A swelling crowd of people has gathered at the rural health centre at Monte Xiluvo in Nhamatanda district in the central Mozambican province of Sofala. Most are mothers with young children who try to protect themselves from the gusty wind as they wait for their consultation with Caetano Mendosa, the nurse responsible for the centre.
As he opens the door for the next patient, swirls of dust blow into the consultation room. It is a credit to the health centre that it’s kept as clean as it is, because there is no running water.
”The lack of piped water is the biggest problem we face,” says Mendosa, who sees about 1 000 patients every month. ”We have to ask their relatives to fetch water for us. It is especially hard for the midwife to conserve water. Imagine assisting deliveries with little water.”
The midwife, Emilia Ofece, delivers about 50 babies a month. Each evening Ofece ensures the large water container she uses is full before she goes home, which is conveniently situated next door. ”I ask those accompanying pregnant women to help with more water if necessary.”
The lack of piped water in certain health centres reflects the reality in rural areas of Mozambique. Few in these regions have the luxury of piped water and even safe water sources are unavailable to most. An estimated 57% of the rural population (about nine million people) do not have access to potable water, according to official figures.
People resorting to unsafe water supplies contributes to the country’s high child mortality rates, with diarrhoea being one of the main killers. An estimated 152 children out of every 1 000 live births do not live to celebrate their fifth birthday; in Norway the mortality rate for under-fives is four per 1 000 live births, according to the United Nations’ Human Development Report 2006.
Juvenaldo Amos, Sofala’s coordinator of malaria, tuberculosis, leprosy, sexually transmitted diseases and HIV/Aids, acknowledges that the lack of water in health centres ”is a serious problem”. But he says there is a renewed drive to improve the water supply. The government is building new centres only where it is possible to install piped water and efforts are being made to ensure that all existing health facilities soon have running water.
Providing homes with accessible, safe water is also a government priority. Nationally the aim is to ensure that at least 55% of the rural population has access to potable water by 2009 and to have 70% with access by 2015. This is to enable Mozambique to meet its commitments under the Millennium Development Goals, says Joaquim Jorge, head of the rural water department.
Although there has been gradual progress — in 2001 only 36% of the rural population had access to safe water supplies — Jorge concedes that it is a major challenge to meet the targets. One of the main obstacles is financing. About $10million is needed annually to dig boreholes and fit handpumps or install small piped water systems to meet the goals: ”We’re dependent on our partners.” As government can contribute only 10% of the total amount of money needed, the hope is that international donors cover the remaining costs.
Even if the funds are forthcoming, though, it is a challenge to find good quality water. In some areas — such as the southern provinces of Inhambane and Gaza and in parts of Sofala, like Nhamatanda — the water is brackish and so it is more costly to ensure water provision. In addition, the maintenance of water sources is a constant battle, says Jorge.
The ministry is in the process of decentralising all of its structures. There is a policy to use local workforces to dig boreholes and build and repair handpumps. Local people are being trained to maintain the equipment and local business people are being encouraged to stock spare parts.
Fina Miguel (14) has been waiting for most of the morning near an electric water pump that often does not work owing to frequent power cuts, most probably because of cable theft. She lives in Monte Xiluvo, near the health centre.
Fina tries to be at the well by four in the morning to avoid the long queues. ”I need to fetch water in the morning as I have school in the afternoon.”
The power comes on again and she fills one of her carriers with water. Her look is one of relief as she hoists the heavy 25-litre water carrier on to her head. — IPS