In some places like northeast Nigeria, the Islamic State effectively controls its local affiliate, the Islamic State in West Africa, and has provided it with trainers, expertise and financing, according to research by the International Crisis Group. But researchers say the Islamic State maintains much looser ties to other militant groups like the insurgency in Mozambique, which remains a largely homegrown movement born of local grievances.
For decades there, impoverished locals had watched as elites in the capital plundered the resource-rich region of Cabo Delgado, along the Indian Ocean, which has served as a hub for illegal timber as well as drug and ivory smuggling.
Then in 2009, one of the world’s largest known ruby deposits was discovered in the province, and two years later, oil companies uncovered a natural gas deposit worth tens of billions of dollars. In a sudden — and often violent — stroke, speculators flocked to the area, locals were forced off their land and some small-scale miners were beaten and killed.
By the time the nascent insurgency launched its first attacks in 2017, targeting police stations and local government leaders, it had widespread appeal among petty traders at the ports and disenchanted youths, local researchers say.
The violent crackdown from the Mozambican military, which was implicated in serious abuses against civilians, may have also helped the insurgency — known locally as Al-Sunna wa Jama’a — gain more traction with locals.
But over the past year, the nature of the war has changed. The militant group has destroyed entire towns, displacing 670,000 people, killing at least 2,000 civilians and kidnapping scores of others, according to human rights and humanitarian organizations, and the U.S. State Department.
How does a country deal with climate disasters when it’s drowning in debt? Not very well, it turns out. Especially not when a global pandemic clobbers its economy.
Take Belize, Fiji and Mozambique. Vastly different countries, they are among dozens of nations at the crossroads of two mounting global crises that are drawing the attention of international financial institutions: climate change and debt.
They owe staggering amounts of money to various foreign lenders. They face staggering climate risks, too. And now, with the coronavirus pandemic pummeling their economies, there is a growing recognition that their debt obligations stand in the way of meeting the immediate needs of their people — not to mention the investments required to protect them from climate disasters.
The combination of debt, climate change and environmental degradation “represents a systemic risk to the global economy that may trigger a cycle that depresses revenues, increases spending and exacerbates climate and nature vulnerabilities,” according to a new assessment by the World Bank, International Monetary Fund and others, which was seen by The Times. It comes after months of pressure from academics and advocates for lenders to address this problem.
downgraded its creditworthiness, making it tougher to get loans on the private market. The International Monetary Fund calls its debt levels “unsustainable.”
nearly $600 billion in debt service payments over the next five years. Both the World Bank and the International Monetary Fund are important lenders, but so are rich countries, as well as private banks and bondholders. The global financial system would face a huge problem if countries faced with shrinking economies defaulted on their debts.s
“We cannot walk head on, eyes wide open, into a debt crisis that is foreseeable and preventable,” the United Nations Secretary General, António Guterres, said last week as he called for debt relief for a broad range of countries. “Many developing countries face financing constraints that mean they cannot invest in recovery and resilience.”
The Biden administration, in an executive order on climate change, said it would use its voice in international financial institutions, like the World Bank, to align debt relief with the goals of the Paris climate agreement, though it hasn’t yet detailed what that means.
flurry of proposals from economists, advocates and others to address the problem. The details vary. But they all call, in one way or another, for rich countries and private creditors to offer debt relief, so countries can use those funds to transition away from fossil fuels, adapt to the effects of climate change, or obtain financial reward for the natural assets they already protect, like forests and wetlands. One widely circulated proposal calls on the Group of 20 (the world’s 20 biggest economies) to require lenders to offer relief “in exchange for a commitment to use some of the newfound fiscal space for a green and inclusive recovery.”
debts soared, including to China, and the country, whose very existence is threatened by sea level rise, pared back planned climate projects, according to research by the World Resources Institute.
The authors proposed what they called a climate-health-debt swap, where bilateral creditors, namely China, would forgive some of the debt in exchange for climate and health care investments. (China has said nothing publicly about the idea of debt swaps.)
sinking under huge debts, including secret loans that the government had not disclosed, when, in 2019, came back-to-back cyclones. They killed 1,000 people and left physical damages costing more than $870 million. Mozambique took on more loans to cope. Then came the pandemic. The I.M.F. says the country is in debt distress.
