Building Back After Historic Storm

Following Cyclone Freddy, Mozambique fights a malaria surge fueled by climate change

By The Global Fund

August 30^th, 2023

When the floodwaters started rushing through Celina Tembe’s home, a neighbor helped Celina and her three children to safety.

“In the past, we knew that during the winter there would be no rain,” says Celina. “But nowadays it has become… normal.”

Most of Celina’s neighborhood in Boane District, Mozambique, was under water. She and her family fled to a local school that had been transformed into an accommodation center for families displaced by the flooding.

The area had already been impacted by flooding, but the situation intensified with the arrival of Cyclone Freddy, the longest lasting tropical cyclone in recorded history. Earlier this year, the cyclone struck Mozambique’s coastline twice, displacing an estimated 184,000 people and destroying close to 132,000 homes.

After sheltering at the school for 10 days, Celina and her children returned home, where they found all of their belongings covered in mud and ruined by water. The family’s crops had been destroyed.

Throughout their neighborhood were pools of stagnant floodwater – the perfect breeding ground for malaria-carrying mosquitoes. People then started to get seriously ill, including Celina’s two young daughters.

“We didn’t have mosquito nets. We were just fleeing from water in our houses,” she said. “I didn’t want to believe the truth. But when I arrived at the hospital, that is when I saw that it was malaria.”

For Celina, hearing the news that both of her daughters had malaria was terrifying. Just six months before the cyclone hit, her 35-year-old husband Maxaieie came home late from work, sick with a fever. Less than 24 hours later, he tested positive for malaria and died.

“That is when I realized that I’m alone now. I’m the father and the mother of my kids. I started working in the field [harvesting crops] to sustain my children,” she says.

After both of Celina’s daughters were tested for malaria and rapidly put on treatment, they both made full recoveries. Today, Celina is doing her best to replace everything they lost from the cyclone, including furniture, mattresses, the family’s television and food supplies.

Celina and her family are not the only ones suffering the grave consequences of climate change.

Malaria is considered one of the most climate-sensitive diseases, with upsurges in cases recorded after storms and flooding in regions around the world. The World Health Organization has estimated that by 2050, there could be an additional 250,000 deaths per year due to climate change – and 60,000 of these deaths could be from malaria.

For Mozambique, home to the fourth highest number of malaria cases globally (10.3 million cases in 2021 for a population of approximately 33 million people) and a country that is highly susceptible to extreme weather events, the intersection of malaria and climate change could be particularly deadly.

The Global Fund works with the government, community and other partners in Mozambique to fight malaria. After Cyclone Freddy, this work accelerated.

In the immediate aftermath, investments were used to provide flood relief equipment, food, and mosquito nets to displacement centers.

Funding was then increased to MOSASWA, a regional initiative between Eswatini, Mozambique and South Africa that works across borders to fight malaria, which is funded by the Global Fund, the Bill & Melinda Gates Foundation and Goodbye Malaria.

Funding was used to bolster spray campaigns close to displacement centers and apply larvicides to kill mosquito larva in areas where water remained after the floods receded. The locations of all bodies of water treated were recorded with mobile applications to provide near real-time data on the larvicide applications.

Spray teams also reached 10,000 houses through indoor residual spraying to better protect people directly affected by the floods.

Adelaide Tamele leads one of the spray teams that worked in Celina’s neighborhood. She has been working as a sprayer for six years now.

She vividly remembers the cyclone and how she and her team had to stop working due to the heavy rains. They then re-doubled their efforts once the storm was over.

“After the floods, we had to continue working in order to finish spraying the houses that we were unable to do, due to the floods,” she says. “After the floods, malaria cases increased – there were a lot of mosquitoes.”

In addition to spraying, Adelaide and her team speak to families about malaria prevention, how to identify symptoms, and where to go for testing and treatment.

Adelaide says she is passionate about leading a team that fights back malaria because it provides her with an opportunity to protect the health of her community. She, too, has been personally impacted by the disease: Her 16-year-old niece died of malaria last year.

“She got a headache… the following day we took her to the hospital because the pain was not going away. She went into an intensive care unit… and then passed away,” she says.

“My dream is to eliminate malaria. I would like malaria to disappear completely.”

The Global Fund supports countries and communities responding to health crises caused by extreme weather events and is urging for increased investments to mitigate the severe health impacts of climate change.