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Crisis info 4: 25 April

Mozambique

The overall situation has in many ways slowly stabilized. The cholera outbreak is coming to an end. Life in many parts of Beira and the flood-affected Provinces of Zambezia, 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 still huge needs in terms of shelter and food with now 72,793 people across 65 displacement sites in Manica, Sofala, Tete and Zambezia.

Monitoring the health situation remains important as people are still vulnerable and other consequences of the disaster can emerge. Malnutrition is not at an emergency level, but malaria is a potential concern. Large areas of stagnant water could result in increased mosquito numbers and therefore malaria transmission, and the cyclone struck just before the harvest season so food availability will continue to be an issue.

Water remains a real concern across the flood and cyclone affected areas of Mozambique. While 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, fixing the water network, and disinfecting and repairing wells.

MSF, Doctors Without Border, Cyclone Idai, Mozambique, Beira, well cleaning
To reduce the risks of contaminated water, MSF is cleaning wells in different locations in Beira.
The wells were flooded during the cyclone, and as a result, people use this dirty water for their households. Photo: Giuseppe La Rosa/MSF

Cholera: Activities and response

The government-led and international cholera response was very quick and comprehensive. Collectively the actions of the Government and international organisations helped avoid what could have been a massive outbreak.

MSF teams 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. After the declaration of the outbreak MSF rapidly set-up multiple treatment centres, started water and sanitation activities in the community and supported the government-led vaccination campaign.

After the declaration of a cholera outbreak on 27 March, the Ministry of Health, with the logistical and technical support of MSF (among others), completed an emergency one dose cholera vaccination in the flood affected areas. The vaccination campaign, which ran from the 3rd to the 10th of April and with a coverage of over 98%, together with the efforts to increase and improve the supply of clean water across the affected region brought down the number of cholera cases dramatically over the past two weeks. That said, we continue with cholera prevention efforts as we still have few cases being reported daily.

MSF, Doctors Without Borders, Cyclone Idai, crisis info
In Tica (Nhamatanda district), MSF team set up two tents for patients suffering from cholera. MSF also installed a generator as there was no electricity and is rehabilitating the health centre.
Photo: Mohammad Ghannam/MSF

MSF provides support the MoH to treat cholera cases, but we have reduced many of our activities in light of the reduction in cases. Currently, MSF has a 40 bed CTC (Cholera Treatment Centre) in Beira and CTUs (Cholera Treatment Units) in Dondo (20 bed) and Buzi (4 bed). All these facilities are expected to be closed or handed over to the MoH by end of the month.

MSF also runs community-based activities to tackle the last remaining cases of cholera and limit the possibility of a resurgence of the outbreak. The activities include providing clean water, improving sanitation, distribution of soap and other hygiene items, as well as health promotion. In addition, MSF is rehabilitating health structures, distributing non-food items such as soap and blankets in areas with difficult access, running mobile clinics to provide primary health care (including malaria and malnutrition screening) and providing mental health care.

Despite the successful actions thus far, the risk of a resurgence of cholera still remains. In particular, we remain concerned about flood-affected towns and villages outside of Beira city, where access is difficult. MSF has already set up cholera-treatment capacity in five such towns or villages.

The main ongoing activities of MSF are: mobile clinics OCB in Beira and OCG in Buzi, medical support and health care provided in hard to reach villages in Nhamatanda district (OCP), rehab of hard to reach health centers (OCBA in the Dondo area), distributions of hygiene kits and continuing to help the authorities with clean water provision (OCA in Beira).

MSF has installed a water treatment unit in Chingussura, one of the previously cholera-affected neighbourhoods in Beira to provide up to 7,500 litres of clean water per hour. MSF also set up a water treatment unit in Dombe to provide water for a settlement camp. This was essential for the control of cholera but is also important for general health. In Buzi, MSF is also providing clean water to the community: up to 130,000 litres of water is extracted daily from the nearby river and cleaned and treated to make it drinkable, and then made available at 10 locations throughout the city.

Zimbabwe

MSF’s second phase interventions for Cyclone Idai in Chimanimani, eastern Zimbabwe are drawing to a close. We are planning to exit on 30 April 2019.

Recent interventions include the oral cholera vaccination (OCV) campaign which started on 16 April 2019 and officially ended on 24 April 2019. A total of 128251 people (91.6%) were vaccinated in Chimanimani while 334761 people (100.3%) were vaccinated in Chipinge as of day eight. MSF provided technical and logistical support during the campaign.

MSF interventions in the second phase also included 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, mentoring and training for nurses and village health workers in selected clinics in Chimanimani.

MSF, Doctors Without Borders, Cyclone Idai, Zimbabwe
Health promotion in Chimanimani, Zimbabwe. Photo: GloriaGanyani

Group and individual mental health consultations in clinics and seven settlements for internally displaced people (IDPs) were held in Chimanimani. Many survivors of Cyclone Idai suffered from trauma and mental stress in the aftermath of Cyclone Idai. A total of 597 people were consulted during group sessions while 26 people received individual consultations from 2 April to 22 April 2019.

MSF also provided water, sanitation and hygiene (WASH) support in Chimanimani hospitals and IDP camps, as well as conducting an assessment in those areas and in 3 over the 23 wards of the district. Health promotion activities were also done to promote good water, sanitation and hygiene practices to prevent water-borne diseases. MSF has also been supporting the shelter cluster in providing standards and design for watsan facilities.

Malawi

MSF has finished its interventions in Makhanga on the 11th of April.

As part of the wrap up meeting our response kindly find the link of the article that got published last Monday (22nd April 2019) in The Nation: https://mwnation.com/voice-from-the-floods/