“I saw my niece at a reception centre, she was carrying a sarong just like the one we used to hang on the door, but now our house is gon
“I saw my niece at a reception centre, she was carrying a sarong just like the one we used to hang on the door, but now our house is gone.
“Ever since I arrived at this IDP (Internally Displaced People Center ), I have experienced sudden mood swings. I can cry, laugh of be depressed for 15 minutes, and then look lost in the horizon,” says Renata, who is still locked into the memory of seeing her daughter riddled with bullets during the last insurgent attack in March 2021, on Palma, the heart of the natural gas project development, in the northern Cabo Delgado province of Mozambique.
The psychological after-effects caused by the war in Cabo Delgado represent the most unknown and hidden aspect of the war in that region. “People react differently, some are depressed, others are agitated. Abnormal behaviour can be detected immediately. In the hospital, you can see a displaced person without asking where they are from” says a general practitioner at the Provincial Hospital in Pemba, one of the places in the province that has seen an influx of people fleeing the insurgents’ actions.
“We must find durable solutions”
Laura Bormes, the UNHCR (United Nations High Commissioner for Refugees communications officer in Cabo Delgado, told CJI that the agency has provided support for
81,000 people, a figure that represents less than 10% of the total number affected. Contrast this with the districts of Palma and Mueda where, at least, 15% of victims of gender-based violence receive assistance.
Bormes acknowledges that "the big problem is the sustainability of psychosocial accompaniment for the victims of terrorism”.
Antonio Saide de Carvalho, director of the provincial hospital in Pemba, the capital of Cabo Delgado, told CJI that the province has “51 psychologists, 7 of whom are here, and the rest are distributed throughout the districts”.
A team from the Institute for Economic and Social Development (IDES), led by political Analyst Fidel Terrenciano, warns about the invisible wounds caused by the insurgency. “The most urgent thing in an armed conflict is to treat the wounds caused by war, but it is also urgent to face the mental and psychological disorders that occur and are not seen,” says Terrenciano. IDES has been on the ground since the outbreak of the insurgency.
The population of Cabo Delgado is perplexed to see how their mental health is seriously deteriorating. A realisation that is, however, met with a lack of specialised care. "During the first few days I was here, we had cases where we approached people and said we were psychologists and wanted to help and they said they didn’t want help”; says a Spanish humanitarian assistant, crisis psychologist and volunteer. One of his tasks is to gradually win the trust of the displaced, approaching them through friendship and empathy
Terrenciano adds that the victims feel ashamed to ask for support, because, prior to the war, they had their own homes, jobs, lives, and now they must deal with loss: loss of family; of property; of everything they used to do and love. "They live with uncertainty, with ambiguity and without knowing how to fix their lives. It is very difficult to adapt to a new life, because everything has been ruined”; explains a volunteer, Mariza Mickoi, in her dual capacity as a health professional and a native of Macomia who also fled her village.
Although humanitarian aid organisations provide psychological assistance, they also acknowledge, as in the case of IDES, that the support does not reach 10% of the displaced people.
After a traumatic event, psychology professionals warn that minors are the ones who most easily come out of the state of stress to which they were subjected through art therapy, for example. However, for parents, whose only sense of belonging in the home are their children, it is more difficult, and they tend to overprotect the children, which can have a negative impact on them. “This is not the time to make demands on the little ones, we must eliminate any breaches of pain and violence”; adds Mickoi.
“I hope God ends it so we can come back. Now I need to take care of my health, I feel bad because of the stress. My hair started greying a week after arriving in Paquite. One week and I am like this” says Sergio Sanga, a displaced person from Macomia. "What can I say? I have no words to express what happened. I thought it was a bad dream. You look out the window and see bullets flying between the houses, near yours, in the school you used to attend," he adds.
The most affected people by the conflict are the displaced because, although they have fled to safer areas, these are unknown places for them, where they have to survive with few resources, find accommodation or feed themselves. Starting from scratch with mixing of confusion in their heads and brocken heart, with the uncertainty of not knowing if they will one day return to their home town and see their beloved ones. Added to these people, are those refugees who are trying to rebuild their lives in other countries – CJI understands that many Mozambicans cross the border into Tanzania and others are in Malawi
“Within these groups, special attention should be given to single-parent families, minors, the elderly, people with chronic diseases, people with intellectual disabilities and especially people with mental disorders, because they are the most vulnerable and because they need the support and help of their carers in order to survive” says Augusto Guambe, coordinator of mental health at the Association of Psychology of Mozambique.
The NGO highlights the need for specialised care and medication to protect people with mental health problems and denounces the lack of medication in psychoneurological units. Its commitment to improving the mental health of the Mozambican population is carried out through group support interventions, individual psychosocial assistance and support to primary care with psychological care for patients with somatizations
“I have felt anxiety since the first day of the war. The sirens of an ambulance that pass from time to time cause me a kind of internal panic because it is not so easy to forget what one has seen or heard,” says João, from Quissanga.
In the Nampula province Meconta district, where it can be said that it is a good example of zoning, the displaced people complain of insufficient water supply – just four water fountains. The access road to the entrance is also precarious and slippery during the rainy season.
Electricity has not yet reached all the families, especially because there are few houses and many of the residences are tents. There is no market, although there are M-pesa and E-mola services (mobile phone- based money transfer services), the few products are sold under the cashew trees.
In addition to lack of employment opportunities, the displaced still need psychosocial support.
The IDP centre in Corane hides many nightmare stories that victims of terrorism went through at the time of the attacks.
Mozambique’s first lady Isaura Nyusi, who visited the Resettlement Centre of Corrane in 2021 and on the occasion proceeded to offer bare necessities to families, said that “helping our neighbour is a gesture of humanity and we are all called to lend a hand to help our brothers and sisters”
The more than six thousand people, divided into two neighbourhoods, share not only pain but also joy at not having been kidnapped or even beheaded like other people, including their relatives. And when the news of the conquest of their homeland rings out, among themselves, they are conflicted about their desire to remain permanently in Corane, despite the difficulties, and the desire to return to their origins to start life anew. Amid that universe, there is no glimpse of psychological assistance with follow-up