You can always do more

You can always do more
By Martie Mtangen and Anthony Dung’u

Anthony Ndung’u once attended to two children who had fallen head-first from different balconies. One fell from the second floor while the other fell from the third floor. The one who fell from the third floor survived while the other one didn’t make it.

“In another world, this child might not have been here, because things were bad” said Anthony, his eyes glazing over as he tried to recall how the tragic events unfolded. “Both kids arrived in terrible conditions. Fluids were leaking out of every opening and at this point, effective emergency and trauma care matter the most.” One of the children survived because he received the necessary emergency care at the right time while for the other, it was just too late. Regarding the child who survived, Anthony shares that “now when I see him coming to be treated for a common cold, I look at him and wonder if he realizes just how far he’s come.”

Anthony Ndung’u is a Kenyan nurse who works in the Paediatric Accidents and Emergency section of the Aga Khan University Hospital Nairobi (AKUHN). Since 2015, he has specialized in emergency nursing with a focus on children, however, on March 20, 2019, his assignment in Mozambique changed his entire outlook on disaster management in Africa. In this case, Mozambique may have been the child who survived, or died, based on different interpretations. However, what is clear is that it was an emergency situation, and the response could help save the lives of many others.

This is a story about Anthony’s response to the crisis in Mozambique, awareness of the effects of climate change on Beira from the Idai Cyclone and how other African countries can learn and always do more.
In October 2018, Daviz Simango received the Dr Benjamin Barber Global Cities Award at a ceremony in the British city of Bristol. According to the conveners of the event, he was presented with the award for “his leadership, transparency and climate action.” The Global Parliament of Mayors created the award to honour outstanding actions or research on urban governance. Mr Simango has been the mayor of Beira since 2003, mopping the streets of disease and corruption. He established several measures to avoid a repeat of the flooding disaster of the year 2000.

You can always do more

You can always do more

The award was well-deserved.
Mozambique is often depicted as a country that teeters desperately on the edge of take-off and oblivion. According to a report by Climate Investment Funds that works with the World Bank Group, it ranks third in Africa in terms of climate-related hazards and is the only country in Africa considered to be at high risk from each of the main climate hazards, which are droughts, floods and coastal cyclones. However, recent investments into agriculture, mining and gas convince development analysts that there is hope for an economically prosperous state in the future.

Beira is the country’s second-most influential city located on the Mozambique Channel off the Indian Ocean. Its prominence stems largely from the fact that the Port of Beira is an access point for inland Mozambique and serves the landlocked Zimbabwe, Zambia and Malawi. However, it features ineffectively-planned settlements, insufficient housing and experiences high tides while sitting only 40 metres above sea level. To give some context, the Kenyan coastal city of Mombasa (which is also at risk of climate action) is up to 45 metres above sea level. Big difference? In addition to this, there are several channels that venture inland from the ocean, meaning that if they were to overflow, a large portion of Beira would be flooded.

This is part of what happened on March 14, 2019, when reportedly 90% of Mozambique’s second-most important city became an “inland ocean” after the destruction orchestrated by cyclone Idai.
Mayor Daviz Simango had tried to do his part. Together with Climate Investment Funds (CIF) and the World Bank, he had rehabilitated and constructed 11 kilometres of drainage canals, flood control stations and a large water retention basin. In conjunction with the Africa Development Bank, he had weatherized rural roads and irrigation systems and localized food processing and storage facilities. He had rallied the troops to ensure that his community was not caught off-guard as happened nineteen years ago. Unfortunately, it did.
The effects On March 14, 2019, cyclone Idai battered southern Africa, destroying sections of Mozambique, Malawi and Zimbabwe. Mozambique was the worst hit with the port city of Beira almost fully submerged in water.

A few days after the cyclone hit, Anthony Ndung’u was checking in for his night shift duty at AKUHN when one of his colleagues stopped him along the corridor and asked, “Have you heard about the cyclone in Mozambique?” Anthony was mildly surprised by the urgency with which Simon, his colleague, had asked this question. Where was the urgency when the news of Kenyans dying of starvation in Turkana had broken? Nonetheless, he responded, “Yes I have.”
“Would you be interested in going to help?” Simon asked.
“Yes, I would be!” he answered, understanding the importance of immediate responses.

