In November, a non-state armed group carried out multiple attacks in Nampula province, Mozambique, triggering the third and largest wave of displacement in the north of the country in months.
This wave of displacement is part of a broader humanitarian crisis caused by the eight-year-long conflict in Cabo Delgado, which has periodically spilled over into neighboring provinces, including Nampula. Over 100,000 people have fled their homes in recent weeks, according to the latest data from the International Organization for Migration. In total, over 300,000 people have been forcibly displaced in northern Mozambique since late July.
In response, Doctors Without Borders/Médecins Sans Frontières (MSF) launched a three-month emergency intervention in Eráti district, Nampula province, to address people’s escalating humanitarian and medical needs. Since December 4, MSF teams have been providing medical care and essential services in areas of Eráti district with the highest concentration of displaced families.
Torn between safety and seeking medical care
Since January, a consortium of 23 humanitarian partners have distributed cash and voucher assistance to people across Mozambique. As of October, Nampula had the largest number of organizations operating, with presence in Cabo Delgado, Tete, Gaza, Manica, Niassa, Inhambane, and Sofala, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA).
While some displaced families have begun returning home, it is not always because they feel safe or ready. In certain cases, the difficult decision is based on access to humanitarian assistance, despite the danger.
José Maurício Alige, who is displaced from Mazua, said people were told they could only receive assistance in their home areas. “But people are afraid to go back. They are still carrying the nightmare in their hearts.”
Some people hop on vehicles that take them back to their villages to access aid, only to come back to transit centers afterwards. Others prefer to remain in displacement sites despite the dire living conditions, citing ongoing insecurity, destroyed homes, and lost livelihoods.
“It’s better to stay here and be hungry than go back,” says Carita Varine, who fled repeated attacks in Memba district.
This approach to aid distribution leaves people without assistance at their point of greatest vulnerability, while also exposing them to further harm. It also undermines the principles of neutral, needs-based humanitarian assistance.
MSF is providing medical consultations, maternity services, nutrition support, and psychosocial counseling in the Alua Velha, Alua Seda, and Miliva transit centers. In terms of health conditions, malaria remains the leading cause of consultations, followed by acute diarrheal diseases, respiratory infections, and skin conditions. In collaboration with the Ministry of Health, MSF is also supporting vaccination campaigns to protect displaced families from preventable diseases.
“Between December 4 and 15, we have conducted over 860 medical consultations,” says Emerson Finiosse, an MSF medical doctor. “There is a high prevalence of malaria, with over 30 percent positive cases among the people who reach us.”
“Also, many women who come to our mobile clinics for prenatal consultations are receiving this care for the first time,” says Finiosse. “This is a worrying indicator of the state of the health system even before sudden displacements occur.”
Environmental conditions complicate health care and sanitation efforts
The ongoing rainy season is also causing public health concerns, with a cholera outbreak confirmed in the districts of Eráti and Memba. In response to critical water and sanitation needs, MSF is constructing emergency latrines and water points. Our teams have also rehabilitated an unused well in Miliva, ensuring safe drinking water for the community. Twelve new water taps have been installed in Alua Sede, which have capacity to serve 1,800 people per day.
The lack of adequate shelter forces many displaced people, most of whom are children, to sleep in open spaces or informal arrangements, exposing them to harsh weather and disease.
Access to food also remains one of the most pressing needs. Our teams are witnessing the challenges faced by displaced people and the mounting pressure on host communities, highlighting the urgent need for transparent, neutral, and needs-based humanitarian assistance delivered to people where they are.
Amid global funding cuts, the humanitarian system is increasingly unprepared to effectively address both the immediate and long-term consequences of the crisis in northern Mozambique.
MSF in Cabo Delgado
In Cabo Delgado, MSF runs projects in Mocímboa da Praia, Macomia, and Palma, and is supporting the response to a cholera outbreak in Nanlia. We provide general outpatient consultations, emergency care, maternity and pediatric services, treatment for HIV and tuberculosis, and mental health and psychosocial support.
In the first half of 2025, we carried out nearly 100,000 outpatient consultations and conducted group mental health activities for over 35,000 people. We run mobile clinics and outreach activities, refer patients to health centers, and support medical facilities and hospitals in collaboration with the Ministry of Health.
