MAPUTO – By now, over 400,000 people from Mozambique’s northern province of Cabo Delgado have been displaced according to government estimates announced last week. After fleeing violence from ongoing attacks by armed groups and military actions from Mozambican forces, these displaced people now face serious health risks and inadequate living conditions, says Médecins Sans Frontières (MSF).

“Approximately 10,000 displaced people arrived by boat to the provincial capital of Pemba last week alone,” said Joaquim Guinart, MSF project coordinator in Cabo Delgado. “They were dehydrated. Women gave birth at sea.”

“There have been cases of severe, potentially fatal, diarrhoea,” said Guinart. “There’s a lot of pressure on local medical staff, as 20,000 people have arrived throughout the last month and more will continue to come.”

Approximately 100,000 internally displaced people have sought refuge in and around Pemba in temporary shelter sites, such as school buildings, or with host families, increasing the city’s population by a third. Many displaced lack clean drinking water and are exposed to malaria with barely any protection, while they remain in unsanitary, crowded conditions, increasing the risk of an outbreak of measles, diarrhoea or COVID-19.

With no end in sight, the fighting that started in October 2017 has continued to increase in intensity. It has forced almost a fifth of the province’s people to leave their homes and reduced access to care and other services in the area to almost nothing.

MSF had to suspend our medical humanitarian activities in Mocimboa da Praia in March, followed by Macomia in May, after an insurgent attack during which the health centre in Macomia where MSF staff worked was ransacked and burned. It is estimated that more than 20 local health facilities have been destroyed during the conflict.

We have relocated our base to the city of Pemba, where we have been providing medical assistance to arriving IDPs and the host community. Even so, we are struggling to continue our activities in Cabo Delgado due to administrative constraints and COVID-19 travel restrictions, which forces us to work with minimal capacity while needs continue to grow exponentially.

MSF started a mobile clinic in Metuge district in September and, due to the constant new arrival of IDPs, a second mobile clinic was launched on 28 October. We hope that this second mobile clinic will reach more people in more remote districts in the coming weeks. MSF is also providing water and sanitation assistance at IDP sites and health facilities, and running the diarrhoea treatment centre in Pemba.

With the support of partners, MSF is building 150 latrines and restoring 27 manual water pumps and five water systems in the Metuge district, ensuring access to safe water ahead of the upcoming rainy season. However, these activities only address a fraction of the area’s growing needs.

“MSF is deeply concerned about the continued violence and deteriorating conditions in Cabo Delgado and the quickly growing number of displaced people, especially with the onset of the rainy season,” said MSF Head of Mission for Mozambique Alain Kassa. “The basic needs of the displaced people remain largely unmet despite existing efforts to provide humanitarian assistance.”

“If no immediate action is taken, this situation will rapidly deteriorate,” said Kassa. “MSF calls upon the Mozambican authorities for support to mobilize additional humanitarian staff and supplies without delay.”