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Anti-Covid arsenal: Outreach, localised study, treatment

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BEER— Covid is a global problem

When Evance, 47, was admitted to the Covid Isolation Centre at Bingu National Stadium in Lilongwe last year, all he longed for was to, once fully recovered, be released from the facility and freely roll across Malawi like a free agent.

“My sense of longing for the outside world was heightened when I saw, with my very eyes, some people succumbing to Covid. That changed my perspective of life,” says the father of two who, at that time, was working as an electrician in Lilongwe city.

When his wish was granted, he set about preaching the message of vaccination, starting the work in his own family, where he sensitised his 40-year-old wife and two twins aged 20 years to the importance of getting vaccinated from coronavirus, which started in Wuhan, China, at the end of 2019.

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In Malawi, the first case of coronavirus was registered on April 2 2020.

Coincidentally, he and family members relocated to Chiradzulu District, where the company he works for has a sister company.

“It, however, took long for my family members to get vaccinated because we started staying in a remote area,” he said.

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Fortunately, earlier this year, Nguludi Mission Hospital (NMH) in Chiradzulu embarked on an outreach Covid vaccine administration initiative as one way of easing access to healthcare services.

NMH Senior Medical Officer Maggie Khumbanyiwa says the facility is ready to vaccinate willing people right in their locations in the Southern Region district of Chiradzulu.

It is hoped that, through outreach activities, service providers will also be able to dispel misconceptions, some of which have been blamed for low uptake of Covid vaccines.

“Achieving high uptake of Covid vaccines is a challenge due to online misinformation. While large-scale vaccine rejection threatens herd immunity goals, large-scale acceptance with local communities in villages will help us achieve the targeted herd immunity,” Khumbanyiwa indicates.

Fortunately for NMH, partners have been coming in droves to support its cause. These include the Catholic University of Malawi (Cunima), which recently donated equipment worth K2.5 million.

Cunima Registrar Francis Vincent Nkhoma said the academic institution felt duty-bound to give back to the hospital as part of meeting its corporate social responsibility goals.

As vaccination efforts continue, either through outreach activities or established healthcare service institutions, some health experts have opined that service providers should adopt a prolonged approach when addressing issues related to Covid.

One of the approaches, they indicate, is a localised Covid immunology study.

This is happening at a time Malawi has experienced a marked reduction in the number of Covid cases, with the positivity rate at less than five percent, the lowest since the beginning of the third wave

The study, according to epidemiologist Professor Adamson Muula, would help stakeholders know the proportion of people that have Covid antibodies.

Muula says it is possible that a significant number of people contracted coronavirus at some point but did not notice anything.

“What we needed now is to do a quick study nationally to check how many people have antibodies against Covid. It is possible that many of our people have gotten Covid at some point but they never became sick or never showed up and, because they did not die, we did not even know them,” he said.

“For example, if the study finds that around 70 percent of Malawians have had Covid, it will mean, in some ways because we say reception is also vaccination, that these people will unlikely die; that is, if they get infected again. But this should not make people relax in following Covid protocols. People who have not been vaccinated will also need to get their jabs because the immunity even gets better,” Muula adds.

Society of Medical Doctors President, Dr Victor Mithi, while acknowledging that such a study would have far-reaching consequences, says vaccination is still the key.

He says, with or without the study, people will still have to get vaccinated as the 60 threshold set by the World Health Organisation is far from being reached in the country.

“It is possible to do the immunology study but it has little benefits in terms of implementation or intervention approaches. Because, even if we know now the number of people who have Covid antibodies, they still need to be vaccinated,” he says.

Ministry of Health spokesperson Adrian Chikumbe acknowledges that the country needs domesticated information.

“There are a number of things that need to be known about Covid. A lot of information we have is not domesticated but we are just using it here. We need our own studies to inform next decisions,” he says.

And, while people are still occupied with news that Covid cases have declined in the country, others are already looking at the bigger picture. The bigger picture is that Malawi’s hospitals still have patients admitted to them due to Covid-related complications. Such people require specialised, intensive care.

To address problems associated with Covid admissions, the United Kingdom (UK) Foreign, Commonwealth and Development Office has facilitated the deployment of a UK Emergency Medical Team (EMT) to Malawi. The team will be in the country for eight weeks to support Ministry of Health’s Covid response programme.

The team will specifically help in management of critically ill Covid patients, help clear community perceptions around Covid and offer support to c national Covid vaccination efforts, Foreign, Commonwealth and Development Office Programme Officer for Malawi Singalilwe Chilemba indicates in a statement.

“UK EMT is a rapid medical response [team with] capability, composed of world-class experts who deliver front line medical care, advice and support to governments, the WHO [World Health Organisation] and local healthcare workers during disease outbreaks and humanitarian emergencies to save lives and alleviate suffering,” the statement reads.

Since the advent of the Covid pandemic, the UK EMT has been supporting global efforts to respond to the pandemic through the deployment of specialist staff to work alongside ministries of health, the WHO-EMT Secretariat, WHO country offices, as well as other United Nations agencies and international non-governmental organisations.

So far, EMT members have been deployed to Ghana, Cambodia, Zambia, Burkina Faso, Bangladesh, South Africa, Chad, Lebanon, Armenia, Lesotho, Namibia and Botswana and also provided support to the domestic response in the UK with the setup of the Manchester Nightingale field hospital

British High Commissioner to Malawi David Beer has justified the move, describing the Covid pandemic as a global problem necessitating a global response.

“Covid is a global problem that requires a global solution. No one is safe until everyone is safe. The UK continues to be Malawi’s close partner in responding to the pandemic, supporting vaccines and the medical response. We are delighted to be able to deploy a UK Emergency Medical Team in order to support the health authorities on the ground,” he says.

UK EMT Team Lead Ngoni Mac Nyambawaro says they will offer nothing less than top-notch services.

“On behalf of the UK Emergency Medical Team, our team of highly qualified experts looks forward to supporting national healthcare teams to attend to critically ill Covid patients and to develop their capabilities to ensure the impact of this response lasts well beyond the time we are in Malawi,” Nyambawaro says.

Health Minister Khumbize Kandodo Chiponda is equally hopeful.

“The Covid pandemic presents a clear challenge to the country’s economy, communities and healthcare system. The on-job support and capacity building of our health professionals by UK EMT, as well as risk communications and community and health worker engagement, will help us prepare better for future waves,” she says.

The UK has been at the forefront of the global response to Covid, kick-starting the Covid Vaccines Access (Covax) facility in 2020 and investing £90 million in supporting the development of the Oxford-AstraZeneca vaccine.

Apart from supporting the immediate humanitarian response in Malawi with £9.67 million, and co-funding the Covax vaccines that Malawi has received, the UK has, so far, also provided 119,040 vaccines bilaterally.

The hope is that, through outreach activities, localised studies and deployment of teams of experts to treat Covid patients, coronavirus will soon have nowhere to hide.

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