Mozambique

1 April 2018

[Above photo: Water transport from Ilha Mozambique.]

Wednesday morning at the Room 6 Clinic meeting I told all that I’d be walking out of clinic at 12N so as to get a start on the drive to Ilha Mozambique. The last patient the students presented to me was a 47yo woman who had the onset of a seizure disorder without antecedents at 32yo. For the past 4 years she has been increasingly forgetful, is occasionally confused and aggressive, wanders aimlessly at times, and has been having up to 3 seizures a day. In addition, over the past year she has lost the sight in her left eye. Her HIV status is unknown. She’s been given carbamazepine 200mg/day,  a miniscule dose, for her seizures and, recently some chlorpromazine for her “odd” behaviors. This was not a simple case and her mismanagement has been legion. I suspect she may have a non-malignant brain tumor, although there could be all sorts of reasons for an early dementia in this country.  We attempted a Montreal Cognitive Assessment test but she couldn’t do any of it. I discussed her care, including her poor previous care, with the medical students, ordered the requisite lab work, and managed to exit clinic by 12:10PM.

Linda was already home and we packed, closed up, and headed for the border. A bridge on the direct road to Mulanje had washed out so we went the longer, but prettier, route through Thyolo and the miles and miles of rolling green tea fields. The border crossings—leaving Malawi and entering Mozambique—were quite easy as our papers were all in order.  We probably should have gotten our visas at the border; $50 vs. $75 at the consulate in Blantyre. We didn’t because we wanted to speed through but considering the 2-3 days it took back and forth to the consulate, the bank, etc. to get them in Blantyre, it would have been a good trade-off.

The roads were mostly all tarmac, very few potholes, passing lines painted in the middle, yellow shoulder lines on the sides, broad paved shoulders for the cyclists, and speeds of 70mph were possible. It felt like driving in S. Africa, but with almost no traffic. We flew and pulled into Mocuba about 2 hours after sunset. We found a clean but unmaintained hotel and collapsed for a good sleep. The next day we sped 8 hours to Ilha Mozambique, crossing the several km one-lane bridge to the island. It was the Portuguese capital of Mozambique for 4 centuries and one of the two major slave departure sites (Zanzibar was the other) in East Africa.

Our hotel, which was a bit tough to find, is a grand old house down a dusty walking alley with a large open central courtyard, 3 (huge) rooms beautifully outfitted, and terraces on both floors and the roof. The latter is for sunset and moonrise viewing, the second floor is where we have breakfast with the garrulous and amazingly informed Italian owner, Bruno, and Judith his lovely Mozambican wife. Breakfast, I should mention, is an assortment of freshly-baked breads, home-made jams, an avocado mousse, eggs, juice, quiche, ham or prosciutto, and lemongrass tea followed by coffee. All interspersed with lively conversation with the other guests and our hosts.

We walked all over the small island yesterday, trying several recommended restaurants, as well as local places. We’ve been in at least 3 that are much better than anything in Blantyre. The shrimp is glorious and the tuna perfect. We hiked through the huge fortress on the north end of the island, where the Portuguese were garrisoned and where the slaves were kept. Looking over the ramparts past the brilliant aquamarine and purple sea, it is amazing to think how cruel we can be to each other for a piece of gold. All the stones for the fortress were taken from the middle and southern end of the island where the current very poor Mozambicans have their shacks.  As a result of the stone removal, the entire area is 10 or 12 feet below the road level. Flooding has been a huge problem and they have finally built a large culvert system with pumps to remove the excess water. The wretched of the earth. But people are, as in Malawi, friendly and don’t express anger when you don’t purchase what they are trying to sell.  Vendors walk through the streets with steamed seafood—clams, oysters, lobsters, etc—heaped high on platters they carry gracefully on their heads, hands-free.

Because I have been so damn ill—2+weeks of a cold, cough, fatigue—this is a very mild vacation for us. No mountains to ascend, rivers to ford, wild beasts to battle.  I’m looking forward to a sunset dhow ride this afternoon with beer and snacks. Someone else minding the sheet and tiller. The lateen rig is something—a single forward-canted mast, a loose-footed triangular sail, and gradual propulsion across the water. We’ve seen a few tiny dugout canoes with a similar rig, using black plastic sheeting for the sail. Poverty and necessity, coupled with ingenuity, are the parents of invention.

I’m finishing Robin Knox-Johnston’s book, Cape Horn, an account of the discovery, mapping, and commercial exploitation of the Cape Horn route to the Pacific.  It is an amazing account of the many, many players, so many of whom perished along the way. Descriptions of the “greybeards”, 100+ foot steep breaking waves, encountered off the tip of the Horn are chilling. The energy contained in them repeatedly destroyed large vessels if struck at the wrong angle. Massive storms and powerful ocean currents made the passage nearly impossible. The clipper ships, those spectacular greyhounds of the sea, which we associate with the Cape, were only around for a couple of decades, preceded for centuries by heavier, slower sailing craft and replaced by steamships when the latter came into service. Reading his account has certainly cured me of any adolescent fantasies of circumnavigating, even if I used the Panama Canal. I’m suddenly aware of my mortality and frailty and even though I’m active, I wouldn’t have the stamina to undertake such a voyage. Nor, at last, the inclination. Whew, what a relief!

As I write this on a terrace of our hotel, shaded by a huge-leafed tree of some sort, someone is playing electric blues from the 60’s and 70’s. I see banana trees rustling in the breeze over the wall next door. I hear some thunder in the distance. Linda bought 3 pretty chitenjes in the off-island Sunday market we visited this morning with new acquaintances from the hotel and is roaming about town while I write and rest. Ariane is in touch with me. Life is pretty sweet.

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