On one occasion, I conducted infection control training for all employees. After realizing how important cleaning, which they used to sweep and wipe by rote, was in connection with hospital infection, the cleaning staff felt proud of their work. They give a thumbs-up every time they see me.

- What is the project that you are currently working on in Mozambique?

“Quelimane Central Hospital, where I am currently working, was built with Korea’s Economic Development Cooperation Fund (EDCF). Due to a lack of experience, it was having difficulties operating a general hospital independently. To solve the problem, Korea has been providing systematic hospital operation consulting and training since 2016 with the support of the Korea Foundation for International Healthcare (KOFIH) and the Inje Industry-Academic Cooperation Foundation.
I, as a nursing professional, focus on supporting vulnerable hospital departments and medical staff. I identify the problems of hospital operation and provide short-term supplementation and improvement and survey the additional long-term support needs through monitoring. This is my second dispatch to Mozambique, following 2019."

- What made you go to Mozambique, and how did you adapt to the country?

“I first came to a small town called Quelimane in Mozambique through a recommendation two years ago. I was dispatched without a good understanding of the region due to the urgent local situation. Because of the absence of local officials and an interpreter, I was the only Korean in town. Although I was at a loss because I couldn’t understand the language, I decided to break through it head-on, and I guess my determination connected. I was able to carry out the task through active cooperation with local colleagues. As a matter of fact, communicating with them and carrying out tasks in English without an interpreter helped me grasp the work quicker than I expected.”

- What was your first impression when you arrived in Mozambique?

“What surprised me when I arrived here was that locals swept their houses and streets every morning and evening and took great care in dressing up. Even the hospitals were surprisingly cleaner than expected. People here may be poor, but they clean themselves, take good care of their bodies and minds, and always enjoy their lives. Their bright and shy smiles and pure hearts brought me back here.”

- What was the most urgent matter when you visited the site?

“The most urgent matter to correct was infection control. They sweep and wipe the floor and hallways of the hospital rooms every day, but medical devices used for patients were left uncleaned and full of mold and moss. Even basic medical practices such as disinfection and injection disposal disregarded the aseptic environmental control, exposing patients to the risk of nosocomial infections.
To raise awareness of the serious nature of the situations, I notified the risk of infection to all hospital staff, including doctors and nurses and even cleaning and administrative personnel. I educated them on the proper use of medical devices and environmental control. I also designated infection control personnel in each department to coordinate overall medical equipment and environmental management and created a checklist to take a systematic approach on infection control in hospitals.”

Nurse Lee Won-hwa dispatched to Mozambique to strengthen the healthcare capabilities of Quelimane Central Hospital

- What is the health status of Mozambique, and what needs to be improved?

“According to the current health indicators of Mozambique, life expectancy is 55.9 years on average, the birth rate is 38.6 per 1,000 population, and the fatality rate of COVID-19 is 1.3%. With 0.08 doctors and 0.40 nurses and midwives for every 1,000 population, Mozambique has the fewest healthcare professionals per 1000 population in Africa.
Quelimane Central Hospital is the only quaternary hospital in Zambezia Province. Its facility and environmental control is well managed with the continued support of this project. However, many areas are still vulnerable, and we need help to improve the hospital system, including a system to evaluate patient conditions, such as pain, nutrition, and bedsores; the medical staff training program for blood transfusion patient management and reading image test results, and; medical device management.
In particular, I’ve observed the reuse of disposable products such as syringes, infusion sets, and nebulizer kits since the COVID-19 pandemic. The biggest obstacle to infection control is the lack of medical resources, and we need an urgent solution. In that regard, departments which required active technical support—emergency rooms, intensive care units, gynecology and internal medicine wards, delivery rooms, and blood banks—were selected as priority vulnerable departments, and we are providing essential job competency training for each division, such as CPR, wound management, blood transfusion management, and medical device management.”

- Have you experienced any changes in the field?

“The project has provided the continued dispatch of nursing and medical experts in the development of management strategies and consulting for the Quelimane Central Hospital for years. As a result, we have seen each department of local hospitals recognize the importance of education and the possibility of developing medical technology that can achieve equality with other countries. Such achievements do not come from the effort by the dispatched person alone but by active cooperation between the KOFIH head office and local medical staff.
When I first came here two years ago and started training the locals, many thought that it was a waste of time to attend the training sessions that did not generate any revenue. But now, even if they run into me by chance in the hallway, they say they were waiting for my advice and ask me to come over to their department. They now know that the training is not only theoretical but also practical, which can be applied to actual medical practices and environments. Employees attending the training know how useful the sessions are.
Whenever I see the local staff making improvements day by day on using medical devices, such as patient monitors, infusion pumps, and ventilators, which were rarely used before, I realize the importance of education once again and feel rewarded for my job. I believe that the little seeds we planted will eventually become fruits.”

- Please tell us about your dream as a person who strives for healthcare around the world.

“The cooperation and consciousness of responsibility that Korea showed in medical development in developing countries, which I saw while staying in different countries as a nursing professional expatriate for ODA projects, were of great significance to me. Based on my experiences in various fields, including clinical practice, I want to live a life that has a positive influence everywhere through medical care.”