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Crisis Info 2: 5 April

Mozambique

Situation

The cyclone has had a devastating impact on people living in flood- and cyclone-affected areas. There are already serious medical and public health needs, and we expect these needs to continue in the coming weeks with cholera and other water-borne diseases, skin infections and respiratory tract infections already present in the community continuing to spread. Some areas of the flood-affected area are still cut off and receiving little to no assistance.

Given the sheer scale of needs, many humanitarian organizations have deployed in Beira and the other affected areas. MSF is focusing on providing medical care and in particular treating cholera which is a very contagious and potentially deadly disease and can spread rapidly without proper isolation and community education activities. Our teams are not only in the health centres and cholera treatment centres caring for patients with cholera but also out in the community explaining, how families can protect themselves and treat their own water and what they should do if they fall sick.

MSF, Doctors Without Borders, Cyclone Idai, Mozambique

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Water remains a real concern across the flood and cyclone affected areas of Mozambique. Whilst city water supplies have returned to many of the flood and cyclone affected areas, thousands still struggle to access clean water. MSF health promotion teams working in the community to help people access clean water and stay safe have heard of stories of people drinking the stagnant water from the side of the road or even taking it from disused community latrines. As such our water and sanitation teams are out in the community putting in water points and assessing existing ones. A dedicated water treatment unit has been installed by MSF in Chingasura, one of the more cholera-affected neighbourhoods in Beira and another is being set up in Dombe (Manica province) in order to provide clean water to IDP camps in the area.

We are also concerned about a possible increase in malaria cases as flood waters recede and the malaria season approaches. With lots of water around and people sleeping rough and unprotected the risk of malaria is already increasing

The extensive damage to the health infrastructure and to medical stocks means support will be required to meet the health needs of the people in disaster-affected areas. The immediate consequences of the cyclone will require a large response, but the normal functioning of the health system must also be maintained; mothers still need to deliver babies safely, people still need vital medication for chronic illnesses as well as HIV and TB.

MSF, Doctors Without Borders, Cyclone Idai, Mozambique

The situation on Cholera outbreak: 

MSF’s cholera response, in support of the Ministry of Health, was very quick – as quick as could be realistically be considered given the supply and access constraints in the days after the cyclone. We were treating patients suffering from acute watery diarrhea suspected to be cholera as well as working in the community to find those suffering from the illness as early as 21 March.

The authorities also took the fundamentally life-saving action of prioritizing restarting Beira city’s water treatment unit as a high-priority action as the start of the response. This is now providing clean water to a large part (though not all) of the city.

Because of these quick response actions by the authorities (restarting the cyclone-damaged municipal water system) and by MSF (immediately supporting the Ministry of Health to ensure appropriate treatment was available as soon as the first patients started presenting with cholera-like symptoms), the number of cases of cholera in Beira has rapidly stabilized, rather than increasing to a rapid high peak of cases as might have been expected in the worst case scenario. . Nevertheless, deterioration is certainly still possible at this stage of the outbreak and we must remain vigilant.

There are still new patients every day falling ill from cholera or suspected cholera and the MSF and MoH staff in the treatment centres are caring for many patients each day.

Response

Beria

  • Our teams are running three cholera treatment centres (CTCs)  in Chingussura, 100 beds – with expansion capacity if needed, Macurungo 100 beds, and Mar Azul 80 beds – as well as one cholera treatment unit (CTU) in Munhava with 50 beds capacity.
  • Running an ambulance and referral system to ensure that suspect patients are taken to the closest CTC with available beds
  • Supporting the Ministry of Health with logistics, planning and technical support or a large-scale cholera vaccination campaign that aims to reach every resident of Beira (MSF will not conduct the vaccination but is supporting with cold chain and ensuring the vaccinations get where they need to go on time).
  • Installed water treatment plant at Chingussura to provide clean water for the health centre, CTC and the local community.
  • Running oral rehydration salt (ORS) points in the community so those who are not too sick can avoid adding to the workload of the treatment centres
  • MSF is running water and sanitation (WASH) and health promotion (HP) in the poorest areas of Beira to talk about the risks of cholera and help the community protect themselves
  • Supporting the care of patients with advanced HIV in the emergency room of the Beira Hospital (first activity of the regular project to restart)
  •  Mental health support for the Mozambican staff who went through the trauma of the cyclone as well as the community.
MSF, Doctors Without Borders, Cyclone Idai, Mozambique
Ruins of the health centre after Cyclone Idai. Photo: Mohammad Ghannam/MSF

