Yesterday morning, I traveled with fellow ONE staff to several health-focused development programs in Lusaka, Zambia. (The country is gorgeous and we’ve taken incredible photos, but because of some technical issues I’ll have to wait until next week to post a few here.)

A couple of today’s highlights were visiting with the Matero Refferal Clinic – a health center in Lusaka that is heavily supported by the Center for Infectious Disease Research – and a meeting with the Clinton HIV/AIDS Initiative and the Zambia Minister of Health. All of the healthcare workers at the Matero Refferal Clinic were wonderful as they showed us around their extremely busy and well-organized clinic. They showed us a new wing they’re building for HIV/AIDS and general health, but they did let us know that they need more medical supplies and staff. There were two doctors at the facility who, combined, see 200 patients each day.

Of note, we learned that patients receiving AIDS treatment at the clinic also receive “nutritional portions” from the World Food Programme. Food is vital to the fight against AIDS. For people infected with HIV, proper nutrition can slow the progression of the virus to full-blown AIDS and improve the effectiveness of antiretrovirals. Unfortunately, at the Matero Refferal Clinic, the size of food portions has decreased from 45 kilograms 5 years ago to just 12 kilograms today. On top of this, many people receiving these small, individually-sized portions will also share the food with their full families.

The meeting with officials from the Clinton HIV/AIDS Initiative (CHAI) and the Zambia Ministry of Health was extremely informative as well. A main take-away: the government’s decision to focus its attention on children with HIV – combined with the government’s collaboration with NGOs and funding from international programs like PEPFAR – has more than doubled the number of children receiving life-saving AIDS-treatment in the country.

Throughout the day, the need for more trained healthcare workers was repeated by doctors, nurses and officials. This is a need that is echoed across Africa: Africa bears 25% of the global disease burden and has 14% of the world’s population- but just 1.3% of the world’s health care workforce. This deficit in capacity means that countries like Zambia face enormous obstacles in improving basic health care for children and scaling-up access to vital health interventions, such as HIV/AIDS treatment.

-Virginia Simmons

Many African countries are facing a grave threat from rising food prices. That’s why we’ve been asking President Bush and other G8 leaders to take immediate action to soften the blow on the poor and reverse the underinvestment in long-term agricultural productivity.

Some of us have been in Mozambique this week; a country like Mozambique is particularly vulnerable to global food shocks. Not only is it very poor (75% of the country lives on less than $2 per day), it also imports roughly 75% of its food and is hit by a drought or flood every six months.

Despite these challenges, many parts of Mozambique have ideal climate conditions for agriculture production and there’s certainly no shortage of land – Mozambique runs 1,500 miles down Africa’s eastern coast and is twice the size of California.

Today we tried to learn why Mozambique is not able produce more food – both for local consumption and export. To find answers to our questions, we visited plant scientist Pedro Fato at the Instituto de Investigacao Agraria de Mozambique (IIAM) just south of Maputo. IIAM is an agricultural research institute jointly funded by the Government of Mozambique and private donors, including the Alliance for a Green Revolution in Africa (AGRA) and the Rockefeller Foundation. Pedro and his team are breeding more nutritious and insect resistant varieties of maize (corn), cassava, sorghum and sweet potatoes – all foods considered staples here in Mozambique. In the accompanying picture you can see Pedro holding orange maize which IIAM has bred to be rich in vitamin A and beta carotene.

Pedro outlined three major challenges to boosting agriculture growth and productivity in Mozambique

1. Water: nearly all agricultural production in Mozambique is rain-fed. With a typical rainy season lasting only three months, basic irrigation techniques and technology could significantly boost yields
2. Inputs (fertilizers and seeds): Fertilizer is expensive and not widely available in Mozambique. There is currently no domestic production; the limited quantities that are available are imported from South Africa. New seed varieties are also lacking. Approximately 70% of farmers are using unimproved local maize, which has lower yields and isn’t as resistant to pests and diseases. Like fertilizer, there is also no local seed production
3. Infrastructure: most of Mozambique’s agricultural activity occurs in the north of the country, where long distances and poor roads make it difficult to move crops beyond village markets. Improved access to markets could dramatically increase incomes for farmers and cooperative groups.

Pedro also told us more money is needed for agriculture research and extension workers so that new seed varieties and inputs can make it into the hands of farmers. He also said commercial farming is needed in Mozambique. Agriculture in here is mainly limited to smallholder farmers, limiting productivity, distribution and export potential. Pedro told us that 95% of maize in Mozambique is produced by small holder farmers.

Mozambique certainly isn’t alone. Many sub Saharan African countries are facing similar challenges. We’re hopeful that the global attention on food prices will translate into a sustained investment in long-term agriculture growth in places like Mozambique.

-Ben Hubbard and Tyler Denton, ONE.org

It takes money to make money, but poor people in Mozambique don’t have access to credit. Commercial banks don’t want to lend to them because there is no incentive in lending tiny amounts of money in such high-risk, isolated areas. Today, I visited Matola province in Mozambique. I met with Opportunity International, an incredible organization that gives microfinance loans to individuals and groups.

Microfinance loans are small amounts of money (often as little as $50 or $100) that enable very poor people, especially women, to start or expand small businesses. These loans are a vital resource in poor communities, where people have trouble accessing credit from traditional banks and money-lenders often charge exorbitant interest rates.

