At Mavalane General Hospital, in Maputo City, men and women are forced to maintain their physiological needs in the same toilet, after having been in a long waiting queue – which disrespects measures of social distancing, in the context of combating Covid-19.

The queue is long.  We find men, women and children. The professionals responsible for cleaning do not spare their words, they always have a scream to repress the users, claiming that they step on the wet floor or because they do not know how to correctly place themselves in the queue.

The users are cornered and do not respond to the shouts of the cleaning ladies but they murmur among themselves, they say it makes no sense to be in a long queue to get access to the restroom. Fear is visible in their eyes, they don’t speak up because they fear reprisals when it is turn to be assisted by the nurses or doctors.

“If we speak, we will be badly treated”, a lady whispers in the ear of other lady by her side. The lady who whispers seems to be around forty-five years old, she is gray-haired and her eyes denounce the illness she has been combating.

“Is just now the moment of cleaning up? They should have done it in the morning”, she goes on whispering, doing her best to hide from the ladies cleaning the floor.

The oldest person in the queue seems to be in his seventies. He is barefoot on a wet and cold floor. He cannot stand himself with his  own legs, he depends on a helper who grabs his arm so that do not fall. The mask protecting him is a kind of dirty rag, with some crusts.

“We don’t even seem to be in Covid-19”, says a shaky woman, who has just got in the line. She feels weak, so she leans on the wall desperately, without worrying about what the cleaning staff will say.

“Some people even seem be blind” says a staff woman, without addressing a specific person.

Our team, which acts disguised, also fits the queue. It will have access to the toilet after twenty-four people have done their physiological needs.   

It’s about nine o’clock. After a few minutes, almost thirty-five, the cleaners allow users to use the toilets. Only two metal latrines, in deplorable state, are available exhibiting parched excrement and urine stains. When we question why there are only two latrines for men and women, the employees say “other bathrooms are clogged and damaged.”

“The water taps doesn’t even work”, we hear a user complaining.

 “It doesn’t look like clean. It’s all the negligence of the State”, says a man, concluding “and then they think the Covid-19 will end up easily.”

After the physiological needs, there is no water to wash the hands, nor to make the droppings run. The faucets that once existed, now live in the users’ memory. Now every man is for himself. After the needs, you pretend that everything is okay.                  

  As we leave the toilet area, we realize that in some departments, instead of mops and brooms, some workers use rags and capulanas to clean the floor, because of cleaning material’s lack. They do it with their feet and in a hurry.     

Patients’ Live Without Toilet For Over Two Years

Mavalane Health Centre – attached to Mavalane General Hospital – has the most frightening problems. Users do not have access to a bathroom for more than two years.

When they find themselves in physical need, they go to a small car park. They hide behind the cars and do their own needs. Because of it, the same park stinks droppings and urine, as the floor is characterized of sand and grass with syringes, masks and used cotton.

“We’re treated like dogs. For two years, this sanitary unit has not bathrooms, people do their needs hidden behind cars”, says Hambene Cumbane, a community health supervisor, representing a Basic Community Organization called Kuyakana (which means We Build Each Other).

According to Cumbana, it makes no sense to know that one of the largest sanitary facilities in the city does not have bathrooms and faucets.

“Here we have many sectors: we have pediatric service, sexual and reproductive health care, HIV, screening and more… we watch ladies, young people and elderlies urinating or defecating on grass. The lack of bathrooms is associated with lack of water, which has been missing for years”, says the activist.

According to Cumbane, even precarious bathroom would help a lot.

“A simple bathroom would minimize the situation. It is the right of the user to enjoy good sanitary conditions. There is no user able to leave the house with a latrine, portable latrines do not exist”, says Hambene, who daily goes to the sanitary unit to monitor the services provided to the user.

“The bathrooms have been clogged for two or three years. There has been no solution, although the leaders of the unit say that letters have been sent to the higher bodies, demanding solution”, stresses the supervisor.

A pregnant lady, who prefers to speak anonymously, tells our report that women – in the same state as her own – dispute a single dirty and degrading latrine.

“Look at me, with all this belly, I have to settle myself in a tired latrine. It’s true, it’s true. It’s horrible what’s happening, we dispute a latrine to maintain the necessities”, says the lady, breathing hardly with her right hand on the huge belly. At her side, there is an adolescent girl with a baby on her back; she doesn’t want to talk, not even anonymously.

“Who is the last one?”

 Murmurs constitute the only way to demand rights. People burn in the sun and don’t complain because the hose tries to protect them. The queue is a huge train. Everyone is crowded, waiting for a ticket to be assisted by a doctor in health consultation.

“Who is the last one?”, they ask each other, accepting the fact that they will be answered lately, in a process characterized by slowness.

The current problems – which are faced in all health facilities and primary-level hospitals in Mozambique – would probably be minimized if the government had not stopped investing about 146.81 billion meticais in the National Health System (SNS), in the last ten years, according to a study by Observatório Cidadão para Saúde (Citizen Health Observatory-OCS).      

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