“I have never seen so many pregnant women in this situation”: Survivors of Tropical Cyclone Freddy face Mozambique’s worst cholera outbreak in two decades

ZAMBEZIA PROVINCE, Mozambique – Tropical Cyclone Freddy and widespread flooding have swept through Mozambique, killing 183 people and leaving more than 640,000 homeless. Making matters worse, in the aftermath of the storm, the country has been forced to confront its worst cholera epidemic in two decades. 

Among those affected by the disaster are some 31,000 pregnant women.

“In all my professional experience as a doctor, I have never seen so many pregnant women in this situation,” said Dr. Equibal Abílio, an obstetrician-gynaecologist currently providing medical support at a cholera treatment centre in Quelimane, Zambezia province.

As of 14 April 2023, more than 27,000 cases of cholera have been reported across ten of Mozambique’s eleven provinces. The water-borne disease can be especially harmful to pregnant women and their unborn children, as it increases the risk of stillbirth and maternal mortality. 

Dr. Abílio said up to three pregnant women a day have come to the Quelimane hospital with cholera over the last month. But with support from UNFPA and partners, the health centre has been better able to counter the outbreak. 

“Provided with technical support, training and supplies, we were able to respond to the situation to minimize complications,” he said.

Meeting the needs of women and girls, now

The storm and its aftermath partially or completely destroyed 55 maternity wards in Zambezia province. With cholera circulating, UNFPA supported efforts to set up a dedicated space for treating pregnant women who have contracted the disease, where they can receive specialized obstetric care with minimized risk of contagion.

The agency is also working with Mozambique’s Ministry of Health to develop guidelines for cholera case management during pregnancy, and training maternal and child health-care providers on responding to the outbreak, with 60 participating so far. 

“Managing cholera cases in pregnancy is very difficult, because you need to prevent and treat both cholera and obstetric complications,” said UNFPA Mozambique maternal health specialist Dr. Marilena Urso. “Health-care providers must immediately intervene while monitoring foetal well-being and preventing the spread of cholera itself.”

“Time is of the essence.” 

Addressing a triple crisis 

The humanitarian community in Mozambique is calling for $138 million to provide assistance to a targeted 815,000 people who have been impacted by the triple crisis of cholera, floods and Tropical Cyclone Freddy. These efforts complement the government’s cholera vaccination drive, which has vaccinated more than 1.2 million people. 

Scaling up humanitarian interventions, UNFPA is on the ground with partners, distributing dignity kits, procuring reproductive health kits, and setting up temporary health facilities in tents to ensure maternal and newborn health services continue amid the catastrophe. Six had been installed across Zambezia as of mid-April. Mobile clinics will soon start operating, providing sexual and reproductive health services to remote areas without close access to available health facilities.

As UNFPA Executive Director Dr. Natalia Kanem has said: “Women do not stop getting pregnant and having babies when crisis strikes. We must provide them with the services and the support they need”.