The surge in displacement in late September marks a turning point in the conflict – now entering its eighth year – with more than 100,000 people already uprooted during 2025.

The violence in Cabo Delgado began in 2017, led by armed groups locally known as al-Shabaab – unrelated to the Somali Islamist militia of the same name. The conflict has evolved into a complex crisis compounded by the effects of repeated cyclones, floods and drought that have devastated livelihoods.

For the first time since hostilities began, all 17 districts of Cabo Delgado have been directly affected, and more than 1.3 million people have been displaced – many multiple times.

“Families are reaching their limit,” Xavier Creach, head of UNHCR in Mozambique said, noting that some who once hosted the displaced are now fleeing themselves.

Civilians continue to be targeted amid reports of killings, abductions and sexual violence, while children face the risk of forced recruitment.

Women and girls most at risk

Women and girls are especially vulnerable when collecting water or firewood, and those with disabilities or older persons often cannot flee the violence. Many are traumatised and urgently need psychosocial support, Mr. Créach added.

The violence has sharply intensified this year, with more than 500 incidents recorded through August – surpassing even the peaks of 2022 – including raids, abductions and the destruction of homes and infrastructure.

Health system under siege

The humanitarian fallout has been compounded by the collapse of health services across the north.

According to the World Health Organization-led response, around 60 per cent of facilities in the worst-affected districts are non-functional due to insecurity, looting and staff displacement.

Essential services such as maternity care, HIV treatment and emergency response have been severely disrupted.

In Mocímboa da Praia, the only hospital is operating with less than 10 per cent of its staff – mostly volunteers struggling to keep the emergency room and maternity ward open.

Aid groups warn that disease risks are mounting, with malaria and cholera cases expected to rise as the rainy season begins.

Severe funding shortfall

The health sector’s annual response plan is only 11 per cent funded for this year, leaving stocks of essential medicines critically low.

UNHCR also faces severe funding shortfalls. It has received only $66 million of the $352 million required for its Mozambique operations this year, leaving response capacity “stretched just as needs rise.”

“The pain is indescribable” on the anniversary of the “abhorrent” attacks, said UN relief chief Tom Fletcher.

“I renew my call for the unconditional, immediate release of all the hostages – and until then, they must be treated humanely,” he continued. “Civilians everywhere have to be protected.”

Mr. Fletcher underscored the fact that since 7 October 2023, tens of thousands of Palestinians have been killed and “hundreds of thousands endure starvation and displacement”.

Calls for ceasefire and accountability

Philippe Lazzarini, Commissioner-General of the UN aid agency for Palestinians, UNRWA, said that Gazans have lived through “two long years of destruction, displacement, bombardment, fear, death and hunger”. In a statement posted on X, he again called for the release of all hostages and Palestinian detainees, an immediate ceasefire and for the unfettered delivery of humanitarian supplies at scale, including through UNRWA.

He also urged accountability for atrocities committed on and after 7 October 2023, saying there was “no other way out of this abyss and mayhem”.

7 October terror

More than 1,250 Israelis and foreign nationals were killed in the terror attacks by Hamas and other armed groups on 7 October 2023 and more than 250 others were taken hostage.

More than 66,000 Palestinians have subsequently been killed in the war in Gaza, according to local health authorities.

Amid ongoing violence and airstrikes, UN humanitarian and health officials said on Tuesday that children are paying the heaviest price, with tens of thousands killed, maimed or severely malnourished, while Gaza’s hospitals and clinics edge towards total collapse.

Child deaths unacceptable: UNICEF

Speaking in Geneva on Tuesday, Ricardo Pires from the United Nations Children’s Fund (UNICEF) maintained that Israel’s “disproportionate response” had left children suffering “in their bodies and minds for way too long”. He told reporters that 61,000 children have reportedly been killed or maimed since October 2023 – one child every 17 minutes – and that many have been traumatised, orphaned and displaced multiple times, “an unacceptable, staggering figure”.

“They’ve been exposed to disease and violence on a scale unprecedented for Gaza,” he continued. “We’ve been denied permission to bring incubators and ventilators to children from the north. They desperately need that to survive. We’re talking about children sharing oxygen masks in order to stay alive.”

UNICEF says that one in five babies in Gaza is now born prematurely, often to mothers weakened by hunger and stress.

Referring to the peace plan put forward by US President Donald Trump, which has been the object of negotiations in Egypt for a second day, Mr. Pires welcomed “the plans by the US Government which bring a glimpse of hope to the region and to civilians and children in Gaza, that a better future is ahead”.

His words echoed those of UN Secretary-General António Guterres who, in a statement on Monday, said that the recent proposal by the US President “presents an opportunity to that must be seized to bring this tragic conflict to an end”.

The opportunity must not be lost, the UN chief stressed. “After two years of trauma, we must choose hope – now,” he said.

Hospitals on the brink

According to the World Health Organization (WHO), only 14 of Gaza’s 36 hospitals are still partially operating – none in northern Gaza – and just 62 primary health-care centres remain partly functional, compared with a pre-war total of 176.

WHO spokesperson Christian Lindmeier said that official figures confirm 400 malnutrition-related deaths since January 2025, including 101 children, 80 of them under five. Over 10,000 children have been diagnosed with acute malnutrition in the past two months, and about 2,400 severely malnourished children are at risk of starvation.

Speaking to reporters in Geneva, the WHO spokesperson warned that the true toll is likely much higher, as many families in overcrowded shelters cannot reach clinics or hospitals. “Famine that was once confined to Gaza City is now spreading south as people flee renewed fighting,” he explained.

Aid still blocked and unpredictable

From the UN aid coordination office (OCHA), spokesperson Jens Laerke added that since October 2023 more than 8,000 missions inside Gaza have required Israeli approval, and that nearly half had been denied, delayed or impeded. “Any aid that gets in is positive,” he said, “but there hasn’t been a single day where supplies met the levels required”.