The day is finally here! We will begin our long awaited journey to Mozambique within a matter of hours! As hard as I may have tried, I could not sleep with all the excitement reaching its greatest height in the past several hours. Months of planning and anticipation all boil down to today! The adrenaline is in full swing; I'm going to Africa!

The excitement is only natural after such intense preperation. Never did I picture myself taking in so much information across such a wide spectrum of disciplines- film, language,history, and of course, politics! And these were only the ones that we covered as a group. My team members and I (all part of the healthcare group) have done our own studies to prepare for this trip, just as other groups (culture & religion, Education and legal systems, and elections) have done their individual study.

In the past week, I had the opportunity to meet with a medical expert who has worked with the Health Alliance International organization in Mozambique for several years. Dr. Johnathan Cohn, an infectious disease doctor, who also works at the Wayne State Medical School. It is through Dr. Cohn that I learned of the role of the Ministry of Health in Mozambique. Dr. Cohn spoke of the dilemma faced by the Minister of Health. While he wishes to provide basic care to as many people as possible in the country, and wishes to make advancements in medicine available in the local hospitals- he is forced to watch foreigners (countries providing aid to Mozambique) run his department since they feel that since they are donating money to Mozambique's healthcare system, they should have the right to decide how and where it is used. In this process, many doctors and nurses either work two jobs (since the government positions pay only a fraction of jobs through private organizations), or they all together are switching to private organizations, leaving fewer and fewer individuals to contribute to the development of national healthcare. So the Minister of Health struggles with finding ways to make doctors and nurses continue to work for the government (with lower pay) rather than accept private offers, as these individuals find ways to best support themeselves and their families comfortably.

Dr. Cohn also mentioned the corruption that exists in all the Ministeries, and at the same time stated that the corruption is far less in the Ministry of Health. He spoke very highly of the previous Minister of Health-Pascoal Mocumbi, and his efforts to support the introduction of anti-retroviral therapy. The most interesting thing I noted from the meeting with Dr. Cohn was the fact that he said despite any and all corruption, and difficulty providing care to the masses, Mozambique has done a decent job of working through the HIV/AIDS epidemic (even through years of civil conflict). For a country with such limited resources and great conflict, they have made efforts to treat 130,000 people with anti-retroviral therapy of the 1.5 million that are infected with the virus. In terms of healthcare, there are many issues to be dealt with by the country, especially the incoming party after elections, but I thought it was great to see yet another aspect in which Mozambique is considered a success story. This has now been a common thread through all that I have met in preperation for this trip- from Pitcher, Manning, and now Dr. Cohn, people really do see Mozambique progressing in all areas rather than being dismantled after Indepedence.

It is so incredible to see a country slowly but steadily working to provide care for its people. After all, this concept is at the heart of democracy. And it makes me realize how much we take even the basics for granted. Efforts are now being made to integrate HIV/AIDS care and possibly treatment into the primary healthcare system in the country. While I feel that donors should play an advisory role in the implementation of policies, I think it is necessary for health professionals to take advantage of their education and provide aid in developing countries around the globe. This is truly one of the reasons why I wish to become a physician. As a physician, it will be my duty to help those struggling in developing nations, to help those who lack the most basic necessities. I hope to visit the MSF site (Doctors Without Borders) in Maputo, as someday I wish to be a part of this wonderful organization. I never imagined having an opportunity to see/visit an MSF site before graduating from medical school! I also hope to be able to see various organizations in action (from a completely foreign operation to an entirely Mozambican operation) and see what more can be done by donors as well as the government to improve healthcare in Mozambique. This is what I truly wish to accomplish through this trip-along with democracy, to see the practice of medicine beyond our borders.