How local heroes are reshaping disability care in Mozambique

In the quiet village of Carapira, in Mozambique’s Monapo District in the Nampula Province, 72-year-old Rosário Lima sits with his family, peeling cassava under the afternoon sun. His grandson, six-year-old Kelve Jaime, plays nearby—running, laughing, and moving with the natural energy of a young child. But this simple scene of family life masks a remarkable journey of transformation, persistence, and hope—one that reflects the challenges faced by many families across Mozambique, where it is estimated that approximately one in ten children under five years old live with some form of disability.

Born seemingly healthy, Kelve’s progress took an unexpected turn when severe malaria struck just 15 days after birth. Though he recovered from the immediate illness, his family soon noticed something wasn’t right. Kelve struggled with basic movements and was unable to sit up properly. His mother and grandparents watched with growing concern as their child failed to reach expected developmental milestones.

“We spent three years without any intervention,” Rosário recalls, his voice heavy with the memory. “We went to traditional healers looking for solutions and never found any...we gave up.”

The family’s desperation grew as they exhausted every option they knew. They faced not only the challenge of Kelve’s condition but also the harsh sting of community discrimination and gossip. Like many caregivers across Monapo District, they felt isolated, unaware of other families facing similar challenges in their community.

Things changed the day they received a visit from Domingos Amisse, a community health worker with the Association of People With Disabilities Mozambique (ADEMO) Monapo. He had been going door-to-door, delivering soap and basins to caregivers of children with developmental delays—a simple but intentional way to build trust and identify children in need. When he saw Kelve, he didn’t just see a child with disabilities. He saw possibility.

“He promised to visit the next day,” Rosário remembers, his eyes brightening at the memory. True to his word, Domingos returned. He carefully assessed Kelve’s condition, asked detailed questions, and did something no one had done before—he offered a clear path forward.

Through PATH’s partnership with ADEMO-Monapo, Domingos could connect the family not just to physiotherapy services at the Monapo District Hospital but to a whole network of support they never knew existed.

This life-changing moment represents the broader impact of PATH’s partnership with ADEMO-Monapo, supported by the Conrad N. Hilton Foundation. Since 2019, this collaboration has helped 913 children in Monapo District alone, bringing hope to families in even the most remote areas, where health care staff are scarce.

ADEMO-Monapo’s work extends far beyond individual home visits. Through technical collaboration with Light for the World and OREBACOM, its local partner in central Mozambique, it has become the only organization in Nampula Province—home to 6 million people—with expertise in producing low-cost supportive chairs for children with cerebral palsy.

Volunteers are trained to monitor child health cards, ensuring families access essential preventive services and that health facilities maintain proper records. This attention to detail at the community level helps identify and address gaps in the local health system that might otherwise go unnoticed.

For Kelve’s family, Domingos became a regular presence, bringing not just medical guidance but practical solutions. Through the adapted Ubuntu parenting program, simplified for use by community volunteers in Nampula by PATH, the family learned techniques perfectly suited to their daily life.

“They taught us how to make toys for children,” Rosário explains, his face brightening. “Kelve had a toy car, which helped him to walk flexibly.”

The program’s holistic approach addressed not just Kelve’s physical needs but the entire family’s well-being, with group sessions on childcare, nutrition, and developmental support—all taught in everyday language that made sense in their community’s context.

The results have been nothing short of remarkable.

“What Kelve was before is not what he is now,” says Rosário, beaming with pride. “In the past, he only sat in one place and did everything in the same place, but now he can walk and play with others without any problem.”

The impact extends beyond just one family. Throughout Carapira’s Anticuane community, people now ask how Kelve learned to walk, creating opportunities to share information about available services. What once seemed like an insurmountable challenge has become a beacon of hope for other families facing similar situations. PATH and ADEMO’s work now reaches across all 17 health areas in Monapo District and has recently been scaled up to three additional districts in Nampula Province, addressing the root causes of childhood disability—from poor antenatal care to chronic malnutrition.

PATH and ADEMO-Monapo’s commitment to understanding and addressing community needs runs deep. Even as they provide direct services, they are conducting research to better understand the challenges faced by families of children with hydrocephalus who need surgical care at the provincial hospital. This combination of hands-on support and evidence gathering ensures their work continues to evolve and meet the most pressing needs of the communities they serve.

“We’re speechless with gratitude,” Rosário says, watching his grandson play. Kelve’s story represents hope for countless other children who could benefit from similar interventions. Through the dedication of community health workers like Domingos, and the powerful partnership between PATH and ADEMO-Monapo, vital services are reaching those who need them most, transforming lives one family at a time.