By Yamikani Yapuwa
Blantyre, May 30, Mana: On one Wednesday morning in April this year, 30-year-old Thoko Gawani (not her real name) suffered a bout of diarrhoea which was accompanied by vomiting.
However, because she had to go to work, she ignored the illness as a stomach upset caused by what she might have eaten the previous night.
The mother of two says she quickly took a bath and was soon on her way to her workplace.
Upon arriving at work at 6:00 am, Thoko went straight into business and forgot about the vomiting and diarrhoea she had experienced when she woke up.
Just as her day was going on smoothly, around 7:00 am, the vomiting and diarrhoea resumed, this time it came with very sharp stomach pains.
Although I took some painkillers, within a short period, I became very weak and laid flat on the floor, failing to move or eat. Worried with my condition, my employer took me to Limbe Health Centre,” Thoko narrates.
Having noticed the symptoms she had, health workers at Limbe Health Centre did not hesitate but to conduct a rapid test which came out positive of cholera.
Thoko says she was immediately put on an intravenous drip and the vomiting immediately stopped.
However, it did not last long. When she took some food in the afternoon, it came back and the health workers added two more drips before she started feeling better.
“I spent a night at the hospital and was discharged the following day because my condition had improved tremendously,” states Thoko.
Currently at home, Thoko says she is feeling much better, noting that she has regained her appetite and strength. She expresses joy that she was taken to the hospital promptly which saved her life.
The Blantyre-based young lady is just one out of the 550 cholera cases the country has registered so far following an outbreak that was first recorded in Machinga District and has since spread to four other districts of Blantyre, Chikwawa, Neno and Nsanje.
A recent World Health Organisation (WHO) report indicates that the age of the cholera cases range between two and 57 with the five to 14 years age group being the most affected.
On the other hand, the United Nations Childrens Fund (Unicef) Malawi floods, polio, cholera Humanitarian Situation report of March 2022, emphasizes that the multiple burden of floods, Covid-19 pandemic, polio and cholera outbreaks require a unique and urgent response to prevent the current emergencies from having a severe impact on the well-being of children.
Public Relations Officer for the Ministry of Health, Adrian Chikumbe concedes that community health workers are being overwhelmed as they have to continue with all the routine services that they provide amidst Covid-19, polio outbreak and now, cholera.
Nonetheless, Chikumbe says the ministry is working tirelessly to treat all existing cholera cases and tracing those who were in contact with the patient as they could be at a high risk of infection.
“We are also promoting health education on safe water for domestic use, hand washing with soap including personal hygiene, food safety and early health seeking behavior,” he adds.
“In addition, we have intensified cholera prevention sensitization campaigns in the affected districts as well as distribution of chlorine to affected populations for treating water,” emphasizes Chikumbe.
However, he adds that if available resources permit, the ministry intends to conduct a cholera vaccination campaign in the five affected districts.
“About 1.9 million doses have been procured and received for the campaign; whereby, people will receive two doses of the vaccines two weeks apart,” he says, with a tinge of pride, cautioning on the urgent need to improve access to safe and clean water and coverage on sanitation.
Chikumbe stresses that to ensure that cholera does not spread out to schools, the Ministry of Health is working in close collaboration with the Ministry of Educations School Health and Nutrition (SHN) coordinators in schools.
“Each school has one teacher appointed as a SHN Coordinator. This is the focal person on health issues between the school and the nearest health facility,” Chikumbe points out.
Meanwhile, the Ministry of Health rolled out administration of an oral cholera vaccine targeting 1.9 million people targeting adults and children from one year old above in the hot spot districts of Nsanje, Chikwawa, Phalombe, Blantyre, Mulanje, Balaka, Machinga and Mangochi starting from May 23 to May 27.
Ministry of Education Public Relations Officer, Chikondi Chimala concurs with Chikumbe that the education sector is indeed undertaking joint awareness activities in schools with the Ministry of Health to ensure they raise awareness among learners about cholera and how they can prevent it.
“The ministry works closely with the Ministry of Health in implementing various public health interventions in schools. Similarly; with cholera, we are undertaking joint awareness activities in schools and usage of other mass communication interventions,” confirms Chimala.
Chimala says the education sector has also ensured that teachers and other stakeholders in schools have their capacity enhanced to ensure that they are able to guide learners in all schools.
On compliance of water, sanitation and hygiene (WASH) in schools, the ministry has set standards for all schools to guide implementation of WASH, according to Chimala.
“The guidelines have helped to ensure that all schools are in full compliance of the expectations. Moreover, the ministry undertakes frequent inspections and monitoring activities to ensure that all standards are being followed,” he says.
“Through our officers in all education districts in the country, the ministry is implementing school-based health and nutrition services as an integral, sustainable part of the education system so as to build a healthy foundation for all learners,” adds Chimala.
Unicef is one of the organisations which has stepped up efforts to curb the spread of cholera. Unicef has since reached out to 50,230 different hygiene promotion approaches as indicated in their Malawi Humanitarian Situation Report of April 2022.
“Further hygiene promotion and blanket chlorination activities have been carried out by Unicef in partnership with United Purpose in the Lower Shire districts of Chikwawa and Nsanje in an effort to contain the cholera outbreak,” report reads.
“Regarding hygiene promotion, mass media awareness campaigns to influence positive behavior change around hand washing, water usage and proper use of latrines have been rolled out through radios, mobile vans and displaying messages in strategic points,” it adds.
“Plans for rehabilitation of water schemes at the community level and distribution of WASH packages for displaced people returning to their villages are underway as the water levels recede and the rainy season is ending,” the report concludes.