A recent surge in violence in Mozambique's Cabo Delgado province has displaced thousands of people already affected by five years of conflict. At the same time, Mozambique is currently at great risk of extreme weather events, with an annual tropical storm cycle that leaves people with little time to recover between storms.
On top of that, many people in Cabo Delgado are now extremely vulnerable due to displacement and a lack of access to medical care. In the past two weeks, local authorities have reported more than 20 attacks on four villages, with 2,800 homes damaged or destroyed by fire.
The current crisis is concentrated in the centre of Cabo Delgado, particularly in Meluco and southern Macomia districts. Since late January, more than 14,000 people have been forced to leave their homes on account of the escalating conflict and are now in search of safety and the basic means of survival. This is the largest wave of displacement in several months.
Violent attacks and ongoing insecurity have driven thousands of people from their homes at the very moment the cyclone and rainy season is setting in. Raphael Veicht, head of MSF's emergency unit
"Violent attacks and ongoing insecurity in several districts of central Cabo Delgado have driven thousands of people from their homes with nothing but what they can carry, at the very moment the cyclone and rainy season is setting in," says Raphael Veicht, head of MSF's emergency unit.
"This is a very dangerous combination. Our teams are responding to the new waves of forced displacement by providing people with basic healthcare as well as much-needed household and shelter items. We are extremely concerned about the protection of civilians within this acute and escalating conflict," says Veicht.
Last week, Tropical Storm Ana – the first tropical storm of the season – made landfall in Mozambique's Nampula and Tete provinces. Displaced people in Cabo Delgado province will be extremely vulnerable to future tropical storms, as many are living without shelter, clean water or sanitation. Storms frequently cause flooding, which significantly increases the risk of outbreaks of life-threatening communicable diseases such as malaria and diarrhoeal disease.
In central Cabo Delgado province, many displaced people have now congregated in small villages and towns, such as Mitambo, Ancuabe and Nanjua, where MSF teams have been running mobile clinics and distributing food, shelter and hygiene kits for 800 families since late January. However, these villages lack the basic infrastructure to sustain so many people, especially clean water, shelter and access to medical care.
"In Mitambo, where we conducted mobile clinics and food distributions, the situation became very tense as more and more displaced people arrived in the village," says Jean-Jacques Mandagot, MSF project coordinator.
"Some were sleeping in fields while others were sheltering in thatched-roof houses left empty by residents who had already left for somewhere safer. Some people stayed for one night and moved on looking for safer areas, while others stayed longer because they lacked the means to keep going," says Mandagot.
There is no permanent health centre in Mitambo and the village lacks vital infrastructure, such as supplies of drinking water. Previously, residents travelled to a health centre in a nearby village, but with the current insecurity, people have had to travel much further and at greater risk – while some people could not access healthcare at all because they could not afford to travel or were unwilling to take those risks. As a result, our mobile clinics in Mitambo in late January had to fill the gaps.
"Each day, our team provided more than 200 medical consultations, and we treated more than 2,000 patients in a single week," says Mandagot. "We've seen a lot of people with malaria, coughs, fevers and diarrhoea. Many patients also have physical pains in their legs and backs from their harsh journeys fleeing danger.
"One man told me he had lost all his possessions – his house, his stores of food – leaving him with nothing. He said he was now forced to beg for food, and that he no longer wanted to be near his village or anywhere that would remind him of the life he had lost."
On 26 January, a village nearby Mitambo came under attack and shots were heard, leading people to move further south toward Maua village in search of safety. Hundreds of thousands of people are currently impacted by the violence in Cabo Delgado province, which has escalated over the past five years.
With the onset of the rainy and cyclone season, the cumulative impact of years of conflict and the worsening humanitarian emergency, it is more important than ever that MSF teams have unrestricted and safe access to the area so that they can provide people with much-needed medical care.
"It is absolutely crucial that medicines and medical supplies can be imported speedily, without bureaucratic delays, so that MSF can scale up the provision of lifesaving healthcare in Cabo Delgado province," says Veicht.
MSF has been working in Mozambique since 1984. For more than 30 years, our teams have responded to medical and humanitarian emergencies countrywide, including HIV, TB, malnutrition, malaria, cholera, natural disasters, COVID-19 and people displaced from their homes by conflict. In Cabo Delgado province, we respond to emergencies and help to fill gaps in healthcare, often working alongside health authorities and other partners.