• Gillian Sims

My little Mozambican friend

Updated: Jun 26, 2018

Three weeks ago we were joined at the milk clinic by three very premature additions.


Two were twins, carried in on the backs of mum and grandma with no special treatment, as if the fact that they were alive at all was reason enough to throw them head first into life’s great hall of hardship. The third was carried in by a grumpy aunt, demanding milk because the baby’s mother had apparently gone crazy, run away and abandoned her child (although mum later arrived at a subsequent clinic in seemingly good mental health).


While the volunteers cooed at the lethargic looking babies, lucky to weigh 2kg at most, their prematurity to me was painfully obvious. Hospital cards reported the babies to have been born at 30 weeks gestation and their dates of birth made them each a week old. I laughed to myself at the thought of 30 week old infants surviving the African bush for a whole week without support. Mozambican newborns are not considered fragile like babies at home, they are expected to survive the same hardships as everybody else, and so are treated with alarming indifference.


My quick examination confirmed that all three babies had a well developed suck reflex, making them roughly 35 weeks and much more likely to survive. Weighing them however, showed they were losing far too much of what little weight they were born with, so my first priority was nutrition. With the help of a translator I gave my “Breastfeed as often as is physically possible” speech. I could see from the glazed faces and occasional giggle that my advice was being taken with a grain of salt. These Mozambican mamas would treat these babies the same way they treated all their babies – by feeding them if they cried. This would not work for such premature babies. They were going to need formula.

Formula demonstration in the dust, using a translator

I worked my way through a formula demonstration resisting the same glazed stares and puzzling amusement. Would any of this advice make any difference?!


I addressed the families and explained how much to give each baby. I was hit with the realisation that the concept of three hourly feeds was beyond these families.


Did I actually expect these Mozambican women to string up a clock on the walls of their bamboo huts, learn how to tell time and follow it counter-intuitively to everything they know? I had to change tack. “These babies need to be fed at least four times during daylight and four times after dark. You must be very patient, and not let them fall asleep during a feed. You must keep them as close as possible to your skin, you must protect them from the smoke of your cooking fire, you must not let young children, or sick children carry them around…” I could only pray my advice was getting through. Following our formula demonstration with the first bottle, I asked a mum to demonstrate what she had learned with the second. Sure enough, her premature baby took three tiny sucks before it fell asleep and the formula was stored away for the next feed. This was an uphill battle.


Everything in me wanted to scoop all three babies into my arms, carry them back to Pemba and begin around-the-clock care to ensure they were at least given a fighting chance at survival. Instead I waved as each family threw a baby into their wrap and wandered back into unforgiving village life. Sometimes I sense the mothers need as much protection as their babies do. No wonder my concern is amusing to the Mozambicans, for whom death is just a part of life.

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