MSF MOZAMBIQUE: MSF launches emergency response as violence drives over 100,000 people from their homes in northern Mozambique

During the month of November, a non-state armed group carried out multiple attacks in Nampula province, triggering the third and, so far, largest wave of displacement in northern Mozambique since July 2025. 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 neighbouring provinces, including Nampula. Over 100,000 people fled their homes, according to the latest IOM data.1 In total, over 300,000 people have been forcibly displaced in northern Mozambique since late July.

While some displaced families have begun returning to their places of origin, these movements are not always the result of genuine safety or readiness. In certain cases, people make the difficult choice to go back influenced by the prospect of receiving assistance.

“They explained that support would only be given there, in people’s home areas,” says José Maurício Alige, displaced from Mazua. “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 Alua Sede and Alua Velha 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 going 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 and undermining the principles of neutral, needs-based humanitarian response.

MSF is providing medical consultations, maternity services, nutrition support, and psychosocial counselling in Alua Velha, Alua Seda, and Miliva. In terms of health conditions, malaria remains the leading cause of consultations, followed by acute diarrhoeal 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 4 and 15 December, we have conducted over 860 medical consultations,” says Emerson Finiosse, an MSF medical doctor. “There is a high prevalence of malaria, with over 30 per cent of positive cases among the people who reach us.”

“Also, many women who come to our mobile clinics for ante-natal consultations are receiving this service for the first time, meaning that they had never started this important process before,” says Finiosse. “This is a worrying indicator of the state of the health system even before sudden displacements occur.”

The ongoing rainy season intensifies 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. Additionally, MSF has 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 precarious living and sanitation conditions, in temporary shelters and with host families, raise health and safety concerns. 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 remains one of the most pressing needs. Our teams witness 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 that is delivered where people are.

MSF has launched a three-month emergency intervention in Eráti district, Nampula province, to address people’s escalating humanitarian and medical needs. We continue to provide vital healthcare services to host communities and people coping with violence and displacement in northern Mozambique. 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 paediatric 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 centres, and support medical facilities and hospitals in collaboration with the Ministry of Health.

Mozambique: Eight years of violence and displacement, but the lives of Cabo Delgado’s people do not make headlines

By Sebastián Traficante, MSF head of operations in Mozambique

The intensification of the conflict in northern Mozambique continues to uproot lives and force people to flee. Civilians are being attacked by a non-state armed group, which continues to clash with local and regional armies. People face violence and a pervasive sense of insecurity, driving massive displacements as families leave their homes in search of safety. Ensuring the protection of civilians, medical facilities and humanitarian workers must remain a priority in this escalating crisis.

When Bernardo and his wife Alima fled their village of Criação, they carried almost nothing with them. They only hoped to find out what happened to their daughters, who were nine and six when armed men abducted them in 2020. For years, the couple heard nothing. Only recently, a survivor who escaped captivity brought news that they were still alive. “Every thought leads nowhere,” Bernardo tells our teams in Mueda, where his family has lived in a camp for displaced people since October. They are unsure whether they will ever see their daughters again.

Eight years into the conflict in Cabo Delgado, fear and uncertainty are a daily reality for hundreds of thousands of people in this northern Mozambiquan province. While international attention gravitates toward the reopening of major energy projects and the security around key resources in the province, the people who have been living through this underreported crisis remain out of the spotlight.

Since October 2017, more than 6,000 people have been killed1 and over one million people – about a third of the population of Cabo Delgado – have been forced to flee their homes2, about half of whom remain displaced. Since late July, Cabo Delgado has experienced devastating levels of violence. This year is now the most violent one on record in terms of the number and frequency of security incidents. More than 500 occurred in the first eight months of 2025, including brutal assassinations, kidnappings, lootings and arson3.

Attacks have struck most districts of the province and spilled into neighboring Nampula and Niassa. Tens of thousands of people have recently fled their homes. For many, it is not the first time. Some are returning to the very same camps where they sought refuge during the deadly attacks of 2020 or 2021.

Families often leave their homes with little more than the clothes they wear. But they carry a heavy burden of fear, exhaustion, and trauma.

Lives upended, health under threat

The displacement site of Lianda has been Bertina’s home for three years, despite mounting difficulties. Food is limited. The plastic sheeting covering her house is so damaged that rain leaks

inside. Water is scarce: it might take up to three days to collect just 40 litres, which is barely enough for one day for her family of nine.

In her home village in Nangade, she used to harvest a dozen sacks of cashew nuts each year. It was enough to sustain the entire family and build a house with a private water tank. After her village was attacked, only the water tank remains.

Bertina is not alone in her experience. Many people tell our teams they saw their houses burn down, their businesses vanish; they left behind farmland and possessions; they lost loved ones. And while they now find a sense of safety in the displacement camps, their physical and mental health remains under threat.

Years of conflict have severely weakened northern Mozambique’s already fragile health system. Devastating cyclones, such as Chido in late 2024, regularly hit and add another layer of complexity to this climate-vulnerable country. Multiple facilities have been destroyed or abandoned, while others operate with minimal staff and supplies. Health workers, understandably, are often among those who flee after attacks. This means that the healthcare system, already stretched thin, lacks important resources.

In some districts, measles vaccination coverage remains dangerously low. Pregnant women often give birth at home because movement is unsafe, health centers are closed or they simply do not have the means to reach them. Treatment for HIV and tuberculosis, which requires regular monitoring and follow-ups, are repeatedly interrupted when violence surges, leaving thousands of people at risk of severe illness and drug resistance.

Humanitarian organisations, including Doctors Without Borders/Médecins Sans Frontières (MSF), face growing challenges reaching the people who need them most. Mobile clinics are routinely suspended due to insecurity. When violence escalates, entire health programmes — from emergency care to community outreach — come to a forced halt.

Eight years on, we cannot look away

Despite this worsening reality, Cabo Delgado rarely gets international media coverage unless major attacks occur or there are developments on energy projects. Yet behind numbers and headlines – or lack thereof – are people living in fear. Families are dismembered, crops are abandoned, water sources lost and access to healthcare services repeatedly interrupted.

MSF is calling on all armed actors to prioritise the protection of civilians and ensure their safe access to basic services. They must respect and protect medical services, enabling health workers to provide care in health structures and in mobile clinics.

Ultimately, people in Cabo Delgado want safety. They want to rebuild their lives. Some still hold on to the hope of returning home, even when nothing is left. Others no longer believe they will ever go back, but they are unable to make plans for a future elsewhere.

With many escalating crises in the world, it is hard to determine what should get our attention. But people in Cabo Delgado are simply asking for a chance to live without fear.

Note to editors

In Cabo Delgado, MSF runs projects in Mocímboa da Praia, Macomia and Palma, while reaching neighboring districts. We provide outpatient consultations, emergency care, maternity and paediatric services, treatment for HIV and TB, as well as mental health and psychosocial support. In the first half of 2025, we carried out nearly 100,000 outpatient consultations and conducted mental health group activities for over 35,000 people. We run mobile clinics and outreach activities, refer patients to health centres and support medical facilities and hospitals in collaboration with the Ministry of Health.