Six countries on the continent are in debt distress, and many more have seen their credit ratings downgraded by private ratings agencies. In March, finance ministers from across Africa said that many of their countries had spent a sizable chunk of their budgets already to deal with extreme weather events like droughts and floods, and some countries were spending a tenth of their budgets on climate adaptation efforts. “Our fiscal buffers are now truly depleted,” they wrote.
In developing countries, the share of government revenues that go into paying foreign debts nearly tripled to 17.4 percent between 2011 and 2020, an analysis by Eurodad, a debt relief advocacy group found.
Research suggests that climate risks have already made it more expensive for developing countries to borrow money. The problem is projected to get worse. A recent paper found climate change will raise the cost of borrowing for many more countries as early as 2030 unless efforts are made to sharply reduce greenhouse gas emissions.
JOHANNESBURG — The Islamic State has claimed responsibility for a days-long ambush of a port town in northern Mozambique last week that forced tens of thousands of people to flee the area and left dozens dead, including some foreigners.
The attack on the town, Palma, was an alarming escalation of the war in the gas-rich province of Cabo Delgado, where insurgents with loose ties to the Islamic State have killed at least 2,000 people in a campaign of violence over the past three years.
In recent months, the local insurgency has grown in strength and seized large swaths of territory, including the region’s other main port town. Last week’s attack demonstrated a new level of boldness from the insurgents and was the closest the group has come to a multibillion-dollar gas project that is operated by international energy companies.
Few analysts believe that the Islamic State in the Middle East maintains a close relationship with the insurgency, which was born out of frustration over local grievances and shares few of the Islamic State’s ideological aims. But claiming responsibility for the deadly attack underscores the organization’s ability to leverage loose ties with militant groups around the world to create the impression of a truly global struggle.
attempted to escape by road on Friday. Militants ambushed a 17-vehicle convoy shortly after it left the hotel, the Amarula Palma, and only seven of the vehicles made it to the beach, where a fleet of boats was rescuing hundreds of people trapped in the town.
At least one South African, Adrian Nel, 40, was killed in the escape attempt from the Amarula Palma Hotel. Several other South Africans are still missing and presumed dead, according to private security contractors, and at least one British citizen was missing as of Sunday night.
This month, the United States formally designated the insurgency, known locally as Al-Sunna wa Jama’a, as a global terrorist entity and U.S. Special Forces soldiers began training Mozambican troops. The insurgents became identified with the Islamic State Central Africa Province in 2019.
Still, many analysts say the insurgency remains a homegrown crisis, born out of an array of grievances that have long plagued the impoverished region.
“This is a domestic insurgency based on domestic grievances,” said Joseph Hanlon, a visiting senior fellow at the department of international development at the London School of Economics, who is an expert on Mozambique. “There are loose ties but the insurgents have not seceded control to IS.”
He added: “This is not an Islamic jihad.”
Since militants overran the town on Saturday, the Mozambique military and contractors with a South African private military brought in by the government have tried to flush the insurgents from the town. But militants still control much of Palma, including the town’s banks, government offices, factories and army barracks, according to a statement that the Islamic State released on Monday.
In recent days, tens of thousands of people have fled Palma for nearby areas, worsening a humanitarian crisis that has escalated drastically over the past year.
At the start of 2020, the conflict had displaced 18,000 people in Mozambique, according to the World Food Program. By the beginning of this year, that number had grown to over 600,000.
“The crisis had been escalating for some time,” said Lola Castro, regional director for Southern Africa for the program. “But at this moment we are looking at a humanitarian disaster.”
Eric Schmitt contributed reporting from Washington.
JOHANNESBURG, South Africa — As gunshots rang out across a port town in northeastern Mozambique on Friday afternoon, nearly 200 people sheltering inside the Amarula Palma hotel confronted a devastating reality: The armed insurgents outside the hotel’s doors had all but taken control of the town and there was no one coming to save them any time soon.
For two days, hundreds of insurgents in the gas-rich region had been laying siege to the coastal town of Palma, firing indiscriminately at civilians, hunting down government officials and setting buildings ablaze as security forces tried in vain to repel them.
