02 Jul 2013
Gloyd S, Pfeiffer J, Johnson W (2013) Cooperantes, Solidarity, and the Fight for Health in Mozambique. In Birn AE, Brown TM (Eds.), Comrades in Health: U.S. Health Internationalists, Abroad and at Home. New Brunswick, NJ: Rutgers University Press.
In lieu of an abstract, here is a brief excerpt of the content:
184 Health Alliance International (HAI) was founded, and continues to be sustained , by individuals strongly motivated by social justice concerns. But those of us participating in international health cooperation through HAI have sometimes found it challenging to maintain our initial idealism and enthusiasm. We have faced not only the overtly threatening opposition of reactionary political and military forces but the more corrosive, subtle, and sometimes principle- testing anxieties of a world increasingly dominated by neoliberal economics, nongovernmental organization competitiveness, and self- promotional entrepreneurialism . How can a solidarity- minded organization like HAI participate in international health cooperation while simultaneously challenging the structures of the larger world order? The answer to this question, and HAI’s story, are told here through the personal narratives of the three “generations” of HAI’s leadership team. One of us (Steve Gloyd) began in 1979 as a cooperante helping the new socialist government in Mozambique develop its ambitious primary health care project; one (James Pfeiffer) began in 1994 as an antiapartheid solidarity activist and anthropologist committed to working with communities to respond to the concerns they identified; and one (Wendy Johnson) came to Mozambique in 2004 as a family practice doctor and public health practitioner focusing on the devastating AIDS epidemic. Our commitment to support and strengthen public sector health services is the common thread to our work— HAI has expanded from its roots in the 1980s as a solidarity movement with a newly independent Mozambique to include advocacy in the United States and projects in Côte d’Ivoire, East Timor, and Sudan. Cooperantes, Solidarity, and the Fight for Health in Mozambique Stephen Gloyd, James Pfeiffer, and Wendy Johnson Chapter 11 The Fight for Health in Mozambique 185 Steve Gloyd In the 1970s, I was fresh out of family practice residency and working in Seattle community clinics, trying to understand the political economy of health and health care. My principal job was consulting in a women’s clinic and participating in a home- birth midwifery collective. Our aim was to help women take control of their bodies and their health care from our insensitive, patriarchal health care system. I learned a great deal from the expertise and experiences of my female colleagues. I also participated in antiwar and solidarity movements, stemming from the American wars in Vietnam, Central America, and Angola. Serendipity led me to work in Mozambique. I saw an African Marimba band founded by a Zimbabwean musician, Dumisani Maraire, and quickly fell in love with the music. I started taking lessons, and within a year I was playing in Dumi’s band. Our band started a Zimbabwe Medical Drive to support Zimbabweans and their struggle to cast off apartheid Rhodesia (as the region was called under British colonial and white- minority rule— see chapter 12). By 1975, Zimbabwe independence fighters began using Mozambique, newly independent from centuries of Portuguese colonialism, as a base of operations. An armed struggle initiated in the early 1960s by the Frente de Libertação de Moçambique (FRELIMO, Mozambican Liberation Front) had finally led to independence , hastened by the fall of Antonio Salazar’s decades- long fascist regime (1932– 1968) in Portugal. Under the leadership of Samora Machel, FRELIMO began to construct a new socialist nation through nationalization of land and commercial enterprises and the development of health and education systems for its poor majority. In its first years, the FRELIMO government established a model primary health care system that preceded and contributed to the progressive Declaration of Alma- Ata of the World Health Organization (see chapter 12). By 1978, most of the population had been vaccinated against smallpox, polio, and measles, and by the early 1980s, twelve hundred rural health posts had been built and staffed. Over eight thousand health workers were trained and employed. During this period about 11 percent of the government budget was committed to health care. The plan aimed to rapidly expand health care to the rural population despite scarce human and financial resources and only about forty physicians for eleven million people.1 As the music and political work progressed, a group from FRELIMO came to the United States for a solidarity tour. One of their goals was to recruit young professionals, called cooperantes, to help rebuild the country after the flight of the Portuguese professional class. Portuguese colonialism had been especially brutal in its exploitation of African labor (often through a system of forced labor 186 S. Gloyd, J. Pfeiffer, and W. Johnson called chibalo) and lack of investment in health…