Surviving Displacement and HIV: A Mother's Journey to Health and Resilience

Cabo Delgado -  Samia* is a 35-year-old woman who has been internally displaced and is currently living in a relocation site in Montepuez. When conflict broke out in Macomia, she was forced to flee her home with her five children, leaving her without a place to live and in a vulnerable situation.

“Houses were burnt down in Macomia due to conflict. People were screaming everywhere. It was terrible. I had to walk for several kilometers. I am glad that I made it here safely with my children,” says Samia.

Samia and her family were able to reach Montepuez safely, but she didn't know the whereabouts of her husband.

Since 2017, Northern Mozambique has been the target of attacks by Non-State Armed Groups (NSAG). The conflict, together with extreme weather conditions have contributed to the displacement of over 830,000 people in the country according to IOM’s latest DTM. The conflict has put a strain on already limited services, infrastructure and facilities, putting especially women and children’s well-being and safety at risk. The province of Cabo Delgado faces multiple challenges and ranks low on many social indicators including elevated illiteracy and unemployment rates, high rates of child marriages and early pregnancies, as well as increasing HIV incidence rates, combined with limited access to family planning services. Gender-based violence, including sexual exploitation and abuse are major concerns for displaced women, girls, and boys.

Samia has been displaced multiple times and she has left her few remaining possessions behind.

“I started feeling so weak when I arrived here. I did not know where to go to seek help. I was separated from my husband and the rest of our people. I got very sick. I had to depend on my young children for support,” Samia recalls. “My children woke me up one day when they heard knocks on the door, I was terrified, I thought we would be evicted from the site. “ Samia laughed in relief when she found out that it was Community Health Workers (CHWs) during their door-to-door campaigns. She was referred to a health facility for a medical check-up when IOM CHWs noticed that she was pregnant and not in good health.

During the check-up, she was diagnosed with HIV and received counselling to initiate and ensure adherence to treatment.

“I was worried that my baby would contract HIV at birth, but the doctor assured me that my baby would be safe and not infected,” says Samia “The only hope I had was the words from the doctor.”

She was given access to anti-retroviral therapy (ARV) and IOM CHWs kept visiting her to provide continuous counselling and support, guide her on healthier food choices, and encourage her to continue taking her medication.

A few months later, Samia gave birth to her baby boy at the health facility. The doctors conducted tests after three and six months and informed her that the baby was safe and had not contracted HIV.

“I am encouraged to take my medication as required to continue living to see my son grow healthy every day,” says Samia. “I am grateful to IOM staff for their continuous follow-up and visits, for providing me transportation to undergo tests, and for delivering my medication. I have regained my strength  and hope to live longer.”

The migration process, including that of forced displacement, can expose people on the move to health risks, such as perilous journeys, psychosocial stressors and abuses, nutritional deficiencies, changes in lifestyle, exposure to infectious diseases, limited access to prevention and quality health care, and interruption in care.

Migrants and displaced people may also encounter various challenges in accessing healthcare, such as administrative, financial, geographic, social, and cultural obstacles, which can make it difficult to receive regular and continuous care across borders, including access to HIV treatment.  Moreover, HIV is often stigmatized, making it essential to engage and educate communities to reduce barriers to care.

Through mobile brigades, mobile clinics , and community-based health services through CHWs, IOM ensures good health and well-being to internally displaced people in hard-to-reach areas, like Samia and her children, who otherwise did not know where to access healthcare services. IOM provides primary healthcare to displaced populations in Northern Mozambique through offering health consultations, antenatal and postnatal consultations to pregnant women, nutrition services and routine vaccination services for children, under the Expanded Program on Immunization (EPI).

Since 2022, IOM Mozambique has reached over 350,000 people through emergency health programs including the mobile clinics and health brigades, and even more through the health promotion and awareness raising campaigns on HIV and TB care, Sexual Reproductive Health, and COVID-19 by the CHWs.

Conflict and humanitarian crises have affected populations in Mozambique, leading to large numbers of internally displaced people. The Government of Mozambique through the Ministry of Health and The International Organization for Migration (IOM) are supporting health in emergencies which provides SRHR - HIV and TB care and treatment to mobile populations, including IDPs, and vulnerable populations in Northern Mozambique with generous funding from German Humanitarian Assistance, UKAID, Irish Aid, Swiss, EU ECHO, UNCERF, Embassy of the Kingdom of Netherlands, and Global Affairs Canada.

The efforts focus on ensuring continuity of health services during conflict or service disruption, providing support to key and vulnerable populations, particularly those on the move and in hard-to-reach areas.

*Name changed to protect identity.

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