FLASH APPEAL MAY - DECEMBER FOR COVID-19 2020 MOZAMBIQUE MOZAMBIQUE Overview Map Tanzania Cabo Delgabo 211,485 IDPs Hospital Zambia Niassa Provincial de v Cabo Delgabo vLichinga Hospital Malawi Nampula Tete v Hospital Central Nampula 3,581 Hospital 14,752 IDPs v Provincial de IDPs Tete Zambezia 22.600 IDPs Manica v 54,405 Hospital De IDPs Quemane Hospital De Sofala Zimbabwe Chimoio v Beirav Gaza Inhambane \ Population Density tete Inhambane (People per Sq.Km.) v South Africa Health Facility v Centr v Xai Xai Pro v Maputo T I ovince M \vChamanculo Maputo City I vHospital De Eswatini Machava The designations employed and the presentation of material in the report do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Displacement figures provided by IOM Displacement Tracking Matrix (DTM) COVER PHOTO IOM health staff and community health workers lead community education and mobilization 2 activities for COVID-19 prevention practices such as frequent hand washing, in Mandruzi resettlement site, March 2020. Photo: IOM / Zohra Mohamed Omar Hanif FLASH APPEAL COVID-19 Table of Contents 22 Nutrition 04 Foreword by the Humanitarian Coordinator 24 Protection 26 Shelter & NFIs 05 Flash Appeal at a Glance 27 Water, Sanitation & Hygiene (WASH) 06 Executive Summary 28 Coordination & Common Services 29 Logistics 07 Overview of the Crisis 31 Annexes 09 Strategic Objectives 32 Methodology for People in Need & Targeted 33 Participating Organizations 10 Response Strategy, Coordination, Capacity & 35 Projects Constraints 41 Acronyms 10 Response Strategy 41 Endnotes 10 Coordination Mechanisms 10 Humanitarian Capacity & Access 11 Constraints, Challenges & Risks 11 Prevention of Sexual Exploitation & Abuse (PSEA) 13 Sectoral Objectives & Response 14 Camp Coordination & Camp Management (CCCM) 16 Education 18 Food Security & Livelihood 20 Health 3 MOZAMBIQUE Foreword by the Humanitarian Coordinator The COVID-19 pandemic is placing countries around the world under The appeal is closely aligned to the Government-led National Plan unprecedented strain. In Mozambique -where people are still struggling for Preparedness and Response to COVID-19 -developed under the to recover from the devastation wrought by Cyclones Idai and Kenneth leadership of the Ministry of Health (Ministério da Saúde, MISAU) in 2019-drought has hit large swathes of the country, and violence and the Government-led Multi-Sectoral Preparedness and Response in Cabo Delgado has displaced tens of thousands of people- urgent Plan for COVID-19, which is being prepared by the National Disaster action is required to contain the virus and the consequences of Management Institute (Instituto Nacional de Gestão de Calamidades, measures taken to contain it. INGC). It represents the contribution of the humanitarian community to these Government-led efforts. This unprecedented challenge requires a concerted and unified effort by all. The international community, the UN system, non-governmental Given the extensive threat posed by COVID-19, the appeal covers organizations and the private sector are all coming together in the whole of Mozambique. However, it includes a distinct focus on solidarity to support the response to COVID-19, under the leadership of provinces that have been hit by climatic shocks (including cyclones, the Government of Mozambique. floods, and drought) and violence in 2019 and early 2020. This Flash Appeal for COVID-19 outlines the immediate life-saving and The appeal covers the immediate response required in the next nine life-sustaining activities that will be undertaken by the Humanitarian months, so as to ensure rapid and coordinated action. However, it Country Team in Mozambique from May to December 2020 to urgently will be regularly reviewed, revised and/or extended as the situation respond to COVID-19’s public health impacts and its secondary evolves. impacts, which span across many sectors. Myrta Kaulard Humanitarian Coordinator for Mozambique 4 FLASH APPEAL COVID-19 Flash Appeal at a Glance PEOPLE IN NEED PEOPLE TARGETED REQUIREMENTS (US$) OPERATIONAL PARTNERS 7.9M 2.96M $68.1M 57 People in Need and Targeted Requirements by Cluster Health $16M Cabo Delgabo Niassa Food Security & Livelihood $15M Nampula Water, Sanitation Tete $14M & Hygiene (WASH) Zambezia Shelter/NFIs $8.6M Manica Education Sofala $5M Logistics $3M Nutrition $3M Gaza Inhambane Proportion of PIN targeted Protection $2.1M People targeted Maputo Camp Coordination 1.4M Maputo City & Camp Management 0.7M $0.9M \ 0.3M (CCCM) Coordination & Common Services $0.5M People in Need and Targeted by Cluster Operational Partners by Type 7.4M Shelter/NFIs 369K UN 5.1M 8 Health 2.3M 2.7M Protection 1.8M INGO Food Security 2.5M NNGO 32 & Livelihood 400K 17 2.5M Nutrition 1.3M Water, Sanitation 2.2M & Hygiene (WASH) 1.5M Education 1.3M 313K Coordination 744K & Common Services 500K Camp Coordination & Camp Management 264K (CCCM) 264K 5 MOZAMBIQUE Executive Summary Impact of COVID-19 they had and resort to negative