18 Mar 19 25 Jun 21

Tropical Cyclone Idai hits Southern Africa: MSF responds in Mozambique, Zimbabwe and Malawi

Doctors Without Borders/Médecins Sans Frontières (MSF) is responding after Tropical Cyclone Idai hit Mozambique and other parts of Southern Africa.

More than a million people are struggling to rebuild their lives in flood-affected parts of Mozambique, Zimbabwe and Malawi. Many are in urgent need of assistance — and for just the basics to survive. The humanitarian disaster caused by heavy flooding and Cyclone Idai is simply enormous in scale. And now, with the first cases of cholera in Mozambique recently confirmed, the need for an urgent expansion of emergency medical activities is clear.

Doctors Without Borders/Médecins Sans Frontières (MSF) was already present in Beira when the cyclone struck, and we launched our emergency response almost immediately afterwards. Our teams on the ground have been carrying out critical medical activities, and we are continuing to rapidly scale up our operations.

Cholera outbreak following Cyclone Idai

Mozambique: devastation and risk of disease

“The cyclone has left a path of devastation with thousands of houses destroyed, which has left the community vulnerable and exposed to the elements,” said Gert Verdonck, MSF’s Emergency Coordinator in Beira, the city hardest hit in Mozambique.  “The supply chain has been broken, creating food, clean water and healthcare shortages. These levels of extreme damage will likely lead to a dramatic increase of waterborne diseases, skin infections, respiratory tract infections and malaria in the coming days and weeks. Furthermore, the local health system with all its regular services, such as HIV treatment and maternal healthcare, has also been disrupted.” 

Today in Beira, MSF teams are hard at work inside three health centres to care for those suffering from suspected cases of cholera and other waterborne diseases, as well as to repair the damage sustained during the storm.

“The cyclone substantially damaged the city’s water supply system, resulting in many people having no access to clean drinking water. This means that they have no option but to drink from contaminated wells, some people even resorting to drinking the stagnant water by the side of the road. This of course results in an increase of patients affected by waterborne diseases. The MSF-supported health centres have seen hundreds of patients with acute watery diarrhea in the past few days,” says Verdonck.

Outside of the health centres, MSF is running mobile clinics to provide primary healthcare to the most affected communities. These teams — made up of doctors, clinical officers, nurses, health promoters and counsellors — are visiting poorer areas of Beira, as well as some of the 37 transit centres where those whose homes have been destroyed are sheltering.

The impact of Idai in Beira and MSF's response

Late in the night on March 14, Cyclone Idai wreaked havoc in the port city of Beira, home to some 500,000 people, as well as in the surrounding districts, where it has destroyed the lives and livelihoods of hundreds of thousands of people. High winds and high waters have so far killed at least 447 people, according to government officials, and damaged or destroyed thousands of buildings — homes, schools, health centres and hospitals — across the area. Many families have been left homeless, and most communities are without reliable access to clean water or electricity.

MSF has so far sent four chartered cargo flights with emergency essentials for the response. At least three more chartered cargo flights are scheduled for this week, departing from Belgium, Dubai and France, and massive aerial freight supply mobilization will continue in the following weeks.

“Thanks to MSF’s long-term presence working alongside the Ministry of Health to treat HIV in Mozambique, we have strong existing links with the country and were able respond in a rapidly,” said Verdonck. “Given how many of our patients and their families have lost everything, our mobile clinics are not just about providing primary healthcare but also about showing up and being there for a community that is desperately in need.”

As our teams work to meet the most critical needs in Mozambique and surrounding areas, your gift today makes it possible for us to deliver care to people made vulnerable by this and many other disasters around the world. Thanks to your support, MSF is already treating patients in some of the places most badly damaged by Cyclone Idai, and we will continue to respond immediately in times of crisis — wherever and whenever humanitarian emergencies may occur.

Zimbabwe: massive damage from Idai's storms

  • Chimanimani district in Manicaland Province is the area of Zimbabwe where Cyclone Idai hit after traversing Mozambique – the last intense storms before the cyclone blew itself out.
  • Overall deaths 154, injuries 162, displaced nearly 5,000 (official figures as of March 22)
  • The damage within Chimanimani district is on a massive scale, with many roads completely wiped away for several kilometres, with the only way to reach some communities now being by foot. Access to safe drinking water is an issue with many pipes washed away.


