(Credit: Stuart Ramson/UN Foundation)

I am in Mozambique this week for the launch of a five-day nationwide campaign to vaccinate 3.6 million children under the age of five against measles. Thousands of health workers have been mobilized across the country from rural, makeshift clinics underneath trees to health facilities in bustling towns and villages.

They all have the goal of eliminating measles from their country, but after personally speaking with Mozambican mothers – some of whom carry their children up to 15 miles to get a lifesaving vaccine – it was clear that their commitment was obviously much more personal.

These and other mothers know that without this vaccine, their children could be one of the 450 worldwide killed by measles each day , or among the thousands who are left blind, deaf or brain damaged by this highly infectious disease.

In a country where the average person lives on less than a dollar a day, health workers in Mozambique are on the front lines of a war against measles.

But it’s a fight they’re winning.

Thanks to the life-saving power of vaccines and the hard work of the Government of Mozambique and other nations around the world, the Measles Initiative – a partnership led by the World Health Organization, UNICEF, the American Red Cross, the U.S. Centers for Disease Control and Prevention, and the United Nations Foundation – and other supporters, measles deaths have been reduced by more than 92% in Africa.

You might have seen recent headlines about measles outbreaks in the U.S and Europe — the most serious in a decade. Worrisome as those are, they represent just a fraction of the children at risk in countries with far fewer resources to fight this highly infectious disease.

A lifetime of protection against measles costs less than $1, making vaccines one of the most cost effective ways to save children’s lives.

That is a price worth paying to ensure every child has a shot at a happy, healthy life.

Peg Willingham is the executive director of a new United Nations Foundation global vaccines campaign, which will launch this fall.

Billionaires Balk at Buffett and Gates Initiative – A brouhaha has been brewing in China amid rampant speculation that Chinese billionaires are dodging invitations to a banquet hosted by Bill Gates and Warren Buffett later this month… because they are nervous about being hit up for donations. (ABC News)

Uneasy Calm Returns to Mozambique After Last Week’s Violence – The head of news and current affairs at Mozambique television told VOA an uneasy calm has returned to the capital, Maputo, and surrounding areas hit last week by violent protests over rising prices that left at least 13 dead and hundreds injured. (VOA)

Four million poor children dying ‘of neglect’ – Save the Children says there have been four million preventable child deaths over the past 10 years because states have failed to help the poorest. (BBC)

Nigeria army in Maiduguri after ‘Boko Haram attacks’ - The army is conducting joint patrols with the police in Nigeria’s northern city of Maiduguri after a wave of killings blamed on the Islamist sect, Boko Haram. The police have also banned riding motorcycles at night as several of the shootings were carried out by people on motorbikes. Twelve people, including seven policemen, have died in the past month. (BBC)

South Africa Unions’ Strike Suspended – South Africa’s trade unions Monday suspended an almost three-week-old strike by hundreds of thousands of government workers that had closed schools and hamstrung ambitious new efforts to expand urgently needed medical services in the region’s richest but most inequitable economy. (NY Times)

U.S. Will Give Mozambique $1 Billion to Fight HIV – The U.S. says it will provide $1 billion over the next five years to help fight AIDS in Mozambique, including strengthening the country’s health system and improving access to treatment. The goal is for the government, aid groups, and private sector to harmonize their efforts to combat HIV and AIDS. (VOA)

Pay attention to West African food crisis, says ambassador – U.S. ambassador Robin Renee Sanders argues that the international donor community needs to keep the food security situation in West Africa front and center so as to ensure that all vulnerable people have access to affordable, nutritional commodities to avoid any later crises. (Huffington Post)

Flying to the aid of Africans fighting illness – Journalist Caitlin Gibson interviews Johnathan Miller, founder of the Airborne Lifeline Foundation, a fleet of eight planes dedicated to transporting medical specialists and supplies to remote corners of Botswana to help villages combat HIV/AIDS and tuberculosis. (The Washington Post)

South Africa wants to join BRIC nations – South Africa wants to be considered among the leaders of the developing world along with Brazil, Russia, India and China, its president said, pushing for his country to be the first African member of the informal group that has growing global influence. (AP)

