Natural disasters, population displacement and health emergencies: multiple public health threats in Mozambique

Abstract

In early 2019, following the 2015-2016 severe drought, the provinces of Sofala and Cabo Delgado, Mozambique, were hit by Cyclones Idai and Kenneth, respectively. These were the deadliest and most destructive cyclones in the country's history. Currently, these two provinces host tens of thousands of vulnerable households due to the climatic catastrophes and the massive influx of displaced people associated with violent terrorist attacks plaguing Cabo Delgado. The emergence of the COVID-19 pandemic added a new challenge to this already critical scenario, serving as a real test for Mozambique's public health preparedness. On the planetary level, Mozambique can be viewed as a 'canary in the coal mine', harbingering to the world the synergistic effects of co-occurring anthropogenic and natural disasters. Herein, we discuss how the COVID-19 pandemic has accentuated the need for an effective and comprehensive public health response in a country already deeply impacted by health problems associated with natural disasters and population displacement.

Keywords: environmental health; epidemiology; public health.

Figure 1

Number of hydrometeorological events and number of people affected in Mozambique between 1956 and 2020. Source of data: EM-DAT (Emergency Events Database), International Disaster Database, Centre for Research on the Epidemiology of Disasters/UCLouvain 2020 Université Catholique de Louvain, Brussels, Belgium. Available at https://public.emdat.be/.

Figure 2

Path of Cyclone Idai (A) in the central region of Mozambique and of Cyclone Kenneth (B) in the far north of Mozambique. (A) Cyclone Idai formed as a tropical depression in the Mozambique Channel on 5 March 2019 and moved over the mainland on 4–9 March, causing heavy rains that resulted in floods in the Mozambican provinces of Zambézia and Tete and in southern Malawi. Idai then moved back eastwards towards the Mozambique Channel, where it gained strength to become a tropical cyclone. On 13 March, Cyclone Idai began moving west again and made landfall during the night of 14–15 March in the central region of Mozambique, affecting the provinces of Sofala, Manica, Zambézia, Tete and Inhambane. It continued to move westwards up to eastern Zimbabwe. (B) Cyclone Kenneth formed in the north of Madagascar and east of the Aldabra Atoll, north of the Mozambique Channel. On 25 April 2019, Kenneth made landfall in Cabo Delgado Province, on the extreme north of the Cabo Delgado and Nampula provinces. Source: Météo-France Réunion. Available at http://www.firinga.com/influences?influ=mozambique, accessed on 22 April 2021.

Figure 3

Monthly frequency of diarrhoea cases reported in 2018 and 2019 in Beira, Búzi, Dondo and Nhamatanda districts (Sofala Province) and in Pemba and Macomia districts (Cabo Delgado Province).

Figure 4

Monthly frequency of suspected and confirmed malaria cases reported in 2018 and 2019 in Beira, Búzi, Dondo and Nhamatanda districts (Sofala Province) and in Pemba and Macomia districts (Cabo Delgado Province).