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Project HOPE, AstraZeneca Aid Rural Morocco’s Recovery

Morocco’s rural communities are still reeling from the devastating September 8 earthquake. With support from AstraZeneca, Project HOPE is helping restore access to health care to meet the long-term needs.

By Emma Schwartz

The 6.8-magnitude earthquake that struck Morocco in September was the strongest earthquake to hit the country in over a century, shaking the ground beneath 300,000 people.

Many of the hardest-hit communities lie in valleys of the rural Atlas Mountains — remote populations south of Marrakech that faced extreme poverty and limited health care services even before the earthquake.

In these largely agrarian communities, now the needs are even more dire.

“In many cases, villages are 100 percent destroyed,” said Arlan Fuller, Project HOPE’s director of emergency preparedness and response. “Their lives have been turned upside down and they have very challenging access issues for even the most basic of care.”

Thanks to support from AstraZeneca, Project HOPE is working with local partners in Morocco to support these communities on the long road to recovery, concentrating on some of the most critical health needs: water, sanitation, and mental health care.

“Our hearts go out to all those affected by the devastating earthquakes which struck Morocco this past September,” said Amine Sekhri, Country Director of AstraZeneca Morocco. “We know that the impacts of this tragedy will be felt in the months and years ahead, as homes, infrastructure and livelihoods have been destroyed. AstraZeneca stands united with communities impacted, and are committed to supporting relief and recovery efforts through our humanitarian partners including Project HOPE.”

‘There’s Not Even A Health Clinic in Most Villages’

woman receiving medical care
A medical team from Project HOPE’s partner, SAMU, provides roadside care in a rural community following the September 8 earthquake in Morocco. After helping meet initial health needs, Project HOPE is now supporting Morocco’s rural communities as they face a longer-term recovery. Photo by SAMU for Project HOPE, 2023.

In the initial days following the earthquake, Project HOPE supported search and rescue operations and deployed mobile medical units in partnership with our long-time partners at SAMU, a Spanish medical emergency organization. In their first week of deployment, SAMU’s team carried out more than 120 health interventions and visited more than 20 villages, sometimes having to hike in on foot for several hours to reach survivors. Rockslides changed the landscape day-to-day, burying roads that were previously open and forcing long waits as access routes had to be cleared.

During this time, SAMU orchestrated the transfer of multiple seriously ill and injured patients to larger hospitals in cities such as Marrakech and Tangier.

“For these communities, the first public health clinic is up to 50 kilometers away,” Fuller said. “Access to any sort of public service was either nonexistent or extremely difficult because of the inaccessible roads and lack of access to the more populated centers. If people in these areas need any kind of substantive health care, they have to get to major cities. Otherwise, there’s not even a health clinic in most rural villages and people have to travel to the one main village that was designated as the health center for the whole valley.”

Many families are still living in makeshift tents next to their devastated homes, and very few have access to bathrooms or showers. As part of our long-term response work in these communities Project HOPE and partners are improving water and sanitation conditions by providing practical hygiene solutions, distributing hygiene kits, and rebuilding potable water systems. These measures will not only be vital for comfort, but they will also play a crucial role in preventing the spread of diseases.

Bridging the Mental Health Gap

children smiling in group
Children at a safe space in Achbarou, a rural community where Project HOPE provides mental health and psychosocial activities through our local partner, High Atlas Foundation. Photo by High Atlas Foundation for Project HOPE, 2023.

The earthquake also left an overwhelming need for mental health support in Morocco’s rural communities. Mental health services are scarce and primarily concentrated in urban areas, leaving a significant gap in coverage for those living in the mountains.

Our assessment through SAMU found many people to be grappling with post-traumatic and acute stress symptoms: nightmares, sleep disturbances, profound grief, emotional anguish, and noticeable alterations in behavior.

In one village of 58 families, the earthquake claimed the lives of 36 children — an incomprehensible loss. The villages in these mountains are small; when one person dies, the entire village grieves.

“Everyone knows everyone,” Fuller said. “They’re either part of the same extended family or they’re just part of the larger connectedness of the village. You lose one person, you lose two people, everyone knows it, everyone grieves. But then you lose three-quarters of the village, it’s devastating.”

child showing off drawing
Children drawing
young girl makes a heart with her hands
Children participate in art therapy activities at a workshop hosted by Project HOPE’s local partner, High Atlas Foundation. Group activities help children cope with mental health issues brought on by the earthquake, including post-traumatic stress disorder. Photos by High Atlas Foundation for Project HOPE, 2023.

In villages like these, the scale and gravity of loss is immeasurable — a disaster that will be felt for generations.

“During interviews, many women became visibly emotional and shed tears when we approached them or asked about their experiences,” said Rawan Hamadeh, a Project HOPE mental health program officer. “Women fear going to the restroom or showering alone and there are mounting fears of sexual violence. The challenges faced by children are equally profound. The absence of structured support mechanisms to assist them in dealing with the overwhelming trauma is glaring. Many schools have been destroyed, and children are apprehensive about the long commute to neighboring schools.”

In the year to come, Project HOPE will provide mental health and psychosocial support to women and children in impacted villages through our partners at Project Soar and the High Atlas Foundation.

women participate in mental health workshop
Women participate in a mental health resiliency workshop in Achbarou. “Joining with Project HOPE to provide deep relationships with our facilitators and the women has been really powerful. Having the in-depth knowledge of the psychological needs and the one-on-one support has been really important,” said Selah Randolph from the High Atlas Foundation. Photo by High Atlas Foundation for Project HOPE, 2023.

With our support, the High Atlas Foundation has set up safe spaces and is providing workshops on topics related to mental health, psychosocial support, resilience, and positive coping strategies to eight villages, prioritizing those most affected and with the least access to resources. Through Project Soar, Project HOPE will be supporting psychosocial groups for hundreds of young students who have had to leave home and relocate to Marrakech in order to continue their studies in school.

“We don’t have licensed psychologists on our staff, so joining with Project HOPE to provide deep relationships with our facilitators and the women has been really powerful,” said Selah Randolph, communications manager at High Atlas Foundation. “Having the in-depth knowledge of the psychological needs and the one-on-one support has been really important.”

As winter approaches and homes remain in ruins, the health risks for those living in the shadows of the High Atlas will only multiply. Through winter and beyond, Project HOPE will be helping these communities heal, rebuild, and find their new normal after the disaster of a century.

“Winter is really extreme in the High Atlas Mountains,” Randolph said. “Even before the earthquake this was a challenge. With entire communities now houseless and feet of snow coming in, there’s a huge need to mitigate suffering.”

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