Mitigating NTDs with water and sanitation initiatives in Mozambique

02 Feb 2024

The Mogovolas district in the northern province of Nampula, Mozambique, grapples with a concerning prevalence of Neglected Tropical Diseases (NTDs) like scabies, bilharzia, and lymphatic filariasis. These diseases thrive due to inadequate access to safe drinking water, basic sanitation, and the adverse impacts of climate change.

The lack of safe drinking water not only accelerates the spread of endemic diseases but also heightens the risk of waterborne diseases such as cholera and diarrhea.  The once-abundant wells and underground water sources have either diminished significantly or completely dried up resulting in local communities using stagnant water sources or enduring long journeys to find other water sources.

During our visit to the Meluli River, we met Luzília, a 20-year-old who, due to the prolonged drought, dug small holes to collect water for household chores. She explained "obtaining water has become exceedingly difficult. Seven of us in my household rely solely on this water source”.

Current stage of the Meluli River, the main source of water for the surrounding communities in Nametil.

The Meluli River, which is the main source of water for the surrounding communities in Nametil © MSF/Lourino Pelembe

Initiatives For Sustainable Water Solutions

To tackle these issues, Médecins Sans Frontières (MSF) in partnership with local authorities and communities, is implementing integrated water and sanitation initiatives in the area. The primary goal is to enhance living conditions and stop the spread of bilharzia and scabies, along with waterborne diseases, by promoting proper hygiene practices.

These initiatives encompass health education, resilience building, and adaptation strategies through rainwater harvesting infrastructure and the rehabilitation of traditional wells and boreholes. 

Eight safeguarded wells, each equipped with hand pump systems, stand as beacons of transformation within these communities. This vital initiative not only shields the communities from exposure to the bilharzia-causing worm but also promises a palpable enhancement in the overall quality of life. 

MSF has also been establishing water sources in closer proximity to these communities, eradicating the need for tough journeys in search of water. Recently, a spring catering to the daily needs of the Namacaro community in Nametil was successfully established. These sources are far more than just water outlets; they stand as symbols of hope for the population, paving the way for a future mitigation from the grip of neglected tropical diseases.

This water will be great assistance to all of us here in our community. The installation of this pump has completely changed our lives, as water scarcity was a painful reality. Now, people have free and easy access to quality water, essential for drinking, cooking, and personal hygiene.

Atumane Amisse
Water committee leader

The new water source is not only bringing convenience but also safety and health to the Namacaro community. Clean and accessible water paves the way for a healthier and more prosperous future for everyone in the community.


Pioneering community-led water management

Beyond medical interventions for NTDs, MSF engages with the local water committees to build community resilience. These committees receive training and guidance on water conservation, source maintenance, and proper hygiene practices to ensure sustained and safe access to drinking water.

Empowering these committees is pivotal in overseeing, managing, and safeguarding water sources. The collaboration between MSF and local authorities and communities aims not only to secure water availability but also to empower those communities to efficiently manage these vital resources sustainably. 

View of the MSF team checking one of the safeguarded wells equipped with hand pump systems built by MSF to facilitate access to water for the communities.

The MSF team check one of the safeguarded wells equipped with hand pump systems, built by to facilitate access to safe water for the communities © MSF/Lourino Pelembe

 The plan to curb NTD contamination in Mogovolas includes building community laundries to deter women and children, who use river water for washing, from needing to use water sources contaminated with bilharzia larvae.

Yahya Latama
MSF logistics team leader

In the meantime, Yahya foresees a challenging future for the district, anticipating escalating water crises due to the persistent droughts caused by climate change. "The wells and boreholes that once sustained the community year-round now last 5 or 6 months," he commented.

Mozambique ranks among the countries that are most vulnerable to the climate change. Since 2022, Médecins Sans Frontières (MSF) teams have been actively responding to climate-sensitive diseases in the Nampula province of Mozambique. The primary objective of our activities is to address the gaps in the healthcare system, in relation to neglected tropical diseases such as lymphatic filariasis and schistosomiasis, as well as vector-borne diseases like severe malaria and dengue.