Crisis info 3: 15 April
One month after the cyclone, the overall situation has in many ways slowly stabilized. Life in many parts of Beira and the flood-affected Provinces of Zambesi, Sofala and Manica has in many ways returned to normal. Many Health centres, schools and other services have re-opened and the streets and markets are busy with life and trade. There are however still huge needs in terms of shelter and food with over 160,000 people still sheltering in accommodation centres and camps after having been displaced from their homes in the flood and cyclone affected region.
Two weeks after the declaration of a cholera outbreak on 27 March, our worst fears about a widespread outbreak in Beira seem to have been averted. The Ministry of Health, with the logistical and technical support of MSF, has now completed an emergency one dose cholera vaccination in the flood-affected areas and it is hoped that when combined with the efforts being made to improve the supply of clean water across the affected region, the transmission of cholera will soon be brought to a close. That said, there is no time for complacency as new cases of cholera are still emerging in Beira, Dondo, Tica and Buzi and patients still need medical care.
MSF is continuing to support the Ministry of Health to address the ongoing cholera outbreaks in Beira, Buzi, Nhamatanda district and Dondo as well as to prepare for possible further outbreaks in other locations like Mafambisse and Matua. In Beira, MSF has begun to scale down cholera treatment activities and is moving from three purpose-built cholera treatment centres as well as a cholera treatment unit in a Ministry of Health health centre (total of 350 beds in Beira) to just the one 100 bed centre and one cholera treatment unit operated in partnership with the Ministry of Health. This is in line with the drop in the number of cases. Outside of Beira, MSF maintains the 20-bed units available for cholera treatment in both Dondo and Tica and a 12-bed facility in Buzi and has two prepared in Matua and Mafambisse just in case.
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. 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 Chingussura, one of the more cholera-affected neighbourhoods in Beira. This is important not only for the control of cholera but also for general health.
MSF has now returned to full capacity providing care for patients with advanced HIV, as well as to those with a statistically high risk of HIV, including sex workers and men who have sex with men in Beira. Whilst, the teams are still mapping the changes and challenges brought about by the cyclone it’s clear that many patients did not access medication for some time and that others were pushed to take bigger risks in order to find food and shelter.
According to the Government of Mozambique, 602 people have been confirmed dead – data as at 8 April 2019
The number of houses destroyed or damaged stands at 239,682, including 111,163 houses totally destroyed, 112,735 partially destroyed, and 15,784 flooded. At least 160,927 people were still sheltering in 164 accommodation sites across Manica (43); Sofala (113); Tete (5) and Zambezia (3) as of 8 April according to government figures.
The total number of registered cholera case reached 3,577 cases on 8 April with 416 new cases reported across the flood and cyclone affected areas, according to the Ministry of Health.
The Oral Cholera Vaccination campaign had reached 745,609 people as of 8 April, representing 82 per cent of the target. More than 715,000 hectares of crops were destroyed at the beginning of the main harvest period, raising concerns for rising food security.
MSF supported teams have so far treated well over three thousand patients suspected of having cholera in the flood-affected areas of Mozambique. The official number of cholera cases as of 8 April was 3,577.
Zimbabwe was hit hard by Cyclone Idai on 15 March 2019. The cyclone caused massive flooding and landslides affecting tens of thousands of people. Many lives were lost while property and infrastructure was destroyed. According to the Civil Protection Unit (CPU), more than 181 people died throughout the country (169 in Chimanimani only), more than 330 went missing (328 in Chimanimani) while about 21 940 were displaced in Zimbabwe (11 255 in Chimanamani).
MSF’s intervention started on 16 March in Chimanimani and Chipinge. MSF doctors and nurses together with other health service providers delivered medical assistance to survivors of Cyclone Idai and provided essential items and basic water and sanitation interventions. On March 21, MSF gained access and set up services at Chimanimani Rural hospital where, in addition to medical screening and treatment, provided medicines for chronic conditions. MSF also managed to access other health centres in Chimanamani either on foot or bicycles or motorbikes and covering distances between 12 to 30 kilometres.
In Chipinge, where MSF has worked since 2016, we supported in the provision of aqua-tabs, essential medicines and NCD’s medication for diseases including Diabetes, Hypertension, and Asthma. MSF is also assisting with psychosocial support to affected communities; through Psychological First Aid (PFA), Training of Trainers on basic counselling skills and identification trauma, anxiety, depression and grief.
MSF technical and logistical plans are underway in support to the Ministry of Health and Child Care in the upcoming Cholera vaccination campaign in Chimanimani from the 15th of April. MSF is worried about the post-cyclone impact including access to safe water in IDP and priority areas, fear of outbreak, mental health concerns and lack of access to NCDs medication.
Nearly one million people have been affected by the Cyclone Idai, and 83,000 people are displaced overall. Nsanje is the worst affected district, with 14 of Malawi’s 28 districts experiencing severe flooding. Rivers broke out of their banks leaving many houses fully submerged and around 11,000 people displaced. To date, official figures confirm 56 deaths, 577 injured and 3 missing.
Since 7th of April, MSF has focussed its support to the Makhanga area in Nsanje’s East Bank, one of the worst affected areas only reachable by boat. An MSF team is supporting Makhanga health centre with essential medicines and human resource support to ensure the continuation of primary health care and HIV consultations and to strengthen the surveillance system.
An outreach clinic was also organised and health promotion activities are being done in the different communities. Given the concerns around outbreaks of water-borne diseases, a big priority of the intervention is on water and sanitation. The team is cleaning the affected boreholes and is setting up latrines and showers. Moreover, the distribution of basic hygiene kits was organised for all households in this area. MSF’s intervention is anticipated to last for another week.