Two Months Later: an interview with João Luís Manuel

Jun 4, 2020

The interview below was conducted over email.  Questions were written and English, and responses were given in Portuguese and translated into English.  The original Portuguese responses can be accessed by double-clicking the button, below.

During a state of emergency, a lot can change quickly. Best laid plans can get upended, delayed, or canceled.

João Luís Manuel is the Director of the Beira Operations Research Center (CIOB) in Sofala Province Mozambique.  CIOB has long been an institutional partner of HAI on many programs and initiatives.  In December, HAI launched Project SPEED, a collaboration with CIOB and the Center for Disaster Philanthropy, with one of its aims to build epidemiologic surveillance capacity at the regional level in Central Mozambique.  The trainings were scheduled for April & May 2020.

The first case of COVID-19 in Mozambique was reported on March 22, 2020.

Below, we checked in with João Manuel, to see how CIOB and Sofala Province have adjusted to the changing circumstances.

QHow has Sofala province responded to COVID-19, and what has been CIOB’s role? 

A Província de Sofala, em especial na cidade da Beira, foram criados Gabinetes para o rastreio de gripes nas Unidadess Sanitárias com vista a identificar os eventuais casos de coronavirus-19. Até hoje, foram 12 testados positivos na Província de Sofala, dos quais 6 são casos importados, sendo 4 Moçambicanos vindos de Africa do Sul e 2 camionistas Zambianos. Os 4 Moçambicanos vindos da África do Sul foram testados porque vinham dum Pais com casos do COVID-19 e não apresentavam sinais e sintomas. Porém, os restantes casos positivos (8) foram colhidos amostras nos gabinetes de Gripes. Portanto, tinham sintomatologia de COVID-19 incluindo os dois camionistas Zambianos que eram casos importados.

Quais são as princiapais tarefas do CIOB no âmbito de Vigilância?

1. Em coordenação com a DPS de Sofala, o CIOB Organiza e sistematiza toda informação inerente ao COVID-19 ao nível da Província de Sofala produzindo o bolentim diário que é consumido por todos os intervenientes incluindo o Governo Provincial. Toda a informação é depois enviada ao MISAU.

2. Em coordenação com a DPS de Sofala, o CIOB Organiza, coordena as equipas do campo e Investiga os contactos directos e secundários dos casos positivos de COVID-19.

 

QWhat impact have social gathering restrictions and other suspensions due to COVID-19 had on CIOB’s work?  What adaptations have been made?

De facto, as restrições às reuniões sociais e outras suspensões tiveram um grande impacto no trabalho do CIOB, a destacar:

O Cancelamento de: encontros físicos de coordenação das actividades, início da implementação de vários projectos do CIOB e interrupçao das actividades do campo dos estudos que estavam em curso, comprometendo deste modo, os prazos e contratos previamente acordados com os parceiros, porém, todos cientes de que se trata duma pandemia que está assolando trietemente todo o mundo.

O adiamento das formações que já tinham sido planificadas em colaboração com o nosso  parceiro (HAI) para os meses de Abril e Maio, a saber: Treinos em Vigilância Epidemiológica; Investigação de Surto e Análise de Dados, formações estas, que trariam uma grande vantagem no âmbito da criação da capacidade institucional do CIOB na resposta ao COVID-19, bem como na resposta à outras eventuais pandemias e surtos. Este adiamento tinha como objectivo evitar aglomerações de técnicos/pessoas e viagens/deslocações dentro do País que é uma das recomendações do estado de emergência do nosso País, pois, é um dos factores de risco para a transmissão de COVID-19.

 

QWhat is the benefit of having epidemiologic surveillance at the regional level?

Como dizia acima, as formações em Vigilância Epidemiológica podem trazer um grande benefício na medida em que havia de criar a capacidade institucional do CIOB na resposta ao COVID-19, bem como na resposta à outras eventuais pandemias e surtos.

Por exemplo: Os 6 casos positivos Moçambicanos testados nos gabinetes do rastreio de gripe na cidade da Beira são de baixa renda e sem histórias de viagem. Algumas das nossas dificuldades é: identificar o foco ou a origem da infecção destes casos. Onde contrairam a infecção? Como de modo particular na Beira, pode se evitar a transição para uma transmissão comunitária do COVID-19 e na Província em geral? Como estruturar um sistema de controle de Vigilância Epidemiológica robusto para os milhares de camionistas que entram e saem da cidade da Beira? Como proceder o isolamento dum caso positivo que partilha o mesmo compartimento/ quarto com 8 membros da mesma família porque a casa tem unico quarto e ainda de construção precária?

