical director at the
5V2G+2J5, Beira, Mosambik
Links to other websites:
Beira is with 600.000 inhabitants the second biggest city of Mozambique. The central hospital of Beira has 900 beds and is responsible for a catchment area of more than 1 million people. The pediatric hospital, which is part of the central hospital, has officially 136 beds. It is divided into the following departments: malnutrition, infectious diseases, neonatology, general pediatric ward, intensive care unit and emergency department. Because of the great patient turnover, approximately 10.000 admitted patients are treated annually and 30000 in the outpatient clinics. Besides this, the hospital is also responsible for the education of the medical students and pediatric residents.
Heart defects are the most common malformations of children and approximately 11 of 1000 newborns are affected. Without an early diagnosis and treatment approximately 20-30% die. Currently in Mozambique exists only one pediatric cardiology support in a private clinic called “Icor” in the capital Maputo, which is 17 hours away by car. It offers for all children independent of their social class a whole year around pediatric cardiology service. Nonetheless is the capacity limited because of the big number of patients.
To improve this lack of medical supply a conservative pediatric cardiology service has been established in the province of Sofala (app. 2,3 millions) in the central hospital of Beira.
According to previous telemedicine services and based on the needs reported, the installation of a diagnostic echocardiography service was initiated. 15 doctors were chosen to be trained over 6 months (October 2022 – March 2023) in echocardiography and pediatric cardiology. After an initial introduction course over 5 days, weekly bed side teaching in groups of two was performed. A dedicated training manual in echocardiography was developed and pediatric cardiology lectures were hold on a weekly basis. Echocardiography was taught stepwise from the basic views up to complex functional measurements. The consultations for admitted patients occurred in form of hands-on bedside teaching only. An outpatient clinic was created and twice a week consultation for outpatients were offered (always together with a local doctor). In addition, training of the nurses for outpatient management was performed successfully. In the outpatient clinic early screening of new patients and the treatment and management of patients with chronic diseases and after surgical or interventional follow-up was initiated. The local doctors became progressively more confident with ensuring the optimal treatment and making indications for surgery or intervention Furthermore the collaboration with the neonatology clinic improved significantly owing to the proximity. This is fundamental in low income countries were the patients often live far away from the hospital. If there is an indication for an operation or intervention the private hospital ICOR in Maputo will be informed. Then with the help of a German foundation a transport by bus is organized. A transport by plane is because of the expensive tickets not possible. The postoperative follow up occurs then again in Beira.
- Continuing the collaboration in form of telemedicine.
- Further projects to improve the local pediatric cardiology service are in progress.