New corn varieties could combat famine during drought – A recent study has found new breeds of “drought-tolerant” corn that could help farmers fight the effects of drought and provide food in periods of low rainfall, with the potential to save consumers more than $500 million in drought related price increases by 2016. (Michael Onyiego, VOA)

Merck provides new funding to fight HIV/AIDS in Botswana – The Bill and Melinda Gates Foundation has partnered with pharmaceutical giant Merck to provide $60 million over the next five years to fight HIV/AIDS in Botswana, which has the second-highest rate of HIV/AIDS infection in the world. (Byron Butler, The Daily Tell)

President Obama’s town hall speech at the White House

The goal was to allow the participants along with their American counterparts to share their insights on everything from good governance, empowering young people and economic opportunity. The forum kicked off with a town hall meeting with the president at the White House.

I was fortunate enough to attend two of the forum’s events and meet with many of the young African leaders to discuss the importance of fighting extreme poverty and preventable diseases, and how our countries can work together as partners in that fight.

On Tuesday, I attended a reception for the forum participants, co-hosted by the U.S. Chamber of Commerce and ONE. And today, I represented ONE at the Networking and Partnering “Unconference,” which brought African leaders and many great private sector and non-profits together to network and discuss ideas on future collaborations.

The president wanted this three-day forum to not just be a “one off” event, but instead, serve as a catalyst for collaboration and conversation with people around the world. Below are some of the amazing young African leaders I met over the past few days, and the innovative organizations they work with:

It was exciting to talk with so many people doing amazing work across Africa, and reminded me of all of the hope and opportunities ahead for ONE members as we continue in our efforts to advocate for better development policies and support greater democracy, accountability and transparency.

My name is Dr. Regina Kapinga, Program Officer at the Bill and Melinda Gates Foundation and I oversee the sweet potato grant which covers more than 10 countries in Africa Mozambique inclusive. On Monday 15th March, a delegation from ONE visited this program — the Sweet Potato Action for Security and Health in Africa (SASHA) — a project located about an hour outside of Maputo, Mozambique. SASHA is a sweet potato research project aiming to directly improve the food security of poor families in sub-Saharan Africa with a goal of reaching ten million households in ten years.

In Mozambique, sweet potato is one of the most important traditional food and cash crops. It ranks third in production, after maize and cassava. The government of Mozambique selected sweet potato as one of the most significant crops for mitigating food insecurity and malnutrition among its 21 million people. All sweet potatoes are excellent sources of carbohydrates, fibers, macronutrients, several B vitamins and vitamins C and K. Most importantly, orange-fleshed sweetpotato are also rich in beta-carotene, the precursor of vitamin A. Sweet potato in Africa is widely consumed mainly in rural areas hence the widespread consumption of orange-fleshed sweet potato could significantly reduce vitamin A deficiency, which threatens an estimated 43 million children under age 5 in Sub-Saharan Africa. In Mozambique Vitamin A deficiency accounts for 69% of the total children.

Our program focuses on several components of which three of them include the following: The first and largest component of the program is breeding sweet potato varieties for Africa in Africa. Secondly, we are multiplying the planting material and using innovative methods to distribute them to farmers. The third component is the integration of agriculture and health to impact vitamin A deficiency through the production and consumption of orange-fleshed sweet potato. We are investigating the best ways to scale up these activities in order to ensure that at risk mothers are able to access orange-fleshed sweet potato and feed them to their children.

We are looking for government commitments to be able to scale up and enable farmers even in remote areas to provide calories and vitamins for themselves through a crop that they trust. Right now we are in 14 countries in Africa, but these are small pockets and we want to scale the program out to reach millions of more families.

One of our days in hot and green Mozambique was spent welcoming some ONE delegation members to a water and sanitation site run by a public private partnership called Water and Sanitation for the Urban Poor (WSUP) which includes ONE’s long-time partner CARE.

