Worst cholera in decades in Malawi

More than 1.500 people died of cholera over the past one year, and the government is struggling to contain its spread

The Malawian government is battling its deadliest cholera outbreak on record triggered by cyclone Freddy, a  violent tropical storm that hit the region recently. In its wake, the perilous storm, caused mudslides and violent floods which damaged the country’s water system and toilets. Malawi, a landlocked country in southern Africa, had all but eradicated cholera, recording only two cases in 2021.

Pundits have pointed to several potential causes of the outbreak, including destructive weather storms, the outbreak of the coronavirus pandemic, a rapid rise in urbanization and a decrease in the population’s immunity.

Campaign against cholera

In 2015, the Malawian government started a robust campaign aimed at eradicating cholera, the authorities worked with traditional leaders to build latrines, hand-washing facilities and other infrastructure in vulnerable communities; an effort to stop defecation in open areas like streams and lakes. Then in 2017, Malawi began administering more than three million cholera vaccines. However, case numbers plummeted from 1.792 in 2016 to the single digits five years later.

Covering from the cold in Mtandile township in Lilongwe. The township has become a hot spot for cholera infections © Joao Silva

“Maybe we didn’t do enough as you can see from the current situation.” said Dr. Charles Mwansambo, the principal secretary in Malawi’s Ministry of Health. He added that a rise in illegal mining along Lake Malawi also contributed to the outbreak. The miners create informal settlements, using the lake for washing and as a toilet.

Vaccine demand

According to health experts, Malawi is currently struggling to keep pace with the demand for cholera vaccines and that the country’s fragile health care system has been stretched. “We received 2.9 million dosages of the cholera vaccine, but as we speak, we have about 40 thousand left. It means Malawians availed themselves for the vaccine. What is worrying however is that those that received the vaccine are not the ones at high risk. Those that are in high risk are proving difficult to convince to take the vaccine.” Said Khumbize Kandodo Chiponda, Malawi’s Ministry of Health in an interview.

A mother stood by her son as he was treated for cholera by nurses in a tent where patients are isolated from the general patient population at the Bwaila District hospital in Lilongwe, Malawi © Joao Silva

“We continue to record rising number of cases across the country, despite signs of reduced transmission and deaths in a few areas. We would like to commend those that are availing themselves for treatment.” She stressed.

Tropical storm

Tropical Cyclone Freddy, which developed over Australia’s Indian Ocean coast region in early February, travelled a record distance of more than 8,000km (4,970 miles) to make landfall in Madagascar and Mozambique in late February. The storm, hit Southern Africa for a second time. The death toll in southeast Africa due to the longest-lasting tropical cyclone ever recorded current stand at 894, according to local authorities in Malawi, Mozambique and Madagascar.  Meanwhile, more than 1.200 people have been injured, 537 are missing and 995.000 have been displaced.

Cholera africa
People attend the burial ceremony of some of the people who lost their lives following heavy rains caused by Cyclone Freddy in Blantyre, southern Malawi © Thoko Chikondi/AP

On another hand, Rudolf Schwenk UNICEF Representative in Malawi said he was concerned about the Cholera worsening conditions in Malawi. “As a severely malnourished child is eleven times more likely to die from cholera than a well-nourished child, a bout of cholera may amount to a death sentence for thousands of children in Malawi. Half the children are in need of humanitarian aid. Almost a quarter of a million children under five are expected to be acutely malnourished, and more than 60.000 severely malnourished, by the end of the month.”

Meanwhile, World health organization (WHO) announced that 22 countries are fighting outbreaks of cholera currently, including Syria and Haiti. But the health agency warned that only 37m doses of vaccine were believed to be available this year. But in October last year, the WHO was forced to ration vaccine doses.

Thus, as the global temperatures rise, our climate will become increasingly more unpredictable and populations around the world will most likely see more and more cholera outbreaks.


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