One month after Cyclone Chido, the struggle to start over

The aftermath of the cyclone has brought another layer of complexity to the situation in Cabo Delgado, a province already devastated by years of conflict. Attacks and military operations continue unabated in different areas of Cabo Delgado, and more than 570,000 people are still displaced by the conflict that started in late 2017. In addition, Mozambique is considered to be one of the countries most vulnerable to the climate crisis, and Cabo Delgado is an area prone to cyclones, tropical storms, and floods, which appear to be increasing in frequency and intensity. The psychological impact has been profound.

“Any gust of wind frightens me,” says Abudo Chuado, whose family is now living in an improvised shelter made of straw and sticks in the community of Nanguasi, Mecufi, a district in northern Mozambique that was highly affected by Cyclone Chido. “I fear something similar will happen again.”

“Most of the time, I feel sad,” Chuado says, adding that he has nightmares every night. ”Not knowing what to eat and living with the uncertainty of tomorrow leaves me feeling powerless.” Other residents in Mecufi who have also lost loved ones, material possessions, and livelihoods describe experiencing headaches, difficulty sleeping, and other health issues.

The mental toll of constant disaster

“Many people in the communities are traumatized by the tragedy, and are searching for strength to cope with the situation,” says Basílio Jamal, an MSF mental health counselor who is part of the emergency response team in Mecufi. 

Since the last week of December, MSF has been providing mental health activities in some affected communities to help people cope with the disaster's aftermath. MSF is also providing support to health care workers, as “[they are] often directly affected by disasters, which makes the work of caring for others even more difficult,” Jamal explains.

“Some people experience nightmares and difficulties eating or sleeping,” says Jamal. “Some people say that every time they try to sleep, memories of the moment of destruction resurface. For those who lost family members, the work of rebuilding their lives is even more challenging. With the support of mental health sessions, people [get tools] to confront this harsh reality.”

According to official data, the cyclone has damaged 52 health care facilities, destroying roofs, equipment, and medicines, and leaving many structures barely functional at best. The medical staff who remain are overwhelmed and working with limited resources. 

“People have lost everything,” says Beatriz Cardoso, mental health promoter. “We try to understand each person’s circumstances to address their mental health needs individually.”

Since the start of MSF’s intervention, MSF teams have carried out counseling sessions and psychological first aid trainings for 32 staff from the Ministry of Health and community health agents, as well as psychoeducation and psychosocial groups and individual consultations with 106 survivors in different locations of Mecufi district.

Recurring cyclones pose constant health challenges

Chido is only the most recent devastating cyclone to hit Mozambique in recent years. In 2019, cyclones Idai and Kenneth both struck within weeks of each other. Kenneth was particularly impactful in Cabo Delgado, where it left tens of thousands of people displaced. In 2023, Cyclone Freddy made landfall twice across different provinces and became one of the longest-lasting and most intense storms ever recorded, leading to various cholera outbreaks.

“The urgency of integrated responses addressing not only the physical needs but also the mental well-being of affected communities is critical to ensuring that vulnerable populations can recover and rebuild their lives in the face of increasingly frequent climate disasters,” says Luisa Suárez, MSF medical coordinator.

Beyond mental health, MSF is helping to rehabilitate the Mecufi health center by donating emergency kits, installing safe water systems, and performing electrical repairs. These activities are essential to restoring services such as the maternal health and delivery, so that patients do not have to be referred to distant health structures. Between December 30 and January 5, 845 outpatient consultations were provided here, and 145 patients were treated for acute watery diarrhea and 68 for malaria. Both malaria and acute watery diarrhea are common diseases following climate disasters, due to the breeding of mosquitoes in stagnant water and lack of access to clean drinking water

Teams are also conducting awareness activities on the prevention of these diseases. So far, 367 people have participated, and MSF has started supporting another health center, in Nanlia town of Metuge district, also a heavily impacted area.

MSF in Cabo Delgado

MSF has been working in Cabo Delgado since 2019, assisting people affected by the conflict through community services and support to health facilities. We currently work in Palma, Mocímboa da Praia, Mueda, Muidumbe, and Nangade districts.