WSUP works in Maputo’s urban slums, called bairros, connecting families with the water network and building sanitation blocks to replace latrines. They also complement the physical infrastructure they install with health and hygiene in the bairro schools. The organization is a unique public-private partnership between private sector companies like Thames Water, Halcrow, and Unilever, NGOs like CARE, Water Aid, and WWF, and Cranfield University. A core component of WSUP’s operation is to working in close collaboration with local authorities, municipalities, and local service providers to provide sustainable solutions that will be used and maintained even once donors leave.

Our first stop was at the bairro’s standpipe—the current water provision mechanism. The standpipe is open for several hours each day and people line up with their jerry cans, sometimes for hours, to get water. When we visited, the line was comprised almost entirely of women and girls who after filling them would carry the jerry cans home on their heads. Our second stop was the home of a family who saved to pay for the installation of a water tap just outside their house. The mother explained that she was thrilled with the tap—it’s allowed her more time to purchase and market the vegetables she sells to earn her family income. Her family has also been able to sell some water to their neighbors, adding a source of income for them.

Walking through the unpaved, muddy streets of the bairro, it was clear that families live close together and there isn’t space in homes for personal sanitation facilities. We visited a latrine—shared by more than 30 families—which is typical of the sanitation situation in the bairros. A sanitation block is slated for installation soon, about which the community is very excited. We then saw a sanitation block in another part of the bairro. The block is a simple, concrete structure that takes about two months to construct. It has toilets as well as a water pipe and place for families to do laundry. The block is maintained by a committee of people in the community, and the water pipe is operated by a woman who draws an income from opening and closing the pipe each day and ensuring that the meter is paid so that residents can receive water.

The need for improved water and sanitation services in Maputo are severe and growing. The city is home to over 1 million residents and is growing at 6% annually. The water supply coverage from a conventional network is around 40%. The general coverage for sanitation is around 82%, and in the peri-urban areas there have been significant investments for the construction of improved latrines. Mozambique’s Government policy is to improve these conditions but it does not have the capacity without assistance.

The WSUP project in Maputo aims to improve the health and living standards of residents by providing sustainable access to potable water for 180,000 people and improved sanitation facilities for 100,000. Their hygiene programs also reach 11,000 children. Our bairro visit really opened our eyes to the challenges in the water and sanitation sector—and the opportunities. WSUP is making impressive progress talking this issue and it was a treat to see them in action!

Last week I spoke to 4-year-old Ercilia in the village of Muzingane Bairro 3. As she played with her friend Carlos on the swings at their preschool, Ercilia told me how much she loves her new playground. She smiled and laughed as Carlos pushed her high up into the air on the swing.

Nothing is more thrilling than the sight of a happy child like Ercilia. And we at Save the Children in Mozambique have seen a lot of joyful children lately — all of them laughing, playing and hanging out with friends at brand-new playgrounds outside of our preschools.

Here in the rural communities where we work, children had few amenities, much less new see-saws and jungle gyms. These new playgrounds, built with funds raised by the 2007 Idol Gives Back television special, add a whole new element of excitement to our early childhood development program. They also give children another reason to look forward to going to school every day.

The response from Americans to Idol Gives Back (video above) is a testament to the power that people can have when everyone works together to support a cause, much like we all do through the ONE campaign. With the opening of 31 playgrounds this summer and 42 preschools last summer, Americans have made it possible for over 3,000 Mozambican youngsters to learn and to play. I know that the kids are more excited than ever to go back to school this year.

The playgrounds were designed by three local Mozambican artists and the jungle gyms, seesaws and tire swings were all built with locally available and environmentally sustainable materials.

MACHALUCUANE, MOZAMBIQUE – JULY 15: Children play in the newly built ‘Idol Gives Back’ playground supported by Save the Children in Machalucuane, Mozambique on July 15, 2009. The village is located about 18 miles outside Xai-Xai, in Gaza province in Mozambique. The villagers have about 7 miles to the nearest hospital and secondary school. (Photo by Per-Anders Pettersson/Reportage by Getty Images for Save the Children.)

Aside from being a great addition to our schools, the playgrounds have created an opportunity for communities to come together and support education for their children.