The violence sent thousands of people fleeing, with some rushing to the beach, where a ragtag fleet of cargo ships, tugboats and fishing vessels was ferrying people to safety.
But at the hotel, with daylight hours dwindling, the local residents and foreign gas workers who remained faced an impossible choice: Either wait inside, defenseless, for a promised evacuation in the morning, or try to make it to the beach.
campaign of violence the militants have unleashed. Insurgents have beheaded civilians in summary executions and left homes, schools and health centers destroyed.
Many analysts say that the insurgency is a home grown-crisis and that the group only maintains loose ties to the Islamic State. Still, the jihadist rallying cry has provided a banner under which mostly impoverished people angry about an array of local grievances can coalesce. It has also inspired the use of the international terrorist network’s brutal tactics.
Few journalists and human rights investigators have been able to report firsthand on the conflict from Mozambique, where government forces and private security contractors have also been implicated in abuses against civilians. And as the attack on Palma unfolded last week, phone lines and other communications in the town were cut by insurgents.
Joseph Hanlon, a visiting senior fellow at the department of International Development at the London School of Economics who is an expert on Mozambique.
The Mozambique government guaranteed Total that it would secure the development, and Total said it would not hire private security companies like the Dyck Advisory Group, which was recently implicated in a report by Amnesty International of killing civilians.
“This attack is arguably the most significant yet, given that foreigners also came under the cross hairs of insurgents and because Palma is the gateway to the gas megaprojects,” said Dino Mahtani, deputy director of the Africa program at the International Crisis Group, who recently visited Mozambique. “It will lead to more pressure on Mozambique for hard military responses, perhaps at the expense of other policies that should still be on the table.”
Earlier this month, the United States formally designated the insurgency, known locally as Al-Sunna wa Jama’a, as a global terrorist entity after the group became identified with the Islamic State’s Central Africa Province in 2019.
engulfed in sporadic fighting between the militants and national security forces as helicopters operated by the South African private contractors flew overhead.
By Friday morning the usually serene Amarula Palma Hotel, a sprawling compound with an outdoor bar and thatched-roof awnings that caters to foreign workers from countries like South Africa and the United Kingdom, had transformed into a chaotic epicenter of the crisis. By midday insurgents had surrounded the hotel and attacked, breaching its perimeter.
Helicopters operated by the private South African security company managed to evacuate 22 people. But with both fuel supplies and the light dwindling, contractors told the roughly 180 people who remained that they would not be able to fly them out until the following morning.
Dozens of people decided to chance an escape by road in the convoy that was ambushed.
On Saturday morning, the South African-operated helicopters evacuated around 20 more people who had remained in the hotel. Several others who had escaped the town and hid in the surrounding bush were also rescued by helicopters. Some had flagged the helicopters by writing out S.O.S. messages in stones, according to Mr. Dyck.
At the same time, a convoy of at least 10 vessels sailed into the bay of Palma in an informal effort to evacuate people, according to the ship-tracking website MarineTraffic.com.
Twelve hours later, they sailed south together. Several of the ships docked at Pemba, where humanitarian workers say thousands of people who were displaced by the ambush were receiving aid on Sunday.
A passenger ferry that usually operates along the coast of neighboring Tanzania also docked in Palma on Saturday and arrived in Pemba the following day, according to ship-tracking data, satellite imagery and photographs shared on social media. Local sailors on traditional wooden sailing boats, known as dhows, also carried some displaced people to Pemba, according to humanitarian workers.
While some of the fleet’s efforts were successful, other boats that attempted to come ashore to rescue people were forced to pull back when militants opened fire with small arms and mortars, according to American officials. At least one American citizen was at the gas project site near Palma during the attack, but was safely evacuated to Pemba, according to a U.S. official.
On Sunday morning, Mozambique Special Forces units launched an operation to reclaim the town. But by Sunday night, militants still held much of Palma, including the harbor, the officials said.
One British citizen who was part of the convoy who worked at RA International, a contracting company headquartered in Dubai, was missing as of Sunday night, according to an executive at the company.
At least one South African, Adrian Nel, 40, was killed in the ambush on the convoy.
