Health-care needs in poor areas are huge
Weather, conflict make MSF’s job difficult
MÉDECINS sans Frontières has been providing health care in Cabo Delgado, one of the poorest and most isolated regions of Mozambique, since February 2019. Early activities were rapidly disrupted by Cyclone Kenneth and replaced with emergency response to displacement and cholera.
Since then, MSF has been building up health-care activities. Bruno Cardoso, MSF’s project co-ordinator, has just returned from Mozambique and has shared more about the situation and what MSF does there.
Cabo Delgado is an extremely poor and neglected province, 2600km north of the Mozambican capital, Maputo.
People in Cabo Delgado face violence, extreme weather events and weak public services, including very limited access to basic health care. The needs are huge.
It is a region with a lot of natural resources, such as rubies, oil, timber and gold, and huge economic potential. However, these resources and its location on the border with Tanzania have left the province rife with illegal activities including drug and ivory smuggling. This situation has seriously deteriorated since the work began to extract one of the largest liquid natural gas reserves in the world.
In late 2017, attacks perpetrated by a poorly-understood insurgency group started to spread south from the far north of the province to other parts. Since then, there have been almost 300 attacks and about 700 people have been killed.
Health care in Cabo Delgado is, in general, worse than in the rest of Mozambique, which already has poor health indicators. Many medical staff have fled the region, leaving health centres deserted.
As a result, access to health care is extremely limited compared to the province’s health needs, especially related to malaria, malnutrition, respiratory diseases and antenatal care.
When MSF arrived, one of our first actions was to improve the triage system – patients with severe conditions had been waiting in the same line as those with less serious issues.
After rehabilitating several parts of the health centre that had been damaged during the cyclone, MSF tackled some of the key structural issues in the centre, like electricity and waste management, to make it better prepared to receive a higher number of patients.
The small fee which patients must pay when entering the health centre remains a barrier to our providing care to those most in need of it.
Security is still a big challenge and we are struggling to access all those in need.
In Mocimba de Praia, we are currently setting up activities to support the local hospital, in the hope that this will enable us reach another part of the province.
For MSF, this is just the start; we are looking to expand to areas where needs are the greatest. But we need to be realistic – the needs are great and we are the only hands-on medical organisation working in Cabo Delgado’s conflict zone. We will have to continue focusing on areas where we can have a real impact.
MSF will always try to go into these kinds of insecure environments, but that does not mean we can access those most in need. In some places, the roads are too dangerous or the violence too unpredictable.
We regularly review and update our strategies in this very volatile context and build in restrictions to ensure the safety of our teams.
Patients with severe conditions had been waiting in the same line as those with less serious issues