MAPUTO, Mozambique (AP) — At least 40 people fleeing extremist violence in northern Mozambique drowned when their boat sank, according to officials and reports in local media.

The boat had set off from Palma, a coastal town near the Tanzanian border, and picked up the majority of its 74 passengers near Namandingo, according to the Mozambican news services, Mediafax and Zitamar News.

The boat hit rocks and sank near Ibo island, said the reports.

At least 32 people were saved, but about 40 people drowned, according to the Portuguese news agency, Lusa. The boat was overloaded as it ordinarily carries about 30 people, reported Lusa.

The drownings occurred as thousands of people are fleeing the extremist violence in the northern part of Cabo Delgado province, many of them taking boats to get to safety.

More than 12,000 refugees arrived on 250 boats that came to Pemba, Cabo Delgado's provincial capital, in the last two weeks of October, reported Mediafax, citing a local government document which said more than half of the arrivals were children.

More than 400,000 people have fled their homes in northern Mozambique because of the conflict with the extremists, Doctors Without Borders said this week. The NGO said that around 100,000 internally displaced people have sought refuge in and around Pemba and “lack clean drinking water and are exposed to malaria with barely any protection, while they remain in unsanitary, crowded conditions, increasing the risk of an outbreak of measles, diarrhea or COVID-19.”

The medical charity said it requires urgent support from the Mozambican government to be able to meet the basic needs of the displaced people.

“If no immediate action is taken, this situation will rapidly deteriorate,” Alain Kassa, the Mozambique country director of Doctors Without Borders. He called upon the “Mozambican authorities for support to mobilize additional humanitarian staff and supplies without delay.”

The organization suspended its operations in the Cabo Delgado towns of Mocimboa da Praia and Macomia earlier this year due to insurgent attacks and shifted operations to Pemba and Metuge where it set up camps for the displaced.