Community members volunteered their time this summer to help build the structures and local auto mechanics donated used car tires for swings.

Through our work with the ONE campaign, we can continue to advocate for support for basic education, including early childhood development programs like the one in Mozambique, providing communities with the tools they need to improve the lives of their children.

-Domingos Mahangue, Field Operations Manager, Early Childhood Development Programs, Save the Children in Mozambique

Thanks to all the ONE members who rallied and contacted their elected officials in support of PEPFAR reauthorization. Last week’s action by Congress will bring hope to millions of children living in countries hit hard by the AIDS crisis. If you are curious about how your actions will trickle down to the country and community level, let me share the stories of four young boys orphaned by AIDS in Africa. PEPFAR is helping them cope with their loss and look to the future.

One country that has been particularly hard-hit by the AIDS crisis is Ethiopia, struggling to meet the needs of four million orphans nationwide. This year, a popular children’s television show, “Tsehai Loves Learning,” has helped orphans deal with grief, while changing attitudes among other young children about children made vulnerable by AIDS. PEPFAR funding made it possible for Whiz Kids Workshop, in partnership with Save the Children, USAID and other partners to produce and broadcast four episodes devoted to helping the youngest Ethiopians understand the issues faced by children orphaned and affected by AIDS.

You only have to see the changes in a little boy named Yonatan, now 8 years old, and his half-brother, Dagmawi, 16, to appreciate how PEPFAR funding is benefiting countless children in Ethiopia. Yonatan was only five when his mother died, but he recalls her death as if it happened yesterday. “He always remembers her, tells stories about her and cries,” says Dagmawi.

Through simple puppets, a little animation and a lot of imagination, “Tsehai Loves Learning” has taught both brothers some valuable life lessons. “That was emotional for me,” said Dagmawi, who watched the first episode about coping with grief with his younger brother. “Not to exaggerate, but tears came up. But it gave me the idea that whenever I’m sad about my mom, I can imagine that I’m talking to her and can tell her that I’m doing ok.”

In Mozambique , twins Samuel and Pedro, 5 year-old orphans who lost both parents to AIDS, live with their grandmother in Guemulene village in Mozambique. Samuel and Pedro now attend preschool thanks to PEPFAR, which funded construction materials for the classrooms, teacher training and education materials. We’re talking about a poor community, where many of the men work in South Africa’s mines and there is a high rate of HIV/AIDS.

When Save the Children first started working in this community, there was only one toy — a hula hoop — which all the kids had to share. The PEPFAR funding is awakening hope for change for these children. Pedro’s grandmother said, “The school will help Pedro to grow and find something to do when he grows up. He says, ‘I want to take my bath and eat so I can go to school.’”

This week, we await President Bush signing the bill into law, and in doing so, Save the Children will be able to help change the lives of millions of children worldwide.

-Tonya Nyagiro, Associate Vice President, HIV/AIDS Program Save the Children

I woke up at 3:30am this morning, left my son Harrison in the hotel room, and headed for our 4:30am departure to Nampula, Mozambique. We flew in a Cessna Caravan of AIM AIR with Capt. Dan Spooner. Capt. Spooner had taken me in AIM AIR with Samaritan’s Purse about a year and a half ago to Darfur from Nairobi, Kenya and then into northern Uganda into the area of the Lord’s Resistance Army.

On the plane flying the length of Mozambique, we were able to capture the beautiful morning light with sun rising on a sharp horizon, red-orange turning bright orange and then a brilliant yellow. After about six hours of travel and one stop in Beira to refuel, we landed in Nampula city and were met by Mayor Castro Serafim who spent the day with us. He is articulate and is now running for reelection. He has been mayor of Nampula city for five years. We also had lunch with the Governor of the Nampula province, Felismino Ernesto Tocale. Interestingly enough, he was a former organic chemistry professor before entering politics.

We spent the afternoon with the Millennium Challenge Corporation (MCC). Accompanying me were Cassia Carvalho-Pacheco, Resident Country Director of the MCC in Mozambique, and Paulo Fumane, Executive Director MCA-Mozambique, who will be responsible for implementation of the Compact.