Mr. Nel had been in Palma working at his family’s construction consulting company alongside his brother Wesley Nel, 37, and their stepfather, Gregory Knox, 55, who were also caught in the ambush. The two men managed to escape to the nearby forest and hid until private security contractors evacuated them by helicopter the following morning.
“They spent the night in the bush, with Adrian’s body,” Mr. Nel’s mother, Meryl Knox, 59, said in an interview. Ms. Knox spoke with her husband on Wednesday as the attack unfolded andthe private security contractors who rescued the men by helicopter on Saturday.
“The insurgents had surrounded the hotel and there was no help from the Mozambican army,” Ms. Knox said. “These guys were just left on their own.”
Christina Goldbaum reported from Johannesburg, South Africa. Eric Schmitt reported from Washington, D.C. Declan Walsh reported from Nairobi, Kenya.
Lynsey Chutel contributed reporting from Johannesburg, South Africa. John Ismay contributed reporting from Washington, D.C. Charles Mangwiro contributed reporting from Maputo, Mozambique. Haley Willis, Christiaan Triebert and Malachy Browne contributed reporting from New York.
JOHANNESBURG, South Africa — Suspected Islamist insurgents seized control of much of a town in Mozambique on Saturday after a three-day siege that has left at least several people dead and hundreds of other civilians unaccounted for as government forces try to regain control, according to private security contractors in East Africa and news reports.
Nearly 200 people, including dozens of foreign workers, sought shelter inside a hotel in the town, Palma, after nearly 300 militants flooded into the area on Wednesday, destroying much of the town and sending hundreds of other residents fleeing into nearby areas.
On Friday afternoon, insurgents attacked a convoy of civilians as they attempted to flee the hotel, killing several people and injuring dozens of others.
in a brutal war unfolding in the country’s north involving insurgent groups believed to be linked to the Islamic State. The conflict has left at least 2,000 civilians dead and displaced 670,000 more in recent years, according to humanitarian groups.
Over the last year, the militant group has grown in strength and seized large swaths of territory across the northeastern province of Cabo Delgado, which is home to some of the world’s largest gas reserves.
The siege this week is the closest yet the insurgents have come to a multibillion-dollar gas project in the area, operated by international energy companies, including Total, and the attack reflects an alarming escalation of the insurgent threat.
become increasingly brutal since the insurgency began in 2017, when militants ambushed police stations in the area. In recent years, the insurgents have attacked villages, destroyed schools and hospitals, and beheaded hundreds of people. The group itself has also grown from a few dozen fighters to as many as 800 militants.
At the same time, government forces have been implicated in serious abuses, including arbitrarily detaining civilians and executing dozens of people suspected of belonging to the insurgency, according to Human Rights Watch.
Earlier this month, the United States formally designated the insurgency, known locally as Al-Sunna wa Jama’a, as a global terrorist entity. In 2019 the group became identified with the Islamic State’s Central Africa Province, which also has a presence in the Democratic Republic of Congo, though it is unclear how closely the militants are linked to the Islamic State in Iraq and Syria.
Earlier this month, U.S. Special Forces soldiers began training Mozambican troops in an effort to bolster the country’s counterinsurgency operations. On Saturday, Rep. Michael McCaul of Texas, the ranking Republican on the House Foreign Affairs Committee, called for the United States to increase that support.
“Reports of the ongoing terrorist attacks in Palma, Mozambique describe a blood bath,” he said. “The U.S. and our partners must do more to combat this threat before ISIS controls more territory and slaughters more innocent civilians.”
He added: “We cannot let ISIS control territory like they did in the last decade.”
Eric Schmitt and John Ismay contributed reporting from Washington, D.C. Charles Mangwiro contributed reporting from Maputo, Mozambique.
French energy giant Total SE and international contractors were scrambling to evacuate staff from a $20 billion natural-gas project in northern Mozambique on Saturday, security officials and analysts said, as a deadly attack by Islamic State-linked insurgents on a nearby town entered its fourth day.
The siege on the coastal town of Palma, which serves as hub for the U.S.-supported project, began on the day that Total announced it would gradually recommence work at its nearby liquefied natural gas plant, citing Mozambican government efforts to improve security in the area.