Eu julgo que estas seriam algumas das perguntas que haviam de econtrar as suas respostas nas formações supracitadas adoptando uma metodologia de ensino de solução de problemas.

 

 QWith the COVID-19 pandemic taking center stage in the news, in your opinion what other threats to the health of Mozambicans aren’t getting the attention they deserve?

Uma pergunta muito interessante. Na minha opinião, as outras ameaças à saúde dos moçambicanos é negligenciar outras doenças que continuam a matar em Moçambique. Por exemplo: a malária e doenças crónicas.

Um dos membros do comitém científico no âmbito do COVID-19 disse ontem e passo a citar “ A Pandemia do COVID-19 está a trazer-nos outro peso na Unidade Sanitária. Muitas crianças estão a dar entrada na pediatria com casos graves de malária o que não acontecia antes.” 

 

 

QHow has Sofala province responded to COVID-19, and what has been CIOB’s role? 

In Sofala Province, especially in the city of Beira, offices have been created to screen for flu [symptoms] in the Health Units in order to identify cases of COVID-19. To date, 12 have tested positive in Sofala Province, of which 6 are imported cases (four are Mozambicans who came from South Africa and two are Zambian truck drivers). The four Mozambicans who came from South Africa were tested because they came from a country with COVID-19 cases; however, they had no signs or symptoms. The remaining positive cases (8) were sampled in the Flu offices. Therefore, they had symptoms of COVID-19.

What are the main tasks of the CIOB in the field of Surveillance?

1. In coordination with the Sofala Provincial Health Directorate, CIOB organizes and systematizes all COVID-19 data at the Sofala Province level and produces the daily bulletin that is presented to all stakeholders, including the Provincial Government. All information is then sent to the Ministry of Health [at the central level].

2. In coordination with the Sofala Provincial Health Directorate, CIOB organizes and coordinates field teams, in addition to tracking direct and secondary contacts of COVID-19 positive cases.

 

QWhat impact have social gathering restrictions and other suspensions due to COVID-19 had on CIOB’s work?  What adaptations have been made?

In fact, the restrictions on social gatherings and other suspensions have had a major impact on the work of CIOB.

The cancellation of physical meetings to coordinate activities, [delayed or cancelled] implementation of several [new] CIOB projects, and the interruption of field activities of studies that were underway [are all major impacts]. This compromises timelines and contracts previously agreed upon with partners; however, all are aware that it is a pandemic that is devastating the whole world.

[We also had to] postpone training sessions in collaboration with HAI, planned for the months of April and May.  Namely: Training in Epidemiological Surveillance; and, Outbreak Investigation and Data Analysis. These trainings, would allow a great advantage in the creation of CIOB’s institutional capacity in the response to COVID-19, as well as in the response to other possible pandemics and outbreaks. This postponement aimed to avoid gathering of technicians/people and travel within the country, which is a dangerous condition for the state of emergency in our country, as it is a risk factor for the transmission of COVID-19. 

 

QWhat is the benefit of having epidemiologic surveillance at the regional level?

As I said, training in Epidemiological Surveillance can bring a great benefit to the extent that it would create CIOB’s institutional capacity in responding to COVID-19, as well as in responding to other possible pandemics and outbreaks.

For example: The 6 Mozambican positive cases tested in the flu screening offices in the city of Beira are of low income and have no history of travel [that may have led to exposure]. Some of our challenges are: identifying the focus or source of infection in these cases. Where did they get the infection? How to prevent community transmission of COVID-19 particularly in Beira, and also in the Province in general? How to structure a robust Epidemiological Surveillance control system for the thousands of truck drivers entering and leaving the city of Beira? How to proceed with the isolation of a positive case that shares the same compartment / room with 8 members of the same family because the house has only one room and is still of precarious construction?

I believe that these would be some of the questions that [could be answered] with [epidemiological] training,that adopts a problem solving teaching methodology.

 

 QWith the COVID-19 pandemic taking center stage in the news, in your opinion what other threats to the health of Mozambicans aren’t getting the attention they deserve?

A very interesting question. In my opinion, the other threat to the health of Mozambicans is neglect of other diseases that continue to kill in Mozambique. For example: malaria and chronic diseases.

One of the members of the scientific committee under COVID-19 said yesterday and I quote: “The COVID-19 Pandemic is bringing us another weight in Health Units. Many children are entering pediatrics with severe cases of malaria, which did not happen before.”

 

 

 

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