We visited four different sites which ran the spectrum of the clean water, sanitation, and land tenure aspects of the MCC Compact. Since the MCC compact has been signed but not yet implemented, we went to the areas where MCC will have an impact before the program had begun, where the planning stages had started. Implementation does not start until mid-September.

Nampula is one of the four northern provinces (like states) in Mozambique that is targeted by the MCC. All $507 million dollars will flow to these four provinces which constitute the poorest region in Mozambique. They are the least developed as a consequence of almost twenty years of devastating war. This war was fought in the countryside, and its victims were Mozambique’s subsistence farmers, millions of whom became refugees in neighboring countries in those years. New roads will link southern Tanzania to northern Mozambique which will open up commerce.

At each stop the routine was similar. Under a tree, in a field, in narrow alleyways, or just crowded together on a dirt road, we met local leaders and authority figures. And whenever I stopped to talk to residents, they were delighted to share something of their hopes and struggles with me. Whenever the Mayor introduced me, he told the people that I represented the MCC, and that America has come to help the Mozambique people live more productive lives…that America will help them realize their dreams.

I added that I, as a director of MCC, represented the American people and their friendship with the people of Mozambique. I told them that ordinary Americans – people just like them – are investing their taxpaying dollars in the future of Nampula so that they will have roads, clean water, and property rights that they deserve in order to earn a higher income and better take care of their own families. I emphasized that MCC is their program, not ours. Our goal was to fulfill their dreams and hopes and make them a reality. I stressed that the American people chose Mozambique because the country met the objective criteria that suggested that they would use the money well and wisely. American officials do not implement the Compact, Mozambican ones do. And it is up to the citizens of Mozambique to hold them accountable for doing so. The responsibility is theirs.

Everywhere we went the people said, “Thank you for coming, and thank you the American people.”

At the first site, we went to a small village that had maybe 100 dirt brick houses, about 30 kilometers from Nampula (Nampula is a city of 400,000 and the province has 4 million – it is the third largest city. HIV is about 12%. Poverty is almost 51%). Here we focused on property rights (or land tenure). The local surveyors had plotted out carefully 600 new lots, all squared off, but still empty. Certificates will be issued to formally give ownership to those who applied and paid a small fee. These deeds will constitute formal title. This concept is new. Ownership has been customary, and the cause of frequent dispute and discord in the community. The lack of legal title also robs these poor people of their most valuable asset: their land. As Mozambique’s financial institutions become more sophisticated, enterprising farmers should be able to use their title as collateral to get affordable loans to expand their business. This land tenure process is one of the 4 components of the compact.

We met under a beautiful tree, and 40 of the town families and representatives came out to meet us. They talked and interacted with me – one asked for energy, one asked for better roads. One asked for sanitation.

Then we visited a particularly blighted area of Nampula to see the seriousness of the sanitation problem in the city. The dusty streets were unpaved, of course, and I had to step around the gaping sewage holes literally collecting the sewage seeping out of adjacent homes. It is the perfect breeding ground for the mosquitoes that carry malaria.

We walked by a water pump and stopped. It was the only one within several kilometers. The people pointed to it: a nice concrete box with a hand pump. That said, it was put in by the government last year, but after a few months it broke down and now does not work. They pleaded with us to fix it, because the women now had to walk two hours each day to get water and that took them away from their children and families.

We traveled in car to another area, and we saw again a huge drainage ditch—a small canyon really– with stagnant water. This was the result of rain erosion caused by a complete lack of drainage engineers in Nampula. Runoff from a nearby hospital trickled in. Garbage lined the floor of the ravine, about 30 feet deep and 40 feet across, adjacent to the houses. Children played in the ditch. Apparently two hours before, a large group of neighborhood women had been gathering the filthy water there to use at home.

