## Humanitarian Crisis Deepens in Northern Mozambique Northern Mozambique continues to grapple with a profound humanitarian crisis, exacerbated by persistent insecurity and the resulting displacement of vast populations. In December 2025, a significant surge of violence, attributed to the armed group Islamic State Mozambique, forced over 100,000 individuals to flee their homes in Memba district. Many sought refuge in the neighboring Eráti district within Nampula province, arriving under extremely challenging circumstances. These newly displaced families, without formal camps, largely depended on the generosity of host communities, who, despite their own limited resources, shared their homes, food, and land. This situation placed immense pressure on already fragile local services, particularly healthcare, leading to a high risk of disease outbreaks. Reflecting on this period, Josefina Pedro, a resident of Alua Sede, vividly described the arrival of people with "fear and exhaustion written on their faces," noting that many had "nowhere to go and nothing to eat." Her account underscores the compassionate response from locals, like herself, who opened their doors, often hosting multiple individuals and sharing what little they possessed, embodying a powerful spirit of solidarity in the face of widespread suffering. ## MSF's Critical Emergency Response in Eráti In response to this escalating crisis, Médecins Sans Frontières (MSF), also known as Doctors Without Borders, launched an urgent 12-week intervention in Eráti district. The primary goal was to provide essential primary healthcare and emergency services to both the displaced and host communities in areas most affected, specifically Alua Velha, Alua Sede, and Miliva. This intervention was crucial at a time when existing local health facilities were critically overwhelmed and struggling to meet the escalating health demands of the expanded population. The scale of the need was immense, with MSF teams deploying mobile clinics to reach remote communities, delivering over 18,000 medical consultations throughout the emergency period, peaking at more than 2,000 consultations weekly. Notably, children comprised nearly two-thirds of all patients, highlighting the particular vulnerability of young populations in such crises. Abdullahi Chara, MSF's emergency medical coordinator, emphasized the critical nature of the initial weeks. "Health facilities were already under-resourced when the influx of people started increasing," he noted, underscoring the precarious situation that quickly deteriorated with the onset of disease outbreaks. The capacity to manage multiple health crises simultaneously was severely lacking, creating an urgent demand for external support. ## Battling Major Health Threats: Malaria and Cholera During the emergency, MSF teams confronted a spectrum of urgent health needs. Malaria emerged as the predominant illness, accounting for over half of all consultations. This high prevalence is typical in tropical and sub-tropical regions like Mozambique, especially in areas with poor sanitation and crowded conditions, which facilitate mosquito breeding and disease transmission. The teams conducted more than 11,000 rapid diagnostic tests for malaria, revealing an alarming positivity rate of 63 percent, indicating widespread infection. Alongside malaria, respiratory infections, diarrhoeal diseases, and various skin conditions were also common, often exacerbated by poor living conditions, lack of clean water, and inadequate hygiene practices in overcrowded temporary settlements. Adding to the complexity, a cholera outbreak was officially declared shortly after the displacement surge began. Cholera, an acute diarrhoeal infection caused by ingesting contaminated food or water, spreads rapidly in settings with compromised sanitation and limited access to safe drinking water, making displaced populations particularly susceptible. MSF swiftly supported the Ministry of Health's response, establishing a dedicated cholera treatment center in Alua Sede and providing training for local health staff to manage cases effectively. Furthermore, comprehensive water, sanitation, and hygiene (WASH) activities were implemented, including constructing emergency latrines, rehabilitating existing water sources, and ensuring the provision of safe drinking water to affected communities. These measures are vital in containing cholera outbreaks and preventing further spread. ## Beyond Acute Illness: Holistic Care and Community Engagement While focusing on immediate life-saving interventions, MSF's response also encompassed broader healthcare services. These included providing essential antenatal care for pregnant women, crucial for ensuring healthy pregnancies and safe deliveries, and offering family planning services, which empower individuals to make informed choices about their reproductive health. Mental health support was also integrated, acknowledging the severe psychological toll that conflict, displacement, and loss can have on individuals and communities. Additionally, MSF carried out extensive health promotion activities, reaching tens of thousands of people with vital information on disease prevention, hygiene practices, and accessing care, thereby empowering communities to take proactive steps towards improving their health. ## Deep-Rooted Barriers to Healthcare Access Persist Despite the temporary relief provided by MSF's emergency response, the underlying structural deficiencies in healthcare access in northern Mozambique remain a significant concern. For many, the ability to receive timely and free medical care is not a given. Isabel Carlos Pereira, a woman displaced from Memba, shared her challenging experience: "Back in my village, we have to pay for consultations and medicines, and sometimes there are no drugs available at the health centre." She further noted that often, people are instructed to purchase medicines from private pharmacies, a prohibitive cost for many families already struggling with poverty. This sentiment was echoed by host community members like Josefina, who described the MSF mobile clinic as "something like a hospital nearby" – a level of accessible care she had never experienced before. The sheer distance to health facilities and the prohibitive cost of transport present formidable barriers. Laura Mário Freda, a resident of Miliva, explained that reaching the nearest health center in Alua Sede could cost between 150 and 250 meticais. "If someone is very sick, mototaxi drivers sometimes refuse to transport them because they are afraid the person will die on the way," she added, highlighting the grave challenges faced. The presence of a mobile clinic, she concluded, was "like a dream," offering immediate access to medical advice and treatment previously unavailable. ## Transitioning Services and Lingering Challenges As the most critical phase of the crisis subsided and many displaced individuals began returning to their areas of origin, MSF concluded its emergency intervention and formally handed over activities to the Ministry of Health. However, this intervention starkly illuminated the longstanding structural gaps in healthcare provision, particularly in remote and underserved regions. These communities continue to confront significant hurdles in accessing not only medical care but also essential medicines and other basic services. MSF emphasizes the urgent need for sustained, coordinated, and needs-based humanitarian responses in a region continually marked by insecurity. A troubling observation during the response was that access to humanitarian assistance often seemed linked to returning to areas of origin. This dynamic inadvertently led some families to go back despite ongoing fear and uncertainty. MSF stresses that humanitarian aid must be provided solely based on need, without any conditions or pressure on population movements, especially during a protracted crisis. The organization reiterates its unwavering commitment to delivering essential healthcare, guided by principles of neutrality, independence, and impartiality, striving to address both immediate emergency needs and the chronic, deeply entrenched gaps in access to care that continue to affect countless lives in northern Mozambique.