Women Leading Us Through the Pandemic
Cesaltina Mungue has a way of putting Pathfinder’s challenges during the COVID-19 pandemic succinctly: “It is not enough just to have COVID information,” she says. “Regardless of COVID, sexual relations happen without protection, so it is necessary to prevent both COVID-19 as well as unwanted pregnancy.”
The heart of Pathfinder’s challenge in the last eight months was just that – continuing our critical sexual and reproductive health work in an era where COVID-19 complicated nearly every decision. Lockdowns, supply shortages, and at times, a fear of going to health facilities due to COVID-19 have challenged the continued provision of sexual and reproductive health care.
But our staff, and the communities they work alongside, are more than up to the challenge.
Cesaltina works as part of Pathfinder’s MAIS project, which encourages the use of modern contraception to prevent unintended pregnancies in six districts of Mozambique.
It hasn’t been easy. Gildo Américo, a Monitoring and Evaluation Officer, felt the impacts of COVID-19 firsthand. Gildo’s job is to review data, report on the health center’s outcomes, and support health providers in data collection. In an era of COVID-19, this work is even more critical. “Because everything we produce,” says Gildo, “ends up going to the Ministry of Health and serves to inform decisions – and this ends up changing what is government policy and people’s lives in general… It’s a big challenge.”
But they are up to it. While meetings used to be pretty large, staff have had to adapt both numbers and priorities.
“We used to hold meetings with 20 and 30 participants,” said Gildo, “but now with the pandemic we have reduced the number to 10-12 and the meetings are more to discuss issues that are challenges and needs of each health unit.”
Across Mozambique, Pathfinder staff are working to reach women, girls, and their communities with continued care. Our RARE project operates in Gaza, Manica, and Sofala provinces, bringing critical care to tuberculosis patients, and antiretroviral (ARV) treatment and support to people living with HIV.
In this work, Pathfinder staff face a constant challenge – destigmatizing HIV, while ensuring consistent adherence to medication to keep patients and their families healthy.
“My job makes people’s lives change,” said Carmelia Mucachua, an activista with the RARE project. “The patients I have visited, they learn through counseling, they understand, and sometimes ask questions and ask for clarification of things they do not understand.”
“I like activists and supervisors because they actually visit me and advise me,” said Rogério. “I feel good because I suffered a lot from wounds, not knowing where they were coming from, but as soon as I got into the treatment, I’m fine. I live here with my wife, two nephews, and two daughters.”
Quica Chilundzo, a field supervisor with RARE, understands the challenges well. “It is an honor to be in the community to help people living with HIV, who have at times suffered discrimination and stigma in their communities,” she said.
Like our RARE project, Pathfinder’s MAIS project has continued its core work despite COVID-19. MAIS routinely provides trainings, mentorship, and technical support to community health workers, increasing the quality and reach of contraceptive services. In recent months, trainings have meant more physical distance, more personal protective equipment, and moving some trainings and assistance online – but the work hasn’t stopped.
After all, women’s reproductive health needs don’t end during the pandemic. One of Pathfinder’s key approaches has been giving women and girls the option to choose long-acting reversible contraceptives (LARCS), proven to be some of the most effective methods at preventing unintended pregnancies. Because supply chains were challenged and routine visits less likely, LARCS have given women the consistency of contraceptive protection for a sustained period of time when access to care is more limited.
Since the start of the COVID-19 pandemic, we have adapted each step of our work to keep staff and communities safe. “The activistas walk protected with all the right materials,” said Program Officer Jonas Maunde. “Gel alcohol, masks, and two bars of soap to promote the process of hand washing in the community. We also have a poster produced by Pathfinder that shows the process of hand washing step-by-step, and in addition to personal masks, activists always carry with them two extra masks in their backpack to ensure if someone without a mask appears in the community meeting, we can offer one.”
MAIS staff, alongside local leaders, worked hard to mitigate the initial challenges. “In terms of difficulties or challenges because of the situation of COVID-19,” said Jonas, “there were certain families who hardly accepted the entry of health agents. But as we have the national community engagement strategy adopted in May of this year, which explains the standards of work in the community within the framework of COVID-19, the strategy has helped to explain to the community (our safety protocols) and we have the support of community leaders and district services that lead – so we always rely on the local leaders who support us and we have excellent experiences there in the community.”
Because Pathfinder continued to make outdoor house visits to people living with HIV during this time, their lives can remain healthy and stable. “I’m 22 years old and I felt sick – I went to the hospital, and am now getting treatment,” said Maria Wate. “My life is changed. The pills are working on me. I feel comfortable. My dream is to continue studying, to do my thing, and to continue living with my mother-in-law, sister-in-law, husband and daughter.”
“I am honored to work as an activist and to be working with different people, and we have become friends,” said Selma Monteiro, a case manager at the Chaimite health unit working with the RARE project.
Adds Cesaltina, “It is with sympathy and understanding that a good result is achieved. If you’re not nice, you won’t have anything good!” We agree. Through the continued challenges brought on by COVID-19, Pathfinder’s values – respect, courage, collaboration, innovation and integrity – will stay at the heart of our work.