Lastly we went to a beautiful setting, about 20 kilometers from town, with tall trees still standing, untouched by the ravages of the civil war. There we met with people in a new development that asked for clean water. There was one standing pump that they wanted to demonstrate to us. When we went over an old woman was tying pieces of cord together so that she could lower her bucket directly down about 30 feet into the well. The hand pump was broken, and there were no parts to fix it. The community was embarrassed that their water pump that they had come out to demonstrate was broken, but the encounter dramatized the fragility of the infrastructure and the importance of sustainable economic development with a goal of self-sufficiency and not permanent dependence. Fortunately, the quality of the water, once the woman had hauled it up, was excellent.

We saw today the “before picture” of what MCC is all about. In September the implementation of the MCC Compact will start right here in Nampula. We leave today with a realistic picture of the needs and challenges. We’re also aware of the appreciation of the people of Mozambique have for the United States, but also the high expectations they have for us. We have to see to it that this investment achieves its intended effects. I look forward to coming back to these sites in a few years to check on the promises of progress.

-Sen. Bill Frist, MD

I woke up to a crystal blue sky in Maputo. I began the day performing a major lung operation for tuberculosis (pneumonectomy), and I ended the day discussing with the President of Mozambique the American people’s commitment to fighting extreme poverty in his country.

Maputo Central Hospital: Surgery

At 7:30am, we departed for Maputo Central Hospital, housed in a 100 year old building, but nonetheless a functional, governmental hospital with 1200 beds. All the doctors are governmental employees, and they make about $700USD per month. That being said, they are very prestigious figures in the community. In Mozambique, there are only 500 doctors for 20 million people, and there are very few specialists. In terms of equipment, there is one CT Scan, in Maputo, for 4 million people. By way of comparison, there are probably 32 in Nashville for about 1 million people.

Dr. Atilo Morais, a superb, thoracic surgeon training in cardiac surgery, gave us a tour through the hospital. He introduced us to his patients. Elias Novela, a 59 year old man, had a history of tuberculosis (TB). His symptoms included a shortness of breath, bloody coughing, and fevers. We reviewed his x-rays which presented a huge right lung mass, thought to be an empyema secondary to his TB. This man would die without surgery of his “bronchopleural fistula” that had developed because of the TB. About 2 million people die of TB every year in Mozambique (about 2.5 million die of HIV/AIDS, and 1 million die of Malaria).

I operated with Dr. Morais having been given full surgical privileges granted for the length of our stay. He spoke little English, and I speak no Portuguese – but luckily, cutting and sewing don’t require any talking!

I explored the patient through the bed of the 6th right rib. We removed the empyema cavity, careful not to spill the purulent material within the TB abscess. This is a big operation, but one common in Maputo because of the high incidence of tuberculosis infection. We removed the entire lung, suturing closed the bronchus, the pulmonary artery and vein. The patient as of right now is recovering well. He will remain on anti-TB therapy and should have a good long-term course. This is something very very rare in the US because out TB gets treated early.

Save the Children: Mozambique

I’m also here visiting with Mary Beth Powers and John Grabowski of Save the Children. Mary Beth leads Save the Children’s Survive to 5 Campaign, which I chair. More than 26,000 children die every day from easily treatable maladies. Almost half of these are newborns. About 6 million children could be saved every year through a concerted effort at vaccination, the use of cheap and readily available treatments for pneumonia, diarrhea, and malaria, ensuring mothers protect their children from malaria-bearing mosquitoes with bed nets, and improving nutrition.

Save the Children in Mozambique has focused our work on interior rural areas, where most Mozambicans live. This majority is extremely vulnerable to shocks such as floods, drought and crop diseases, as they are solely reliant on rain-fed agriculture. HIV/AIDS is dealing severe blows as well, fueled by the expansion of international trade corridors with neighboring countries. Save the Children’s work includes strengthening food security and combating child malnutrition, especially during the “hungry season,” as well as aggressively expanding HIV/AIDS programs to help stem what the government has termed a national emergency.

John Grabowski recently oversaw the merger of three Save the Children programs operating in Maputo: US, Ireland, and the UK. He explained the synergy that emerged from this commonsensical pooling of resources and strategy. Save the Children has moved strongly in the direction of outcomes measurement, moving in a results-driven direction.

