Since 2017, there has been protracted crises in the Northern region of Mozambique due to climate disturbances and ongoing conflict. While the Cabo Delgado territory has faced endemic insecurity over the last few years, the situation has deteriorated drastically in recent months as militant extremists purge several towns and villages, uprooting thousands. As the fragile humanitarian situation in Mozambique deteriorates, millions of people are also faced with increasing food insecurity, the effects of drought and the impacts of Covid. An intensification of violence has caused mass displacement and at least 1.3 million people are projected to need urgent humanitarian support. Many families have been forced to separate due to the rapid nature of the insurgencies, the majority of arrivals to humanitarian centres are women and children who have been separated from other family members, showing physical and mental signs of severe trauma.

The northern region of Mozambique has experienced instability for many years, however, since 2017 multiple insurgencies by the local al-Shabah militia have forced thousands to flee their homes.  The militia has gained traction across the region by recruiting younger citizens who are disenfranchised by high levels of poverty and unemployment. Conflict has mainly taken place in Cabo Delgado province, 697,538 persons had officially been displaced by violence in this region by May 2021 and there continues to be an exodus of movement to neighbouring provinces. The country is still recovering from two tropical cyclones, Cyclone Idai and Cyclone Kenneth, which affected over 2 million people. By March 2020, humanitarian assistance had been provided across 73 resettlement locations, providing support to 99,000 people affected by the environmental crisis, yet there remains widespread disruption and displacement which has been further exasperated by the insurgencies earlier this year. More recently, nearly 12,800 people (43% being children), have dispersed to the districts of Mueda, Montepuez, Nangade and Pemba in search for safety. There have been continuing attacks in the region, with the most recent being an assault on the town of Palma in March. Thousands of civilians were killed under a 12-day siege by al-Shabah and from this attack alone it is estimated that 600,000 USD a month is required for adequate humanitarian assistance. According to Human Rights Watch (HRW), many of those displaced have had to pay bribes in order to be evacuated, forcing many to trade in their remaining financial resources in order to be taken to safety.

The IOM health team spoke to local leaders in surrounding resettlement sites in Montepuez and detailed critical health needs among the population. The resettlement sites are located more than 10km from the closest health centres, and so care provisions are restricted. It is estimated that 36% of health facilities in the Cabo Delgado province have been damaged or destroyed and in the areas most affected by the conflict there are no operational health facilities.  Humanitarian access has been limited in the region as ongoing violent insurgencies in Cabo Delgado has meant the boundaries of conflict are continually shifting. As a result, delivery of aid has been largely sporadic and humanitarian corridors from the region have been difficult to establish.

In terms of food supply, humanitarian access is currently limited and crops in the region are exposed to extreme climate variabilities which has disrupted food production. This has further extended the crisis, as basic supplies for those who are displaced are extremely limited. The UN Refugee agency has called for Mozambicans fleeing the ongoing violence to be given asylum in Tanzania. However, the UNHCR and partners have received continuous reports that thousands of asylum seekers have been pushed back at the border. Meanwhile, humanitarian partners in Mozambique are currently scaling up their support in Cabo Delgado and since the beginning of 2021, they have assisted more than 500,000 individuals impacted by the violence. Resources have been extremely stretched and the humanitarian appeal for the crisis is currently only 1% funded, concurrently, the security situation in the area is declining rapidly and many humanitarian evacuation flights from the area have been forcibly suspended. 

There has been a significant increase in the number of COVID-19 cases since the beginning of 2021. It has been estimated that around 50% of all COVID-19 deaths recorded in Mozambique since the onset of the pandemic occurred in January this year, which has been accredited to the rapid spread of new variants in the region. Health workers have struggled to treat the number of COVID-19 patients, particularly as IDP shelters are severely overcrowded and there are ongoing sanitation issues. In 2020, the ICRC partnered with other NGOs to rehabilitate the COVID-19 centre in Pemba and in 2021, nine primary health facilities have been restored to help manage the outbreak and other complex health needs in the region. Mozambique is currently a core champion for the ‘People’s Vaccine for COVID-19’ advocating for equal access to patents and research. However, while the World Health Organisation has persistently called for equal vaccine distribution, only 0.1% of the doses currently administered worldwide have been provided in low income countries. Amalgamated with the ongoing conflict in the region and climate risks, Mozambique is faced with intersecting health and social crises which need to be further addressed by the humanitarian community.

While the reasons for this conflict are undoubtedly multifaceted and intricate, the consequences of these violent insurgencies are felt by human beings who are already having to adapt to ongoing climate emergencies in the region.  This is a protracted crisis that needs to be addressed holistically, the need for aid is likely to increase across the year and it is imperative all aspects of the crisis are addressed concomitantly before the situation escalates further.