Total, which took over the project from Anadarko Petroleum in 2019, had pulled out nonessential staff in early January, following an attack that reached the gates of the LNG plant on the Afungi peninsula. The plant and offshore gas fields, one of which is operated by Exxon Mobil Corp. , are the largest foreign investment project on the African continent. Construction has been delayed by the escalating insurgency.
Some 2,600 people have been killed in the impoverished Cabo Delgado province, about half of them civilians, since Oct. 2017, while more than 600,000 have been driven out of their homes.
Several hundred insurgents entered Palma early Wednesday morning, indiscriminately firing machine guns and rocket-propelled grenades at civilians and into homes, according to Human Rights Watch and Focus Group, a risk-management company that supports clients operating in the area.
Sister Janice McLaughlin, an American nun who was imprisoned by the white minority government in war-torn Rhodesia for exposing atrocities against its Black citizens, then returned to help the new country of Zimbabwe establish an educational system, died on March 7 in the motherhouse of the Maryknoll Sisters of St. Dominic, near Ossining, N.Y. She was 79.
Her religious order, of which she was president for a time, announced her death. It did not provide a cause.
Sister McLaughlin spent nearly 40 years ministering in Africa. She lived much of that time in Zimbabwe, starting in 1977, when the country was still known as Rhodesia.
She arrived in the midst of a seven-year struggle by Black nationalists to overthrow the white minority apartheid-style regime headed by Prime Minister Ian Smith, a fierce opponent of Black majority rule.
Catholic Commission for Justice and Peace, a group of laymen and clergy that opposed the government, Sister McLaughlin helped expose human rights abuses across the country. These included the systematic torture of Black people in rural areas and the shooting of innocent civilians, including clergy. She also wrote about the forced resettlement of nearly 600,000 Black citizens, who had been held in heavily guarded camps in overcrowded conditions lacking proper sanitation and food.
Just three months after her arrival, she was charged with being a terrorist sympathizer and locked in solitary confinement for 18 days. She faced a penalty of seven years in prison, but the United States interceded, and she was instead deported.
Her writings had been published in obscure journals, but her imprisonment drew widespread attention; the Vatican, the United Nations and the State Department spoke out on her behalf. On the day she was thrown out of the country and walked across the tarmac to the plane that would take her out of Rhodesia, a group of about 50 Black and white Rhodesians, many of them priests and nuns, gathered at the airport, cheered her on and sang the Black nationalist anthem, “God Bless Africa.”
On the flight out, Sister McLaughlin told The New York Times that she was not a Marxist, as the Smith regime had alleged, but that she did support the guerrillas.
“I think it’s come to the point where it’s impossible to bring about change without the war,” she said, “and I support change.”
Robert Mugabe as the new president. Before he would plunge the once-wealthy nation into chaos, corruption and economic ruin, he asked for her help in rebuilding the educational system, and she readily agreed. Among other things, she established nine schools for former refugees and war veterans.
When she died, she was eulogized by President Emmerson Mnangagwa, Mugabe’s successor.
“She chose,” he said in a statement, “to leave an otherwise quiet life of an American nun to join rough and dangerous camp life in the jungles of Mozambique, where she worked with refugees in our education department.”
Her presence, he added, “helped give the liberation struggle an enhanced international voice and reach.”
Janice McLaughlin was born on Feb. 13, 1942, in Pittsburgh to Paul and Mary (Schaub) McLaughlin and grew up there. She graduated from high school in 1960 and attended St. Mary of the Springs College in Columbus, Ohio, for a year, then entered the Maryknoll Sisters Congregation in Maryknoll, N.Y., near the Hudson River village of Ossining, north of New York City.
The order, founded in 1912, was the first American congregation of Catholic nuns dedicated to overseas missions.
told The Times in 2013. “We try to live simply with the people. As Mother Mary Joseph said to us, ‘If anybody’s going to change, it’s going to be us.’”
She worked in the Maryknoll Sisters communications office from 1964 to 1968 and organized a “war against poverty” program in Ossining. Moving to Milwaukee, she earned her bachelor’s degree in theology, anthropology and sociology from Marquette University in 1969.
Then came her dream assignment — to work in Kenya, where she ran courses in journalism for church-sponsored programs. At the same time, she studied the anticolonial struggles going on across the continent.
