Mozambique | Preview #6 for hands holding the line...
At a pediatric HIV clinic in Nampula, a boy runs his fingers across bottles of antiretroviral treatment. He mouths words inaudible, tracing long names he cannot yet read. He swings from the door handle, peers into my lens, then looks up as an adult hand slips a note to the nurse. He does not know about the long-standing relationships that local organizations AMASI and Ovarelelana have built with this clinic, ties that opened the space for me to stand here with a camera. My photographs, too, are part of that exchange. Perhaps he does not even know why he is here: maybe a caretaker is collecting ART for him, or for another sibling. These transactions float above his head. For him, play remains intact, ordinary yet strangely out of place within the clinic walls.
Children, for the most part, live outside this calculus of exchange. They do not negotiate favors to access HIV testing, ration pills, or consider program targets. Yet they inherit the outcomes of adult choices: a father who reappears but neglects a child's treatment, an aunt who takes in another mouth to feed, a caretaker who negotiates discretion within the household so that adherence can continue. And as programs falter under constrained budgets, adults are left with fewer good options to care for children who slip between imagination and harsh realities.
For adults, exchange is constant. Outreach workers often frame HIV prevention talks as favors, trading moments of attention for a chance to test. Sex workers double as educators, their activism intertwined with labor. Families seek not only food or transport, but dignity. Patients remind providers that without them, no program exists. These transactions cut both ways – sometimes reinforcing stigma, sometimes pressing for care that restores respect.
In Mozambique, the HIV response moves through these transactions, visible in polos stamped with donor logos, in whispered negotiations at clinic doors, in the silent arithmetic of who is given a snack before the pills are taken. Dependency seems to make sense in an economy that has long stalled for the majority of people, but it also exposes the fragility of social safety nets with too many holes.
The brightest moments come where these worlds overlap—when play drifts into the clinic, when conversations begin not with ledgers or targets but with humor, respect, and humanity that soften the daily grind. In these serendipitous encounters, not in transactions alone, the possibility of ending HIV feels most alive. Perhaps it is providence, but the light quite literally breaks through in these images as I review them, revealing stories born of the world of exchange yet illuminated by the intangible: whimsy, passion, connection, and love.
About this article:
- Learn more about the work of local organizations mentioned in this article.
- Part of the hands series: Previews of the people and themes at the center of the response to HIV.
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