João Mindo: A PEN-Plus Success Story

For three years, João Mindo had difficulty walking, eating, and even breathing. It wasn’t until a PEN-Plus clinic opened in rural Mozambique that he received his diagnosis: rheumatic heart disease. Following mitral valve repair surgery in Maputo, the 14-year-old (pictured above with his older brother, Lazaro) now receives care close to home.

“When I got sick, I couldn’t play. My heart would beat so fast. Since my heart surgery, I’m fine, and I can run and play.”

Meet João Mindo, a 14-year-old living with rheumatic heart disease in a rural area of northern Mozambique. João lives with his widowed mother and three siblings in a home with neither electricity nor plumbing. The family’s only means of support is his mother’s small-scale farming.

João’s health problems began in 2020. For three long years, he had difficulty walking, eating, and even breathing. It wasn’t until February 2023, when a PEN-Plus clinic opened at Nhamatanda Rural Hospital, 20 kilometers away from his home, that João finally received a diagnosis: rheumatic heart disease.

“We were told he needed surgery for his heart condition,” said João’s older brother, Lazaro. “My mother was heartbroken João had received such a serious diagnosis, and she had difficulty accepting that he needed surgery. I told her we had to pursue treatment for him.”

The severity of his condition meant João would have to travel 800 kilometers to the south, where he could undergo mitral valve repair surgery at ICOR (Heart Institute) in the capital city of Maputo.

Complicating matters was the fact that João’s family had lost their identification papers in 2019, when cyclone Idai devastated the area. Without those papers, João could not travel to Maputo.

“The lack of resources in the area often means we have to solve one problem before we can confront the next,” said Dr. Ana Mocumbi, a cardiologist who co-chairs the NCDI Poverty Network. “João didn’t have the identification papers required to fly in Mozambique, so we had to make him exist on paper before he could travel for his surgery.”

The PEN-Plus Partnership provided all the necessary support for João to undergo surgery, which included help in obtaining identification papers, travel arrangements to Maputo, and negotiating an agreement with Lazaro’s school to ensure he could continue his studies while accompanying his brother to Maputo.

João and Lazaro stayed in the capital for three months, during which João underwent a successful surgery and recovered well. The brothers are now back in their hometown with their mother.

Access to essential medicines is often a significant health barrier in rural Mozambique. The PEN-Plus program ensures that João has consistent access to lifesaving chronic care for his condition, including specialized treatment and medicine. This has not only improved his health but also alleviated his family’s financial pressures.

“I will forever be grateful that everything went well,” Lazaro said, “and I expect João to have a healthy life.”

In rural Mozambique, where noncommunicable diseases often go undiagnosed and untreated, João’s story highlights the importance of specialized treatment, access to lifesaving medication, and financial support to ensure that young people like João can defy the odds.

Written by Ivanilson Abilio, membership and engagement manager of the Maputo Co-secretariat of the NCDI Poverty Network.