Much of her work in Rhodesia consisted of documenting massacres. When her office was raided by the government, two colleagues who had also been arrested were released on bail, but she was held as a dangerous communist subversive. “If I had Black skin,” she had written in her diary, “I would join ‘the boys,’” using the common term for the Black freedom fighters. She believed in the redistribution of wealth to redress past injustices.
a recent remembrance by Robert Ellsberg, publisher of Orbis Books, an imprint of the Maryknoll Order.
“I was suffering for a cause, and the pain and fear no longer mattered,” she added. “I was not alone. I was with the oppressed people, and God was there with us in our prison cells.”
NAIROBI, Kenya — The nurse lay in bed this month, coughing, wheezing and dizzy with fever.
It was three months after rich countries began vaccinating health workers, but Kenyans like the nurse, Stella Githaiga, had been left behind: Employed in the country’s largest public hospital, she caught the coronavirus on an outreach trip to remote communities in February, she believes, sidelining her even as Kenya struggles with a vicious third surge of infections.
Ms. Githaiga and her colleagues are victims of one of the most galling inequities in a pandemic that has exposed so many: Across the global south, health workers are being sickened and killed by a virus from which doctors and nurses in many rich countries are now largely protected.
That is just the most visible cost of a rich-poor divide that has deepened in the second year of the pandemic. Of the vaccine doses given globally, roughly three-quarters have gone to only 10 countries. At least 30 countries have not yet injected a single person.
Scientists have long warned that such unfair treatment could not only haunt poorer countries, but also rich ones, if the continued spread of the virus allows it to mutate in ways that undermine vaccines. But the greatest human costs will almost surely be borne by less wealthy nations.
the vaccine doses given globally.
“I don’t think we have the capacity, as a country and even as Africa, to treat our own,” said Hazel Miseda Mumbo, vice chancellor of the Great Lakes University of Kisumu in Kenya, who has studied the country’s health system. “While these countries in the West are still scrambling for vaccines, Africa will have to wait. It may be a sad situation.”
In a worrisome sign of how uneven distribution is, even Kenya, one of the continent’s wealthier countries, is faring badly.
dangerous variants circling the world. President Biden has promised to have vaccines for all adults in the United States by the end of May. Israel has vaccinated 60 percent of its people, and Britain has inoculated 41 percent.
Like many developing countries, Kenya is relying on the global mechanism for procuring and distributing vaccines known as Covax. The program was built on the idea that many countries, including richer ones, would use it to purchase shots as a way of spreading their bets across vaccine makers. Instead, dozens of wealthy nations bought doses straight from pharmaceutical companies, elbowing the international effort out of the way and delaying shipments to the developing world.
flight suspensions and school shutdowns that eventually forced children to repeat the school year — kept the virus from overwhelming the country last year, as did its relatively young population.
But control measures like lockdowns, available to rich and poor countries alike, are no longer the best defense against the coronavirus. The most valuable currency is now vaccines, opening a yawning gap between those that can afford them, and those that cannot.
The pandemic has worsened in Africa since a variant first seen in South Africa, shown to be able to reinfect people, began driving up cases in southern parts of the continent.
“Before that, it was believed that Africa had escaped this pandemic,” said Tulio de Oliveira, a geneticist at the Nelson Mandela School of Medicine in South Africa. “Unfortunately, it didn’t.”
With cases soaring in Kenya, vaccine delays will cost more lives. The number of reported Covid-19 cases — more than 120,000 infections that have led to around 2,000 deaths — is thought to be an undercount.
Kenya had also ignored other countries’ worries about being used as “guinea pigs” and participated in vaccine trials, raising expectations for earlier shipments.
“The clinical trials resulted in vaccines,” said Dr. David Ngira, a postdoctoral researcher in global health law at Cardiff University, who has been tracking vaccine rollouts in Africa. “And on this premise, the Kenyan participants, as well as the surrounding communities and country at large, should have been given some priority in vaccine access.”
But that has not happened. Even Kenya’s low expectations have been scaled back: A promised 4.1 million doses from Covax by May has been cut to 3.6 million doses. The country has ordered a total of 24 million doses.
