The northern province of Cabo Delgado is one of Mozambique’s most volatile regions. An intense conflict began in the region in October 2017, which has resulted in some 800,000 people fleeing from their homes.

These are the latest developments.

1. The violence has moved south, leading to new mass displacement

Throughout June, fear of violence followed by confirmed attacks have triggered panic and mass movements of people from areas that were previously considered relatively stable, such as Ancuabe and Chiure districts, near the provincial capital of Pemba. More than 30,000 people are thought to be on the move as a result of the ongoing wave of violence.

This is the largest movement of displaced people so far this year. Many people have fled multiple times, forced on each occasion to abandon their few possessions and means of survival.

Over the past year, Mozambican armed forces and regional allies have increased their presence in a number of regions. The hotspots of the violence have shifted geographically, and people have begun to return to places that were previously under attack or under the control of non-state armed groups.

The situation remains very fluid. Médecins Sans Frontières (MSF) teams are distributing relief items in various locations where people are sheltering following recent attacks, including Ntele, in Montepuez district, where more than 1,000 families arrived in late June. Most people arrived with few or no possessions and experiencing great psychological distress.

So far, MSF teams have distributed 701 kits containing essential relief items including tents, jerrycans, cooking pots and mosquito nets. Our teams continue to provide assistance in areas where we have established projects, such as Macomia, Mueda and Palma.

2. People's humanitarian needs are enormous, but aid is in short supply

Some areas in Cabo Delgado province are already hosting large numbers of displaced people and now must adapt to a new influx of arrivals. This has an impact on local communities. In most places, the humanitarian aid available is massively insufficient for people’s needs.

Overall, there are many vulnerable people with substantial humanitarian needs. People are in need of healthcare, water and sanitation services, and food. In some of the hard-to-reach areas, particularly in northern and central areas of the province, assistance is incredibly limited.

In the districts where we are working, people have had their lives overturned by fear of attacks, counter-attacks and unpredictable eruptions of violence. In some areas, we are the only international humanitarian organisation working there on a permanent basis, despite the clear need for much more aid. 

Many people avoid the towns at night because they feel they will be safer out in the fields and the bush. But in staying outside overnight they face other dangers, like malaria. In Macomia, four out of every 10 adults coming to our clinics in May, and eight out of every 10 children, tested positive for this deadly disease. 

Across the province, specialist care for chronic medical conditions, such as HIV, is often unavailable, despite the prevalence of these diseases. In Mueda, a hill town in the north of Cabo Delgado province, where our teams work in the local hospital and run mobile clinics, we have seen the condition of many patients worsen after their treatment was interrupted.

3. The crisis is taking a heavy toll on people's mental health

The Cabo Delgado crisis is far from over. With the violence continuing unabated, hundreds of thousands of people are suffering from the effects of fear, violence and displacement – both in terms of their physical and their mental health. Almost everyone in the region has experienced trauma of some kind during this conflict, from witnessing or experiencing violence or losing their loved ones or their homes.

As long as we can ensure that our teams are safe, we will continue to strive to reach the people with the greatest needs in Cabo Delgado province, wherever they are. With such huge humanitarian needs, it is critical that people can access assistance.