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Mozambique Humanitarian Situation Report No. 17 Fatima Jose Manega (20) stands near a disabled toilet, installed by UNICEF at the Ndjenja Resettlement camp. © UNICEF/UNI309984/Prinsloo Reporting Period: January-May 2020 © UNICEF/UN0311486/Tremeau Highlights • Mozambique is facing multiple humanitarian situations due to Situation in Numbers COVID-19, insecurity, and drought with at least 7.9 million people in need of assistance. 3.95 million children in need • UNICEF has supported 369,535 children under five to have of humanitarian assistance access to health consultations and 28,991 children immunized (based on people in need) with DTP3 in three provinces of central Mozambique; • UNICEF supported immunization against measles of 94,659 children from 8.5 months to 14 years in 12 districts of Nampula of 7.9 million people in need which 49,281 girls and 45,378 boys. (OCHA, COVID Appeal May • UNICEF supported the transportation of 733,500 doses of Oral 2020) Cholera Vaccine for Cabo Delgado province • 177,585 children have been screened for acute malnutrition, 300,000 people displaced in and 1,714 cases of SAM have been identified and admitted for cyclone affected areas treatment with UNICEF’s support. (IOM, June 2020) • UNICEF reached 196,000 people in five provinces with safe water supply and sanitation services. UNICEF’s Response and Funding Status UNICEF Appeal 2019 US$ 83.6 million 2019/2020 Funding Requirements US$ 83.6 M * Refer to the footnote on Annex A Results Table. 1 Funding Overview and Partnerships In response to Cyclones Idai and Kenneth, UNICEF launched an appeal for US$ 83.6M to provide immediate life- saving services for women and children in Mozambique for the period between March 2019 and May 2020. From January-June 2020, the CO received only US$ 1.96M for emergency response in Nutrition and Cabo Delgado from Germany National Committee, CERF and UNICEF’s Global Thematic Humanitarian funds. Overall (from March 2019-June 2020), UNICEF received a total of US$ 50.4M against the appeal which represents 60% of the requirements with more than 50% of these funds targeting WASH (38.8%) and Health (22.7%) sectors. In 2019, the governments of Canada, China, Germany, Japan, Luxembourg, Norway, Sweden, the United Kingdom, the US (USAID) as well as the European Commission/ECHO and UNICEF National Committees of Andorra, Australia, Austria, Canada, Czech Republic, Denmark, France, Germany, Japan, Netherlands, Norway, Portugal, Spain, Switzerland, the United Kingdom and the United States generously contributed to the UNICEF Mozambique humanitarian response. Funds were also received from UNOCHA’s Consolidated Emergency Response Fund, UNICEF’s Global Thematic Humanitarian fund as well as UNICEF Botswana and UNICEF Philippines country offices. UNICEF expresses its sincere gratitude to all public and private donors for the contributions received. Situation Overview & Humanitarian Needs In the north of the country, particularly in Cabo Delgado the security situation has worsened significantly since the last report with the increase of the attacks by the non-identified armed group/insurgents and subsequent population displacement. More than 100 attacks were reported by UNDSS in six districts in the northern part and more than 200,000 people were displaced in the entire province (17 districts), the vast majority living with host families. It was also reported that a 42 out 126 health facilities are non-functional in at least eight districts. The IDPs from Cabo Delgado are also seeking safe locations out of the province with approximately 5,000 IDPs having moved to Nampula province. Other emergencies affecting the province of Cabo Delgado includes COVID-19, Cholera, and measles. In addition, according to National Institute for Disaster Management (INGC), between January and February 2020 the country recorded events of strong winds and heavy rains affecting approximately 125,000 people in the provinces of Sofala and Zambézia, in some cases the same people affected by Cyclone Idai in 2019. These events resulted in the displacement of 8,5331 people in these two provinces. Overall, as of June 2020, there were 95,338 displaced (54% total IDPs are children) and resettled in 72 sites distributed among four provinces all in the central region of the country with 82% of the sites located in Sofala and Manica provinces. Major needs reported by the IDPs are food, shelter and health care. In relation to food insecurity, in May 2020 FEWS NET Mozambique indicated that due to a third consecutive year of drought in the south and armed conflict in Cabo Delgado, many poor households are expected to continue facing Crisis (IPC Phase 3) outcomes through September. Moreover, the water availability for human and animal consumption is of concern in the interior of Gaza and Inhambane provinces as water sources are gradually drying up, forcing households to travel longer distances. However, the water scarcity is not expected to reach the critical levels recorded in the 2016 El Niño drought. Mozambique is also facing cholera outbreaks in two provinces, with 