By Ruth Ayisi
Six-year-old Rahel could no longer stand upright. As her spindly legs gave way, she flopped down on the dusty ground, doubled over and vomited a watery liquid.
Her mother, Florentina Uzebe, knelt down and covered the vomit up with sand and then put her arm around her daughter, who was now sobbing softly.
Rahel is one of the 3,214 people with malaria at a camp in Chaqualane, in the southern province of Gaza, where around 40,000 displaced Mozambicans have congregated, escaping from the country's worst floods in living memory.
Ten days after the Limpopo and Save Rivers and surrounding dams burst their banks sending a gush of water raging through much of the countryside in the southern provinces of Maputo, Gaza and Inhambane, the survivors are battling against the threat of disease.
Their bodies are weak after hours or even days perched on the top of trees and roofs with no water or food. Others escaped by walking for hours, like Florentina.
With her young baby strapped on her back, and sometimes carrying Rahel, Florentina waded about seven kilometres in dirty waters that sometimes reached as high as her shoulders. "This is the second time I fled for my life and have lost all my possessions, " said the 28-year-old mother. "First it was the war and now the waters."
Today, almost a million people need humanitarian assistance, including 190,000 children under five years old. Hundreds, maybe thousands of people drowned.
As the muddy floodwater subsides, stagnant water will remain a breeding paradise for the mosquito larvae.
"Malaria cases have doubled," says Claudio Marra, a doctor working for UNICEF in Gaza province. "But what we're seeing now in the camps is just the tip of the iceberg. Many of the children are dying at home."
UNICEF is working with the Government to make sure that drugs are available in all camps, villages and towns to treat malaria. The difficulty has been that much of the malaria is chloroquine resistant; and so the government has agreed that in this emergency, a different drug, Fansidar, be used as the first-line treatment for malaria.
For children living in the flood ravaged Limpopo River valley, and the impact of malaria on their fragile bodies is compounded by many of the children being malnourished and suffering from severe anaemia.
Even before the floods, malaria was the number one child killer in the country.
Besides malaria, everywhere is now a high risk for a cholera outbreak. Other major threats are measles, meningitis and dysentery. Respiratory infections, skin diseases, conjunctivitis and diarrhoea are already a problem in the camps.
As an important preventive measure, UNICEF will support a Government vaccination campaign next week in all the camps and towns against measles and meningitis for children and neonatal tetanus for pregnant women. The cold chain system of refrigerators and cold boxes to keep the vaccines at the correct temperature is now being put into place, and the vaccination teams will travel by road and helicopter to ensure they reach all children and pregnant women.
Providing safe water has been a priority to prevent diarrhoeal diseases, also a major killer of children. "Just a few days ago many of the flood victims were drinking the muddy waters," says Dr. Marra.
This battle against disease is not easy in Mozambique, one of the world's poorest countries, where about 245 children out of every 1,000 die due to preventable diseases before they celebrate their fifth birthday.
Rahel is unfortunately typical of thousands of other children who survived the floods. Her body has been dramatically weakened by lack of food, exhaustion and her poor current living conditions.
Last night, despite heavy downpours of rain, like the tens of thousands of other displaced people, the child slept with her mother and baby sister, Citeria, outside under a tree. "We got very wet," said the mother in the local language Shangaan. " Rahel is now very feverish." The girl's head was burning hot.
But at least Florentina has been able to take her children to see a health worker, who was working tirelessly in a tent, set up temporarily as a makeshift health post. In the past week, the few health workers in the Chaquelane camp had seen over 5100 patients, most of them young children.
After a four-hour wait with hundreds of other sick people sitting on the ground, Florentina and her children were attended to. Around her, masses of people were coughing, children crying and others lying down, exhausted and weak.
Florentina has no plans to return home at the moment. "I am too afraid that the floods will come again,'' she said. Besides she does not know whether anything of her house is left.
For now Florentina's priority is to nurse her two children back to health, even if she has to do that outside under the branches of a tree. As she walked away from the crowded health post, a swirl of dust engulfed her and dark clouds gathered overhead threatening another very wet night.
For more information on UNICEF, visit its web site at http://www.unicef.org