Damage to Mozambique from the impact of Cyclone Idai, which made landfall on March 17, appears to have been far more extensive than initially reported. Officially, the death toll remains at 84 confirmed casualties, however, the President of Mozambique has reported that the initial toll may be as high as 1,000. Given that residents of this area are among the poorest in the world, with significant health challenges under ordinary circumstances with HIV, malaria and other vector-borne diseases, respiratory and diarrheal illnesses, as well as persistent challenges with maternal and child health care, the risks to the health of the population over the coming weeks are very high. According to news reports and situational updates from the few humanitarian agencies that have been able to reach Sofala district and the coastal city of Beira, which took the immediate force of the storm, the area has been transformed into an “inland ocean.” Flooding across Beira, home to over 500,000 people, appears to be not only widespread but very deep, approaching the roof lines or entirely submerging thousands of structures. Damage outside the city may be considerably higher but assessments in the more rural areas will take significant time to complete. The primary road into Beira is considered impassable and aid is reported being delivered by helicopter. Power and communications have been cut almost entirely for the nearly 20 districts surrounding Beira. Small pockets of cellular coverage remain available far inland near the cities of Chimoia and Mutare on the border with Zimbabwe, but even these areas remain tenuous and oversubscribed over the course of the day. Direct Relief is coordinating with local partners in Mozambique including the Real Medicines Foundation and the provincial Ministry of Health for Zambezia to move emergency medical supplies into the affected area.