Their average loan from Opportunity International is small – around $170 dollars – and after just two years of operation the organization is already breaking even in the country, meaning it can expand its operations to reach even more people.

Study after study has shown that in spite of high levels of poverty, high risk and rapidly changing environments, good microfinance programs boast a repayment rate of more than 95%. Evidence also indicates that income generated from microfinance projects can spur wider development benefits because borrowers, especially women, are likely to use their extra income to invest in health care or education for their families.

We were taken to meet two groups of women whose lives had been transformed by the loans. They were able to use their money to buy stock to sell at their market stalls selling biscuits, clothes, charcoal etc. One woman had even used her money to open a restaurant. The great thing about talking to these women was how happy they were. They were so cheerful and delighted to show us around.

One woman, Rabia, has five children who live with her (in fact we met two of them – they were doing their homework at their mums stall). Rabia has one of the best success stories. She took us to see her old house, which was tiny and made of iron sheeting, and the new one she is building with the proceeds of her stall (picture above). The new house is huge (bigger than my house!) and really well organized – one room is bigger than her entire old place. As you can imagine, we were really inspired by these women.

It’s important to keep things in perspective though. One woman we spoke to was happy that she had increased her income, but she still only spent $4 a day on feeding her family of 5. It was fantastic to see what a difference a small loan could make to peoples’ lives, but we could also see that there is a long way to go to lift the community out of poverty.

-Hermione Davies

In Mozambique, less than half the population has access to clean drinking water. As a result, diarrhea and cholera, two diseases caused by unclean water and poor hygiene, are leading causes of child deaths in the country.

Today, I had the opportunity to see a MCC-supported program in Mozambique that is piping clean water into a community. I saw how lives can be transformed with access to clean water. While most of us in the United States take safe drinking water for granted, there are over one billion people around the world without access to clean water. But thanks to some amazing programs funded by the U.S. and others, some of the world’s poorest people here in Mozambique now have access to clean water, which is not only helping keep them healthy but also increasing their ability to earn money and attend school.

One neighborhood we toured has struggled with cholera outbreaks for many years. In January, with the help of the Global Fund and others, a clean water piping system was brought to the community. The results are remarkable- while last year over 1,000 people were stricken with cholera, by this year that number had fallen to 20.

Another benefit for the community has been more time for work and school, especially for women and girls. Women and children are often charged with the task of collecting water for the family. Before the new piping system was introduced, this meant they often had to spend hours each day collecting water. Now that each family has a stand pipe in their yard or home, attendance rates at schools have improved and women are able to dedicate more time to income-generating activities like gardening.

Clean water is one of the most basic human needs and it was very inspiring to see first-hand how US development assistance is literally saving and transforming lives here in Mozambique.

-Kim Smith

More from our trip to Mozambique. (Previous posts here.)

Before we left the suburb, several of the kids asked us to take their photo. (See above.)

I know I’m missing items from today- but I’ll have to fill in more later. The next time we have internet access, I, and/or others on the trip, should be able to post more here.

-Virginia Simmons

More from our trip to Mozambique. (Previous posts here.)

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In the afternoon, we visited with head of PSI in Mozambique and then visited a Maputo suburb.

In the suburb, which felt like a neighborhood, Yara of PSI explained how to use insectcide-treated bednets to a group of children and their caretakers. At the presentation, about 3/4 of the women said they were raising children who were not their own.

After, Yara took us to visit two families. The first was a family of eight (2 parents and 6 children) who live in a small 7 x 9 ft. house. The other was a mother, Regina, who has four children and whose husband died last week. Regina’s mother has bad legs but still commutes an hour and a half to work each day so that she can help feed her grandchildren.

She told us she was tired. And that her legs hurt.

-Virginia Simmons

More from our Mozambique. (Previous posts here.)

Later in the afternoon we traveled to a marketplace where a theater group, funded by the group PSI, performed a short play about sanitizing water. During the performance we learned that you just need to drop a few drops of the products (certeza) into a jug of water, shake it around, and wait 30 minutes to purify the water. The actors were, well, quite good – and a large crowd, including many children, gathered to watch. At the end, anyone who asked a question got a free bottle of the product. Each bottle is enough for 60 large jugs of water – and usually cost the equivalent of about 30 cents.

Similar theater groups perform plays about malaria and HIV.

-Virginia Simmons

Right now I’m writing you from Mozambique – where I have the incredible fortune of traveling with fellow ONE colleagues to visit internationally-funded programs and meet the people they serve.

I have a few moments tonight – so I wanted to post a little about mt first day here and share a few photos.

We began the day at a health clinic funded by PEPFAR in Maputo city. Above to the right is a photo of Fatina, a heathcare worker who showed us around the clinic’s maternity ward. When I asked how she came to this field, she said that she was tracked as an exceptional student since the 6th grade and trained for the profession. She’ said that she’s now delivered thousands of babies.

Fatima also said that they don’t have enough medically-trained staff and, at least at the time of our visit, they were out of antiretroviral (HIV medications) for babies. Also note the holes in the facility’s roof. When it rains outside, it rains in rooms of the clinic.

-Virginia Simmons