Health officials say they are grateful, but even Covax shots come with a hitch. Vaccines covering the first 20 percent of Kenya’s population were free, but only on the grounds that the government pay for enough doses to cover another 10 percent of its people.
global economy could suffer losses exceeding $9 trillion, nearly half of which would fall on rich countries like Britain, Canada and the United States.
heart specialist in Zimbabwe — a mentor to younger doctors and a pillar of the country’s health system — was killed by Covid-19. That same month, a senior doctor in northern Nigeria died from the virus, confined to an isolation center.
Kenya’s health system was already hobbled last year by mistreatment of doctors and nurses. Many health workers, unpaid for months in some cases and often given inadequate protective equipment, walked off the job, forcing some hospitals to go months without nurses. One had to close its Covid-19 isolation unit and send patients home. In December, a 28-year-old doctor died from Covid-19 after having worked without a salary for months.
“It’s a moral emergency to protect health workers worldwide,” Gavin Yamey, associate director for policy at the Duke Global Health Institute, said. “Sickness and death of health workers in systems that are already weak could exacerbate those problems even further.”
For Nyachira Muthiga, a public hospital doctor who worked on a Covid-19 ward in Nairobi last year, the arrival of Kenya’s first vaccines brought a sense of relief. But the crushing experiences of the last year have made her wary.
Before contracting the illness herself, she lost many patients. Substandard protective equipment left her vulnerable, she said. And reports of corruption that cheated hospitals of much-needed money, she said, broke something in her.
Though she got the vaccine last week, she worries that those same endemic problems in the health system — combined with vaccine hoarding by rich nations — could put shots out of the reach of ordinary Kenyans for much longer.
“I am still hopeful,” she said, “that the health of our citizens will be a high priority at some point.”
Abdi Latif Dahir reported from Nairobi and Benjamin Mueller from London.
NAIROBI, Kenya — American Special Forces soldiers began training Mozambican troops this week as part of an effort to repel a spreading insurgency in northeastern Mozambique that American officials say is linked to the Islamic State. The insurgency, near some of the world’s biggest gas reserves, has killed at least 2,000 civilians and displaced another 670,000.
The American program is modest in size and scope: a dozen Army Green Berets are to train Mozambican marines for the next two months. But it signals the entry of the United States military into a counterinsurgency effort that has been aided so far mainly by South African mercenaries, who have faced accusations of human rights abuses.
The war in Mozambique is part of an alarming expansion of insurgencies believed to have ties to the Islamic State in several parts of Africa. In the past year, militants have captured swaths of territory in the northern province of Cabo Delgado, including a port on the Indian Ocean, and beheaded hundreds of civilians, according to human rights groups.
“I don’t think anyone saw this coming,” Col. Richard Schmidt, the deputy commander of U.S. Special Operations Forces in Africa, said in a telephone interview from Maputo, Mozambique’s capital. “For this to crop up so quickly is concerning.”
accused the mercenaries of possible war crimes, including killings of civilians. More broadly, their effectiveness against the insurgents has been limited.
John T. Godfrey, the State Department’s acting coordinator for counterterrorism, told reporters last week the United States was “concerned” by the presence of private contractors who have “not demonstrably helped” to win the battle against the Islamic State.
“It’s frankly a feature of the landscape in Cabo Delgado that complicates rather than helps efforts to address the terror threat there,” Mr. Godfrey said.
A senior State Department official, speaking on the condition of anonymity to discuss sensitive matters, said the military training program, which will focus on basic soldiering skills, could lead to more ambitious American help for Mozambique’s military including combat casualty care, planning and logistics.
The United States is also looking to step up intelligence assistance for Mozambique, the official said.
Last week, the State Department also imposed sanctions on a reported ISIS arm in the Democratic Republic of Congo and its leader, Seka Musa Baluku. Islamist insurgents affiliated with the Islamic State are also active in Libya, Mali, Niger and other parts of West Africa.
Regional experts, though, say some of those groups may be using the Islamic State name to sow fear and attract funds, while prosecuting conflicts that are essentially local in nature.
“They may be cloaked in the black flag,” said Mr. Mahtani, the Crisis Group analyst. “But what is motivating them to kill? It could be global jihad, but it could also be local conflicts and grievances.”