  • MSF continues to provide consultations and medical supplies in the joint-stabalization centre set up on the outskirts of Chimanimani.
  • However, our priority has now moved to inside Chimanimani, after an MSF team finally made access into the district on Thursday. The district was cut off from access until last week, due to heavy rock fall blocking roads, or bridges being washed away. In some parts, the flooding washed away entire homes, shops and factories. Many lost their livelihoods as well as chronic medicines.
  • A fixed team is now working with health ministry staff out of Chimanimani hospital. So far, low numbers of patients seen, with three cases of watery diarrhea.
  • Two MSF outreach teams are also moving around Chimanimani, outside of the main roads, trying to access as many of Chimanimani’s 20 health clinics and surrounding settlements as possible, to assess health needs, distribute medicines to clinics and village health workers.
  • This is the first time many parts of the area have been accessed from outside since the cyclone hit. With many roads washed away or flooded, the teams are walking between 3 to 12 kilometres to reach stranded communities, who have no safe water supply.
  • So far, the MSF team has reached Nyahode clinic, with 20 cyclone-related injuries and 3 diarrheal cases seen. The team donated medical supplies. Yesterday, the team reached Charleswood, a mining community, doing health promotion, donating medical items and aqua tabs.
  • Bjorn Nissen, MSF's country representative in Zimbabwe says: “someone needed to get to these cut-off communities to see what their needs are, so that’s what MSF is doing with a health ministry nurse, reaching the last mile, carrying essential medicines, basic supplies and aqua tablets to purify water for drinking.”
  • So far, health needs include trauma, antiretroviral treatment refills for HIV patients, chronic disease medications. However, the longer term consequences of blocked access should be considered: electricity was disrupted affecting routine vaccination services, stockouts of medical supplies and drugs, treatment interruptions for HIV, TB and chronic disease patients, lack of detergents and chlorine.
  • An MSF team from Chipinge also today reached Copper, a valley to the south, which was one of the hardest hit, to conduct an assessment.

Malawi: heavy flooding and large-scale displacement

  • Heavy rains started on March 3. This weather system moved offshore and turned into Cyclone Idai last week, which moved back to Mozambique. Heavy rains continued throughout the region, including in Malawi.
  • Flooding affected the majority of Nsanje district, in southern Malawi with around 16,000 households affected, according to the national disaster report. Rains have now largely stopped and access to the flooded areas is improving, however some parts remain under water or cut off with limited communication.
  • There are continued challenges to access the most affected areas so it is very difficult to get a clear picture of overall needs.
  • A huge number of houses have collapsed. Many thousands remain in displacement camps and makeshift sites such as schools and churches. Big reconstruction efforts will be required in coming weeks.
  • There is massive destruction of agricultural crops and animals. It’s estimated that 50% of the area’s crops might have been lost. To date MSF has not witnessed any challenges with food availability in the areas it is intervening in, but proper assessment can only be done when water levels subside further.
  • Electricity has returned to Makhanga district, which remains cut off from all road access. 


  • MSF is working with local Malawian authorities and the Disaster Management department, and with other local and international organizations.
  • An MSF team of 18 people is supporting the health ministry to cover the needs of an estimated 18,000 people in Makhanga on the eastern bank of the Shire river, with health, sanitation and non-food-item supplies.
  • An MSF base and warehouse in Bangula is being supplied from Blantyre. Our teams are moving by boat to Makhanga, where the main response is happening.
  • So far, our teams have not detected acute medical needs, but we’re concerned about the many people on chronic medication, including for HIV and TB treatment.
  • In Makhanga health centre, health ministry staff have still not returned to work, so MSF continues to ensure primary health, HIV services and basic disease surveillance continues, with approximately 150 consultations per day. 
  • To date, there have been no reports of waterborne diseases but it’s a concern. Outreach teams have visited communities to clean and repair boreholes plus test water quality to ensure access to clean water, build basic latrines, showers shelters, distribute non-food items and hygiene kits and educate communities on hygiene and safe water practices.  
  • MSF has now reached more than 2,000 households in Makhanga with hygiene kits, which includes buckets, cups and soap. Due to our concern about cholera, we will construct basic cholera treatment units of 4 beds and conduct training, so as to be prepared just in case.