By December 2023, according to UNHCR, close to 710,000 people were internally displaced in Mozambique as a result of conflict, tropical cyclones and flooding.

Responding to cholera outbreaks and natural disasters

From January to February, we worked with local authorities, other organisations and communities to help control the spread of cholera in Niassa province, especially in remote areas where access to healthcare was limited. Our activities included setting up and strengthening cholera treatment units in eight locations, treating patients, training health workers, and running health promotion initiatives to raise community awareness about the effects of the disease and preventive measures. We also donated medicines and medical equipment, including cholera beds, hygiene kits for patients’ families, water purifiers, antibiotics and oral rehydration salts. Following the launch of a vaccination campaign by the Ministry of Health and a decrease in the number of cases in Niassa, we handed over these activities to provincial authorities.

In April, we responded to an outbreak in Nacala-Porto, Nampula province, by implementing measures to improve infection prevention and control in a cholera treatment unit, constructing a temporary morgue and emergency waste zone, and installing water and sanitation facilities. We also conducted staff training.

In February and March, Cyclone Freddy made two landfalls in Mozambique, affecting over one million people. A total of 183 people lost their lives, and 123 health facilities were destroyed. Within two weeks of the second landfall, over 8,000 cholera cases were reported in Zambezia province. This was the worst cholera outbreak in the country in eight years.

In response, our team set up four cholera treatment centres (CTCs) in the city of Quelimane. As well as providing support with treatment, and training for medical and non-medical staff, we donated medical equipment and medicines. In April, we handed over these activities to health authorities following the launch of a vaccination campaign and a reduction in cases in the province.  

We also responded to cholera in several districts in Cabo Delgado, where we set up CTCs, trained medical and hygiene staff, and donated medical and logistical material.

Between February and March, following heavy rains in Maputo province, the Umbeluzi River burst its banks, causing intense flooding.  We immediately sent teams to distribute hygiene kits and tents to displaced people, and supported medical, water and sanitation activities.

Assisting people affected by conflict

Since 2017, conflict between armed groups and government and allied forces has continued to displace and traumatise thousands of families in Cabo Delgado province, in northern Mozambique. By December 2023, over 540,000 people remained displaced, while 600,000 previously displaced people returned to their areas of origin. There are still urgent humanitarian needs across Cabo Delgado that remain largely unaddressed for both displaced people and returnees, especially regarding access to food, water, shelter and basic services, including health and education.

The conflict has had a significant impact on people’s mental health, with many traumatised after witnessing murders, kidnappings and sexual violence. Families returning to their areas of origin often have the same needs as those who remain displaced, as they have lost their homes and livelihoods. We rehabilitated health centres that were destroyed by the conflict, supporting the Ministry of Health to re-open general health centres. In Mocimboa da Praia we opened a transitory provincial hospital in a closed school, as the hospital was destroyed.

MSF has been working in Cabo Delgado since 2019, delivering healthcare to people displaced by the conflict or returning to their homes, through community-based services, fixed and mobile clinics, and support to health centres and local hospitals in Macomia, Mocimboa da Praia, Mueda, Muidumbe, Palma and Nangade districts. We offer a wide range of services, including general and specialised healthcare, mental health support, sexual and reproductive healthcare, health promotion, and patient referrals. We also work to ensure access to safe water and effective sanitation and waste management, and distribute essential relief items, such as soap, jerry cans and cooking kits.

We are also supporting the Ministry of Health to restart HIV/tuberculosis programmes disrupted by years of conflict, and to improve the delivery of health services by increasing biomedical, laboratory and pharmacy management capacity. In Macomia, Mueda and Mocimboa da Praia, our teams support general healthcare and 24-hour emergency services, including maternity care and ambulance referrals to Pemba provincial hospital.

Treating diseases

In Beira, Sofala province, we offer sexual and reproductive healthcare, including safe abortion care, HIV testing and treatment for vulnerable and stigmatised groups, such as adolescents, sex workers, transgender women, and men who have sex with men. We also provide care for patients with advanced HIV at healthcare facilities in the city.

Our team in Beira Central hospital has been working to ensure early diagnosis and treatment to improve the management of opportunistic infections in people living with advanced HIV. Since 2021, we have extended this project to 10 health centres in Beira, where we provide support for sexual and reproductive healthcare, and diagnosis and treatment of advanced HIV, as well as mentor Ministry of Health staff.

In Mogovolas district, Nampula, we have been working with the Ministry of Health since 2022 to improve access to healthcare for vector-borne, water-borne and neglected tropical diseases, focusing on severe malaria and other febrile illnesses, schistosomiasis, lymphatic filariasis and scabies. We have mobile teams working in general healthcare facilities and communities, as well as in a laboratory.

In general healthcare facilities, we provided training and mentoring for Ministry of Health staff. In communities, we organise health promotion and case finding, and facilitate peer support groups. We also offer physiotherapy to patients with chronic lymphoedema of the limbs, one of the consequences of lymphatic filariasis, a disease caused by infection from parasites. Meanwhile, a laboratory team in Nametil supports blood bank management and diagnosis.