Buzi

  • Rehabilitate the health centre and make it fit
  • Working on the supply of clean water in the community
  • Health promotion and psych-education to the community to explain the psychological symptoms that people might be experiencing after the trauma of the cyclone and flooding
  • Construction of a 10-bed cholera treatment unit that will be used should cases be detected in Buzi.
  • Providing peri-natal care in the community as well as supporting the local midwives at the hospital
  • Supporting the Ministry of Health with a cholera vaccination campaign from 03 April. This will entail logistical support as well as the actual vaccination and will target all residents of Buzi. It is expected to last a full week.  

Dondo

  • Supporting the MoH to care for cholera patients in a 20-bed CTU, operational from 03 April
  • Providing primary health care at the Dondo Health Care Center
  • Supporting the Ministry of Health with a cholera vaccination campaign from 04 April. Currently, this consists of limited logistical support only.
  • Helping to rehabilitate the health centre to make it fit for purpose. Support is specifically being provided to the destroyed maternity ward and to the emergency room.
  • Assessments of needs in rural areas, for potential small rehabilitation of health structures and NFI distribution.
  • Mobile clinic activities are operating in Chibuabuabua, Tundane and Mutua.
MSF, Doctors Without Borders, Mozambique, Cyclone Idai
Karin Huster, MSF’s medical referent for the mobile clinics and the medical community outreach work, listens to Isabel Wenha,
health promoter, during a visit to the community in the slum of Matope in the Munhava district of Beira city. Photo: MSF/Pablo Garrigo

Dombe

  • Setting up a water treatment station to provide clean water to people living in IDPs camps around Dombe
  • Assessment of medical needs in IDPs camps in Dombe
  • Epidemiological surveillance for Malaria, AWD, Mental health and malnutrition.
  • Assessments of needs in cut-off areas like Mossurize (Manica province)

Macharote

  • Primary health care in the Macharote health care centre
  • Helping to rehabilitate the health centre which was really heavily destroyed by the floods and cyclone

Mafambisse

  • Preparing for a possible cholera outbreak with the construction of a 20-bed CTU, expected to open from 05 April
  • Providing primary health care at the Mafambisse Health Care Center
  • Supporting the Ministry of Health with a cholera vaccination campaign from 04 April. Currently, this consists of limited logistical support only
  • Helping to rehabilitate the health centre to make it fit for purpose
MSF, Doctors Without Borders, Mozambique, Cyclone Idai
Health promotion training for the community health workers who will visit and sensitize the population of Beria city’s
Mapote neighbourhood, in Munhava district, which was particularly badly affected by Cyclone Idai. Photo: MSF/Pablo Garrigos

Matua

  • Preparing for a possible cholera outbreak with the construction of a 20-bed CTU
  • Providing primary health care at the Mafambisse Health Care Center
  • Supporting the Ministry of Health with a cholera vaccination campaign from 04 April. Currently, this consists of limited logistical support only
  • Helping to rehabilitate the health centre to make it fit for purpose

Maputo

  • MSF provides specialized care for patients suffering from advanced HIV and co-infections such as TB, DR-TB¸ hepatitis C and Kaposi Sarcoma.

Tica

  • Preparing for a possible cholera outbreak with the construction of a 20-bed CTU in Tica
  • Epidemiological surveillance for Malaria, AWD, Mental health and malnutrition.
  • Supporting the Ministry of Health with a cholera vaccination campaign in Nhamatanda district (Sofala province) from the 4th of April
  • Assessments of needs in the 17 health centres in Nhamatanda district

MSF has been working in Mozambique since 1984. We have responded to epidemics and natural but in recent years our main medical activities have been focused on the fight against the dual HIV/TB epidemic in the country.