African hospitals and clinics usually lack the equipment and laboratories necessary to save lives. That’s why technological innovations that can reduce the costs of medical technology for developing countries are so important. I’ve been joined here in Maputo by Dr. Rebecca Richards-Kortum, professor of bioengineering at Rice University in Houston, Texas. Dr. Rebecca is a national leader in designing effective, simple health technologies that are appropriate for the conditions in African clinics. She’s also a pioneer in looking for enterprise-based solutions for getting these technologies into the hands of the people who need them most. She demonstrated three fantastic devices that she and her students at Rice have been working on: a diagnostic lab-in-a-backpack, a low-cost imaging device to detect oral and cervical cancer, and a combined incubator and bilirubin phototherapy device for newborns (it costs less than $100 to build with locally-available materials, as opposed to about $2,000 for factory-made equipment).

You can learn more about Dr Rebecca’s pioneering work right here.

Iris Ministries Orphanage and Clinic: Samaritan’s Purse

In the afternoon, we drove about 35 minutes outside of Maputo, to Zimpeto to the Iris Ministries orphanage which houses over 425 children ranging from a few weeks old (they have 42 babies) to 20 years of age. Arco-Iris in Portuguese means “rainbow,” signifying God’s promises. This remarkable orphanage began simply by reaching out tot eh street children, providing them with clothes, food, shelter, and medicine. It has grown to where it now has a 700 person school, a pastor’s training center, and a large community clinic where I was able to see several patients over the course of the afternoon. We were greeted by a warm, prayerful crowd of about 200 people; many were students from the school. A young boy read a welcome message, and there were songs and dancing! Iris is supported by Samaritan’s Purse.

The first little boy was 24 months old. He had spontaneous tremors of his distal arms and legs; he is hyperreflexic. With normal facial features, the cranium seemed quite small. My diagnosis was severe brain injury probably suffered at birth. He really needs a CT, given the contours of his hea,d to evaluate his brain, and I will make the referral. But he probably will not receive it due to the lack of CT scans in the country.

The second patient was a 14 year old girl. She had a 6 month progressive history of difficulty swallowing and talking –a feeling of fullness in the throat. Chest x-ray shows a military pattern consistent with TB; barium swallow shows a mass high in the neck – the culprit. The remainder of exam was fine: intraoral, thyroid, neck nodes. I tested her for TB, and while waiting for results, she will be started on triple therapy to fight TB. Tentative diagnosis: TB mass of the neck (She should respond to the medicines I gave her).

There is no greater or more gratifying profession than being a doctor.

Meeting with President Armando Guebuza
Hurriedly, I switched from casual clothes to more formal attire to go see the President of Mozambique. He was friendly, quick to smile and respond, sort of fellow. I introduced him to my son, Harrison, who is an investment banker in New York, and he paid a little extra attention for that reason.

I then told we had had the opportunity to see Maputo, Chimoio and Nampula, though they were quite a distance from one another (the coast line of Mozambique is twice as long as that of California).I told him that I have loved exploring the inside of his country and the insides of his people! (That was supposed to be a joke since just hours before I had my hands I the patients’ chest.)

I congratulated the President on his outstanding leadership in signing the MCC compact last year—12 months ago almost to the day. But, since then, Mozambique has fallen 6 months behind schedule given their 5 year clock to work on the projects that they have targeted (clean water, agriculture, and land tenure). The American people are holding them accountable for the $507 Million dollars; Congress will watch how well they implement this funding like a hawk.

Save the Children Reception

The Save the Children’s reception was held at the home of John Grabowski. I met with a number of doctors, including a cardiologist, who asked if Vanderbilt would send a team of cardiac surgeons, cardiologists, an intensivist, and a perfusionist to help upgrade the cardiac surgery program in Maputo. Since Vandy is already doing so much in Mozambique on global health with the Institute of Global Health run by Sten Vermund, we should give it a shot. We noted that 2/3 of the 27,000 people who will die over the next 24 hours could be saved with inexpensive technologies, if we could just get them out in time.

-Sen. Bill Frist, MD.