coping mechanisms, including increasing Immediate health impacts on people and systems child marriage and transactional sex. Studies have shown that, following The first case of COVID-19 was reported in Mozambique on 22 March pandemics, there is a decrease in children that return to education and an 2020. As of 26 May, Mozambique had 194 confirmed cases of COVID-19, increased risk of childhood labour and early child marriage. Those with of which 168 were locally transmitted. The country’s capital, Maputo, and limited mobility, particularly older persons and people with disabilities, the province of Cabo Delgado are currently the epicentres of the outbreak are at increased risk from COVID-19 and may face further barriers to in Mozambique, with Pemba and Afungi registering more than 50 percent accessing life-saving services due to movement restrictions. of the overall cases. Other provinces affected are Manica, Inhambane, Following the country-wide closure of schools on 23 March, 235,000 Gaza, Tete and Sofala. children are no longer accessing critical school feeding programmes and COVID-19 is expected to heighten the risks of people living with malnutrition is expected to worsen in the period ahead. An estimated co-morbidities and in challenging living conditions. There are 1.3 million 67,500 children will require treatment for malnutrition in the next nine older people in Mozambique, 5 per cent of the population. About 16 months. Currently, more than 3,000 children under five are being treated percent of women over 60 years of age live alone, increasing their risk of for severe acute malnutrition (SAM) and there have been over 4,000 cases exposure,1 about 2.3 million people living with HIV (12.4 per cent of the of pellagra (vitamin B3 deficiency) recorded since May 2019. population) and an estimated 162,000 people are living with TB, of whom Response priorities and challenges 58,000 also have HIV. People living with immunocompromised conditions Priorities and early achievements have poor access to health services, with 50 per cent of the population The Humanitarian Country Team in Mozambique has developed an 2 living more than 20 kilometres from the nearest health facility. Following Flash Appeal for the COVID-19 response, which incorporates both Cyclones Idai and Kenneth in 2019, over 100,000 people are still displaced the public health response and action to tackle the most urgent in 76 sites across six provinces. In Cabo Delgado, over 162,000 people secondary consequences. The appeal complements the Government of have been affected by insecurity, most of whom are living in overcrowded Mozambique’s (GoM) National Plan for Preparedness and Response to conditions in host communities. Displaced people living in camps, camp COVID-19, which calls for US$28 million for the public health response, like settings, resettlement sites or host communities, are all at heightened and the Government’s Multi-Sectoral Preparedness and Response Plan. risk as their right to information, access to healthcare, hygiene, protection Humanitarian partners are ramping-up their support to the services and livelihoods are constrained. Government-led response. All provincial capitals have established Prior to COVID-19, multiple disease outbreaks—including cholera and isolation centres and training of rapid response teams have been malaria—were already stretching Mozambique’s weak health systems given at provincial level. Partners also supported prioritization of risky and 94 health centres were damaged during the cyclones. IDPs in Points of Entry. In the Solidarity Flight that landed in Maputo on 18 Cabo Delgado face significant challenges to accessing primary health April, the Jack Ma Donation provided vital equipment for the COVID-19 care. Critical services—such as sexual and reproductive healthcare, response, including: 18,900 swabs and viral transport medium, 18,912 immunization activities and continuity of care for HIV, tuberculosis, extraction kits, 3800 PPE, 3800 face shields and 10 ventilators. malaria and cholera—are expected to be disrupted as resources shift to Partners are advocating with Organizations of People with Disabilities the COVID-19 response, potentially increasing maternal and infant deaths. to ensure participation and inclusion of disability issues into COVID-19 Indirect impacts on people and systems preparedness and response. Partners are also working with the Ministry COVID-19 arrived in Mozambique at a time when humanitarian needs of Education and Human Development to mitigate the impact of the were already rising due to consecutive climatic shocks in multiple parts epidemic on children’s education. of the country and growing insecurity in Cabo Delgado. Drought, cyclones, Challenges and impact to operations floods and violence over the past year have left at least 2.5 million people There are gaps in reagents for testing for COVID-19 and availability of in urgent need of humanitarian assistance across the country.