The crisis in Cabo Delgado, Mozambique, has rapidly escalated as a result of conflict, insecurity and violence, leaving an estimated 1.3 million people in need of urgent humanitarian assistance and protection in 2021. Attacks by non-state armed groups expanded geographically and increased in intensity in 2020, significantly heightening protection risks, especially for women and girls, people with disabilities, older persons and people living with HIV/AIDS. Reports of violations against civilians, including killings, beheadings and kidnappings, increased in 2020. The number of people displaced by the crisis more than quadrupled from March (over 110,400) to November 2020 (nearly 530,000), with children accounting for an estimated 45 per cent of people displaced. More than 90 per cent of displaced people are staying with family and friends in host communities’ whose already meagre resources are being strained by the growing influxes: in Ibo district, there are now more IDPs than host community members; in Pemba city, more than 100,000 displaced people have arrived over the past year, on top of the original population of around 224,000 people. Meanwhile, 10 per cent of displaced people are staying in collective sites which are overcrowded, lack privacy, and have limited access to safe shelter, water and sanitation. This is contributing to protection risks, including gender-based violence, rising numbers of child and teen pregnancies, and increased exposure to exploitation and negative coping mechanisms, including transactional sex.
Health, Water, Sanitation and Hygiene (WASH) and Education services across Cabo Delgado—which were already stretched—have been significantly impacted by the escalating violence. Insecurity has damaged or destroyed 36 per cent of health facilities across Cabo Delgado province and there are no functional health facilities in the districts hardest-hit by conflict (Mocimboa da Praia, Macomia, Muidumbe and Quissanga). This has reduced capacity to detect and respond to disease outbreaks, including cholera, measles and COVID-19, and to provide critical care, such as sexual and reproductive healthcare, immunization activities, access to anti-retrovirals (ARVs) and treatment for tuberculosis (TB). At the same time, an estimated 176,000 people have lost access to their primary water source due to disruption of services from centralized water supply networks as a result of conflict. Lack of access to safe water and hygiene facilities is a major concern and heightens the risk of disease outbreaks: 45 per cent of health facilities in Cabo Delgado lack access to water and 85 per cent of schools lack adequate hygiene facilities.
Food insecurity is rising as conflict and repeated displacement, compounded by climatic shocks, have disrupted communities’ agricultural activities and livelihoods. More than 900,000 people in Cabo Delgado, Niassa and Nampula are now facing Crisis or Emergency levels of food insecurity (IPC Phase 3 and 4), while disruption of markets due to insecurity has driven up the cost of food and household items