Violent attacks in Cabo Delgado, Mozambique: “It was like the end of the world”

Metuge, Cabo Delgado Province, Mozambique

Mozambique 2020 © MSF

In recent months, resource-rich northern Mozambique has become the epicenter of social and economic tensions, with devastating consequences for the population. In February, at least 200,000 people were forced to flee conflict in Cabo Delgado, Mozambique’s northernmost province. Since then, numerous attacks by armed groups on villages across the region have uprooted thousands more from their homes.

During an insurgent attack on May 28, 2020, four Doctors Without Borders/Médecins Sans Frontières (MSF) staff members were working at the health center in the town of Macomia just before it was ransacked and burned. All roads were blocked in and out of the town as insurgents entered the village. The only way to escape the violence was to flee into the bush.

That day, twenty-seven MSF staff living in Macomia fled with the rest of the town’s population, dodging stray bullets as the combat intensified around them. No MSF personnel were killed during this incident, but the trauma they lived is very real.

Metuge, Cabo Delgado Province, Mozambique
Mozambique 2020 © MSF

“The only way to escape was through the bushes at the back of the hospital. I ran from the area when I heard shooting around Macomia. The entire town was running towards the bush.

We were at least a thousand people—men, women, elderly, children, the sick and their caregivers—all running away from the sounds of shooting. It was like the end of the world.

People were running through thick forest. This was wild bush with a lot of thorns. People were thirsty and hungry, there was no water in that area, just stone and hills.

People were trying to stop and rest, but the helicopters were flying very close.

The road to Licangano wasn’t easy—there were numerous hills. It was up and down. Many old people, sick people, and kids could not manage to jump over the obstacles, or to climb the steep cliffs. Many kids were lost in the panic…

I saw a woman with a baby trying to get down the hill. She could not manage without help, so she left her baby above and lowered herself over the ledge. At that moment, heavy shooting started nearby. The woman was yelling for help—pleading for someone to pass her baby to her. No one could help her.

People were running…terrified.”

Mozambique 2020 © Audrey Hulet

No official report provided the number of civilians killed or wounded during the attack. MSF has received unverified reports of at least 15 dead, including multiple children, some due to starvation as they hid in the bush for days to escape the fighting. We did not have access to the area immediately after the attack. Some of our staff were allowed back to survey the damage and begin the process of suspending operations in Macomia due to the heightened security risks.  

After Cyclone Kenneth ripped through the north of Mozambique in April 2019, MSF helped rebuild and renovate the Macomia health center and medical lab. During the May 28 attack, that lab (pictured here) and health center were completely destroyed.  

Macomia Health Center
Mozambique 2019 © MSF
Macomia Health Center
Mozambique 2020 © MSF

The Macomia health center provided vital medical services for a population of 29,000 people. MSF provided support in the form of human resources: 27 people including nurses, a pharmacist, water sanitation and hygiene teams, drivers, and guards.

In the midst of the ongoing violent conflict, little access to health care and poor living conditions continue to exacerbate the already dire situation for thousands of people in northern Mozambique.

MSF is committed to supporting displaced people throughout Cabo Delgado Province. Our role is clear: To provide humanitarian and medical assistance to the people that need it most. But to do so, we must be able to guarantee the safety and security of our medical teams, patients, and facilities.

MSF in Mozambique
Following continued violent attacks, MSF has suspended activities in Mocimboa da Praia and Macomia. However, we continue to work in Cabo Delgado province. Today, supports the cholera treatment center in Metuge, having built two latrines and provided four nurses to respond to the increased needs and population size. Our teams are making assessments for future activities to support the response of local authorities, as the number of displaced people in and around Pemba continues to grow. MSF in Mozambique MSF has been present in Mozambique since 1984. In the city of Pemba we support health authorities in improving access to water and sanitation as well as responding to possible outbreaks of diarrhea and cholera. MSF is also present in Maputo and Beira, caring for people with advanced HIV, tuberculosis, hepatitis and other vulnerable people. Across all projects, MSF supports Mozambique’s Ministry of Health in its response to the COVID-19 pandemic through the implementation of preventative measures, including infection control, triage, and surveillance.