Concern about the potential spread of COVID-19 in Mozambique was elevated in late March, when according to Mozambique's National Migration Service (SENAMI) over 14,000 Mozambican migrants returned from South Africa over the Ressano Garcia border within a span of a few days, as South Africa declared lockdown due to COVID-19.
Most of these thousands of Mozambicans travelled back to their home communities in the southern provinces of Maputo, Gaza and Inhambane, which are the main senders of migrant workers to South Africa.
One returnee recalled: "I was very scared when I heard about this illness that is killing people around the world. When the cases began to be confirmed in South Africa, my employer warned of the seriousness of the disease and the upcoming lockdown. As we could return home, I thought it would be better to return to my family in Mozambique because in case of infection with this disease they could look after me. I fulfilled the 14-day quarantine and continue to stay at home with my family. We only go out in case of pressing need. Everyone who enters the house should wash their hands with soap and water."
In response to these concerns, IOM Mozambique activated its network of community health workers across the southern provinces to identify the returnees in their home communities and ensure they are reached with key prevention and quarantine messages. The effort is funded by European Civil Protection and Humanitarian Aid Operations (ECHO) and the United States Agency for International Development (USAID).
To identify returnees, IOM community health workers rely on IOM's registry of active mine workers, health facility registry books, community networks and traditional leadership. Community leaders and traditional medicine practitioners also have been helpful.
Returnees are contacted by phone and health workers deliver key information on mandatory quarantine, COVID-19 prevention and management measures, and referral pathways as needed. The returnees are also asked if family members have symptoms, and are encouraged to share the message with family, friends and neighbours. The data from returnees are shared on a weekly basis with the Ministry of Health.
Mozambique declared its first COVID-19 case on 22 March, and some four weeks later as of Monday, April 20 has reported 39 cases, 8 imported and 31 local transmission, located in the capital Maputo and in some areas of the Cabo Delgado province. Eight people have recovered and 1,110 have been tested. Concerns are growing about the potential impact of a COVID-19 outbreak in a country where public health issues include HIV, TB, malnutrition, as well non-communicable diseases, especially hypertension.
The effort began in late March. Thus far, over 850 migrants have been called, and also the family members of each migrant, inquiring on the health of over 4,100 relatives. To date no one among the migrant returnees who are phone-screened have reported COVID-19 like symptoms.
"This effort has a positive impact because we help to ensure the safety of migrants' families," said IOM Field Supervisor and Focal point for COVID-19 in Inhambane Andre Chambal. "We list and map the returnees, and they know that they can call our lines if they have symptoms. We are glad to support migrants and their families in preventing the spread of COVID-19."
Returned mine worker Laissane Tivane from Inhambane province agreed. "I was surprised when I got the call from an IOM Community Health Worker, wanting to know if I'm okay," he said. "They explained the symptoms of COVID-19, prevention measures and told me to stay home until completing the mandatory 14-days quarantine and to call in case of any symptoms. I am grateful for the attention our health and families."
It is estimated that over 11 million Mozambicans are living abroad, with South Africa one of its citizens' top destinations. Mining and farming jobs are the norm for Mozambicans in South Africa, especially for those working in the formal sector, with about 24,000 Mozambicans working in the mining sector. Farming data are less complete, however in Mpumalanga province alone, 2004 estimates indicated some 80,000 Mozambicans were working in farms there.
IOM Community Health Workers have been working for the past three years on a program funded by the Centers for Disease Control and Prevention and conducted in cooperation with the Mozambican Miners Association and Mozambique's Ministries of Health and Labour, Employment and Social Security The cross-border programme includes occupational health screening for miners as well as follow-up of any TB confirmed migrant and their relatives in their Mozambican home communities as well as workplaces in South Africa.
In 2019, this programme provided over 18,000 occupational health screenings for mineworkers passing through the Ressano Garcia border to work in South Africa. Additionally, 141 migrant workers received follow-up and support to complete their TB treatment, and 435 household contacts were screened for TB.
IOM has been supporting the Mozambican Government COVID-19 preparedness and response plans by implementing a community-based strategy focused on migration-affected communities.
Efforts include training for traditional birth attendants and community leadership on COVID-19 prevention, work with community radio stations to share COVID-19 messages in local languages, and message dissemination in border crossing areas through community workers and local partner NGOs.
IOM teams also work together in resettlement sites to set up hand washing stations and conduct COVID-19 sensitization and preparation.