Maputo, Mozambique: 14 August 2014

Maputo, Mozambique
14 August 2014

Maputo, Mozambique, a beautiful Southeast African Portuguese-speaking country of 26 million, hosted the August 14, 2014 World Allergy Training School for 85 young, enthusiastic, mainly primary care physicians. Eager to absorb both the didactic and hands-on workshop information on diagnosing and treating allergies, asthma, and COPD, the attention and concentration did not wax from the opening ceremony at 9 AM to the closing ceremony at 7 PM. In a country where HIV, malaria, high maternal and infant/young child mortality, and other communicable diseases have taken top priority. Unfortunately with no allergists, asthma and allergy has been given a lower priority disease consideration both for education and allocation of public health resources. Realizing this deficiency, the attendees were very receptive to our educational efforts and our suggestions for helping raise awareness of allergic diseases.

The conference was opened by Dr. Eduardo Munhequete (VALE Manager of Occupational Health), the local chair of the local planning committee whose devotion, time, and passion helped to make this WATS conference one of the most successful WATS every held.  Other speakers at the opening ceremony included 1) Dr. Eduardo Samugudo Júnior (Director of Mozambique Health Institute for Research), 2) Eng. Pedro Gutemberg (VALE Country Manager) 3)  Dr. Eugénio Sacarias (President of Medical Council of Mozambique), and 4) Dr. Dana Wallace. Dr, Wallace gave a brief introductory slide presentation to introduce both the WAO and the WATS/ESP collaborative ongoing project, funded by the World Allergy Association and the American College of  Allergy, Asthma, and Immunology Through careful public relations planning (a special thank you to Ms. Munhequete), television and newspaper cameraman from multiple stations were present and snapping photos and interviewing the Mozambique physicians.

The WAO faculty included Prof Joao Tebryica (Brazil), Dr. Dan Ein (USA), and Dr. Dana Wallace (USA). Major allergy topics included Asthma, COPD, allergy skin testing and immunotherapy, anaphylaxis, allergic rhinitis, chronic sinusitis, atopic dermatitis, and urticarial/angioedema. Hands-on workshops included prick skin testing, anaphylaxis auto-injectors and action plans, and using spirometry for diagnosis of asthma and COPD.

The closing ceremony which summarized our educational and healthcare goals for increasing the awareness, manpower, and financial support for diagnosing and treating allergies and asthma was an inspiring “beginning” of ALLERGY in Mozambique. Speakers included Dra Eulália Mbeve (Chief of Occupational Department in Mozambique Health Ministry), Dra Sandra Mavale  (Pediatrician and researcher in Pediatric Asthma), Prof. Sam Patel  (Chief on Medical Department in Maputo Hospital, part of the Eduardo Mondlane University Medical School, and Dr. Jorge Arroz (President of Mozambique Medical Society).

The pre-conference discussion dinner with Dr. Munhequete, Dr. Patel, Dr. Samugudo, Dr. Sacarias, Dr. Dan Ein, and Dr. Dana Wallace highlighted the need to introduce allergy as both a disease group and subspecialty at the medical school level. The three Mozambique medical schools, all government supported, are 1) Catholic University of Mozambique, Beira, 2) Eduardo Mondlane University, Maputo, and Lurio University, Namula. Of the approximately 2000 physicians in Mozambique, approximately 75% are employed by the public sector and 25% in non-government organizations and the private sector. Topics discussed included increase of mid-level providers to extend the hands of physicians, and increasing the formulary for asthma medications, e.g., combination ICS/LABA, which would actually reduce the overall asthma health care costs. Mozambique physicians recognize that healthcare problems still exist in terms of manpower shortage, especially in more rural areas (the average physician has a panel of 10,000 patients and sees about 100 patients a day), and resources for obtaining diagnostic studies and medications for treatment.  

This WATS was unique in that it was a jointly supported endeavor by the WAO, the public/governmental healthcare system, and a private non-governmental organization- VALE. VALE is a 32-country mining company, with 40 physicians who care for their 3000 employees and families in Mozambique, offering an excellent private health insurance. They are dedicated to improving the health, not only of their employees, but also of the entire population of Mozambique. While the WAO supported the travel expenses for 15 physicians traveling from up to 2500 km away, VALE paid for an additional 15 travel grants and helped with the overall food and hotel costs. Sociedade Medica de Mocambique provided all of the local conference planning under the guidance of Ms Shiela Amaro, was also very generous in donating many hours of planning, staff, and financial support of this WATS program. And a special thanks to Dr. Ralph Cash (husband of Dana Wallace) who served to facilitate the workshops, assist with IT, and serve as the WAO photographer. But most of all we owe a huge "Thank-you" to Amanda Hegg of the WAO staff as it was only through her excellent guidance, planning, and coordination that we were able to achieve this astounding success. It is this type of collaboration that makes for a successful program, permits WAO to stay within their budget, and sets the stage for continued development of resources for education of healthcare professionals that can help to meet the unmet needs for patients with allergy and asthma.