Two days later on March 22, he was part of the nine-man team from Aga Khan on a four-hour direct flight to Maputo.
“It seemed to be business as usual in Maputo”, Anthony revealed as he marvelled at the clean streets and the organization. “It’s much cleaner than Nairobi. We spent the first night in Maputo and flew to Beira the next day.” He was not ready for the scene that unfolded in Beira, 1000 kilometres away from the capital city.

“The scene was gory… the water had moved inland by 80 kilometres from the sea and everywhere was flooded. From the plane we could see how far the water had come in and the areas that had totally submerged. It was a scene from a bomb explosion: roofs had been torn off, buildings had crumbled, and village settlements had been swept away… These were poor communities, and the little they had was swept away. I [even] found them living in a school.” Anthony’s description corresponds with the UN’s account which revealed that schools, houses and other public infrastructure were wrecked, and by mid-April, up to 69,000 people had been displaced, 12,297 were battling cases of malaria and 6,258 cases of cholera had been reported. The situation was dire so there was no time to waste.

Aerial view of the effects of cyclone Idai
Motivated by the gloomy situation, the team got to work. After a reconnaissance mission by the armies on the ground, they mapped out that the worst-hit areas were Buzi (almost 200km from Beira) and Guara Guara (about 45km west of Beira). The cyclone had thrashed through the towns at speeds of about 178 km/hr, meaning that as roofs were torn off buildings and furniture billowed into the air, they clattered into anything, including people. The team treated many villagers who were badly cut or had injuries that became infected, but Anthony also said they treated “many people with pre-existing conditions because the cyclone also hit those who were patients at Buzi hospital.” In Guara Guara, they treated those with wounds and cuts, administered tetanus vaccines, pain killers and analgesics, tested for malaria, started patients on intravenous fluids, fixed nasogastric tubes and dewormed patients.

Scenes of destruction at Buzi Hospital
There was a particular case that stood out for Anthony. A patient limped into the treatment centre at Guara Guara, and his name was Luiz. Luiz came in with a nasty cut on his toe, which Anthony cleaned up and dressed. When he was done, he told Luiz, “keep it clean, and keep it dry,” before realizing that Luiz had no shoes and was surrounded by water from the flooding. This is a bittersweet metaphor on emergency response in Africa: you get a lot of help after the tragedy has struck, but you’re helpless to a large extent because the tragedy has struck.
By March 27, the team was back in Nairobi, exhausted but happy to have helped fellow Africans when they needed it the most. As I spoke to Anthony, I was curious to know what his biggest lesson from this experience was.
“You can always do more… that’s the biggest lesson I learned. You may think that there’s nothing else you can do, but if you really want to, you can always do more.” Says Anthony. The problems associated with climate change have surfaced more forcefully with Cyclone Kenneth hitting parts of Mozambique after causing extensive damage in the Comoros islands. Similarly, raging floods hit parts of Southern Tanzania as well as Durban in South Africa, which left more than 60 people dead and more than 1000 people displaced. For now, the countries with coastlines experience the bulk of the damage and global warming will (as reiterated recently in a landmark report issued by the UN Intergovernmental Panel on Climate Change) lead to the loss of 90% of all coral reefs. For landlocked countries, there are some repercussions as well. An increase to the earth’s temperature of 2C would almost double current global water shortages, leading to a massive drop in wheat and maize harvests, drastically increasing the risk of poverty for hundreds of millions of people, particularly in African countries where agriculture is a major source of income.

Anthony (in a black cap) teaches a group of children how to fly a kite
Mayor of Beira, Mr Daviz Simango had tried to do his part in helping his people and protecting them against climate change. Developing countries are infamously known for last-minute emergency efforts to salvage situations rather than prevent excessive damage through prior planning. Mr Simango’s efforts were commendable, especially because he tried to prepare for the inevitable. How much more damage would have been caused if he had not prepared? We will never know. What is clear, however, is that we need more leaders to wake up, follow suit and do more.

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