Mozambique struggles to contain cholera outbreak after cyclone

QUELIMANE, Mozambique — Weeks after massive Cyclone Freddy hit Mozambique for the second time, the still flooded country faces a spiraling cholera outbreak that threatens to add to the devastation.

There were more than 19,000 confirmed cases of cholera in eight of Mozambique’s provinces as of March 27, according to the United Nations Office for the Coordination of Humanitarian Affairs, a figure that nearly doubled in a week.

Freddy was probably the longest cyclone ever, lasting more than five weeks and hitting Mozambique twice. The tropical storm killed 165 people in Mozambique, 17 in Madagascar and 676 in Malawi. More than 530 people are still missing in Malawi two weeks later, so the death toll there could well exceed 1,200.

Freddy made landfall for the second time in Mozambique’s Zambezia province, where dozens of villages remain flooded and water supplies are still contaminated.

At a hospital in Quelimane, the provincial capital of Zambezi, the director general of the National Institute of Health, Eduardo Sam Gudo Jr, reported that there were 600 new confirmed cases a day in Quelimane district alone, but said the real number could be as high as 1,000.

At least 31 people died of cholera in the Zambezi and more than 3,200 were hospitalized between March 15 and March 29, according to Health Ministry data.

Cases are highest in the district of Icidua, on the outskirts of the city, where most residents live in bamboo or adobe huts and fetch water in buckets from communal wells. Cyclone-induced flooding exposed many of these wells to water contaminated by sewage overflows and other sources of bacteria. Cholera is spread through feces, often when it enters drinking water.

But until the water pipes broken in the floods are repaired, these wells are the only source of water for the people of Icidua and similar communities. For now, temporary solutions offer the only hope of stemming the epidemic.

Volunteers go house to house distributing bottles of Certeza, a local chlorine-based water purifier. Each bottle should last a family a week, but supplies are running low as local production struggles to keep pace with demand. There are also not enough people to distribute the Certeza, although larger supplies could be purchased, Gudo said.

In the meantime, health workers are struggling to treat those infected with many clinics and hospitals badly damaged. “The cyclone destroyed the infrastructure here,” said José da Costa Silva, clinical director of the Icidua health center. “We work in parts of the hospital that were not destroyed. Some colleagues work outside in the open air because there is not enough space available for everyone.

A total of eighty health centers were affected by the two Freddy landings in Mozambique, according to INGD, the country’s disaster management agency.

Although cyclones occur in southern Africa from December to May, human-induced climate change has made tropical cyclones wetter, more intense and more frequent. The now dissipated La Nina natural event also aggravated hurricane activity in the region. Although Cyclone Freddy itself has yet to be attributed to climate change, researchers say it exhibits all the hallmarks of a warming-fueled weather event.

Formed in early February off Australia, the exceptionally long-lived cyclone made an unprecedented crossing of more than 8,000 kilometers (5,000 miles) from east to west across the Indian Ocean.

It followed a looping path rarely recorded by meteorologists, hitting Madagascar and Mozambique for the first time in late February and then again in March before hurtling towards Malawi.

Restoring normal water supplies in Mozambique will take time, as many damaged pipes run through areas still inaccessible two weeks after the last impact of the cyclone.

“A cholera outbreak in a floodplain with a very high water table is ‘mission impossible’ to solve,” Myrta Kaulard, the UN resident coordinator in Mozambique, told The Associated Press. “Sanitation is a huge problem and the floods have affected key infrastructure, such as water pipes and electricity supply… Repairing such infrastructure in flooded areas is another ‘mission impossible’.”

Meanwhile, rural areas around Quelimane face other threats. Many villages and fields are still under water and the humidity has spawned swarms of malaria-carrying mosquitoes. In a makeshift camp for displaced people on the edge of a flooded rice field near the village of Nicoadala, 20 out of 290 residents are suffering from malaria, according to Hilário Milisto Irawe, a local chief.

On March 24 alone, 444 cases of malaria were reported in Quelimane district, but the number is likely much higher as many, like those in the camp outside Nicoadala, do not have access to health facilities. .

Compounding the public health crisis, the material livelihoods of hundreds of thousands of people are at risk as Freddy strikes just before the main harvest. It also transported seawater inland, threatening long-term soil fertility in an area where malnutrition is already chronic.

“All our farms are flooded. Our rice fields are destroyed. All we can do is start over, but we don’t know how we’re going to do that,” Irawe said.