2,858 total cumulative cases in Cabo Delgado (1,146 cases and 17 deaths, CFR 1.5%) and Nampula (1,712 cases and 5 deaths, CFR 0.3%). It is important to note that most of these cases were recorded earlier this year and currently the caseload is decreasing in both provinces. There is also an ongoing measles outbreak across the country. As of May 2020, 366 measles suspected case were reported in 44 districts, of which 123 (34%) were confirmed (all IGM+). In terms of COVID-19, the country recorded 1,0122 cumulative cases (as of 6th July), with 277 recoveries and a death toll of 8. The majority (87%) of the cases are concentrated in Nampula, Cabo Delgado, Maputo city and 1 https://displacement.iom.int/reports/mozambique-%E2%80%93-covid-19-preparedness-assessment-resettlement-sites-manica-sofala-tete-and 2 https://covid19.ins.gov.mz/ 2 Maputo province. Given the upward trend of COVID-19 cases, the Government extended recently, for the 3rd time, the state of emergency until the end of July. Summary Analysis of Programme Response Nutrition As part of the nutrition priorities in the affected areas by Cyclones Idai and Kenneth, UNICEF had continued its support to the screening and treatment of severe acute malnutrition (SAM) in children under 5 years of age. This has been done through the Mozambican Ministry of Health – Nutrition Rehabilitation program (PRN) at the different components that include the inpatient care of severe cases with complications at hospital level, the ambulatory treatment at health facility level, and through outreach activities such as Integrated Mobile Brigades (IMB), that aims to provide primary health and nutrition care to hard-to-reach communities and resettlement sites. From January to May 2020, with UNICEF’s support, a total of 177,585 children have been screened for acute malnutrition, and 1,714 cases of SAM have been identified and admitted for treatment. A total of 78,830 caregivers received IYCF counselling messages in the communities, 136,373 children were supplemented with vitamin A, 64,803 were dewormed. UNICEF has also delivered 2,689 boxes of RUTF and other essential nutrition therapeutic supplies to assure correct treatment of Acute Malnutrition of the affected children. UNICEF is also responding to the current situation in Cabo Delgado, targeting Internally Displaced People (IDP) and host families in the districts affected by insecurity and high influx of IDPs. The Pellagra outbreak continues to affect the population in the provinces of Manica and Sofala where the total of registered cases has surpassed the 4500 number of people diagnosed since 2019. In 2020, for Sofala the total number of registered cases is 611. UNICEF has provided the treatment with Nicotinamide for this condition that continues to be available at health facilities of the affected provinces. UNICEF has maintained its role as the Nutrition cluster co-lead at national level and at subnational level in Beira and Pemba. Regular nutrition emergency coordination meetings are held in Maputo, Beira and Pemba hosting 30 plus partners. The meetings are facilitated by Ministry of Health with UNICEF support as co-lead. Health In Sofala, Manica and Cabo Delgado provinces, UNICEF continued to support the Provincial Health Directorate (DPS) in implementing essential health services; child health consultations; treatment of malaria, diarrhea and pneumonia; and immunization. These activities were delivered through three delivery platforms namely health facilities, community-based services and Integrated Mobile Brigades (IMBs). During the period January-May 2020, 569 community health workers were provided with refresher trainings in delivery of preventive and curative health and nutrition packages as well as risk communication and safety measure on COVID-19. In the same period, the UNICEF support in promoting health, preventing and treating disease in the community enabled 369,535 children under five to have access to sick child consultations (in health facilities and communities), 28,991 children were vaccinated with DTP3 and 3,795 pregnant women 15-49 living with HIV received antiretroviral treatment (ART). During the rainy season, UNICEF has provided support to implement IMB for communities affected by heavy rains in Gorongosa and Maringue districts of Sofala province. A Cholera outbreak was declared in Cabo Delgado province following the heavy rains that plagued the region (isolating the northern districts) and the growing influx of the population due to insecurity resulting from military operations in the northern districts. So far, a total of 1,146 cases have been reported in Ibo, Mocimboa da Praia, Macomia, Metuge districts and Pemba city, which has led to 17 deaths, and a case fatality rate (CFR) of 1.5%. In Nampula province, there have been reported 1,712 cases with 5 deaths, CFR 0.3%, in 11 districts. UNICEF has supported assessment missions in remote sites, including the islands, and has supported the setup of cholera treatment centers, provision of AWD kits, ORS and IPC equipment to improve case management in both provinces.
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