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Fighting diseases amid Covid-19

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ACKNOWLEDGED CHALLENGES—Kandodo-Chiponda

Malawi has had a long battle with non-communicable diseases (NCDs). The advent of Covid-19 is making the fight against such diseases—which include cancer, diabetes, stroke, epilepsy and obesity— perhaps more important than ever.

NCDs are the leading cause of death worldwide.

In Malawi, a country which ranks among some of the poorest in the world, 28 out of every 100 deaths are caused by NCDs.

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As in most poor economies, the second wave of Covid-19 has placed a heavy strain on Malawi’s healthcare service delivery system with most health workers deployed to fight the pandemic.

This raises concern that other diseases, NCDs inclusive, are being neglected.

As the government, with support from stakeholders, scales up the fight against the global pandemic, the Malawi NCD Alliance warns against a rise in the burden of NCDs in the country.

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The alliance—a group of civil society organisations comprising Women’s Coalition Against Cancer, Cancer Survivors Quest, Diabetic Association of —Malawi, Jiyavanne Diabetic Foundation and Hope for Cancer and Stroke Association of — Malawi has for a long time been working at creating a platform for an inclusive approach to the fight against NCDs in the country.

It is only through such collaboration that stakeholders and resources can be mobilised to hasten the fight against the silent killers in the wake of the coronavirus, says the group’s vice-chairperson Maud Mwakasungula.

“With the spread of coronavirus, there is an urgent need to highlight its impact on people living with NCDs as we call for more support towards the fight against Covid-19. We must also ensure that we highlight challenges people with NCDs are facing due to Covid-19,” Mwakasungula says.

But despite government’s efforts to ensure that other health services are not disrupted due to Covid-19, research shows that many people living with NDCs are facing challenges to access services in public health institutions.

For example, research conducted by the Malawi NCD Alliance in September 2020 found that people with NCDs had to wait several hours before receiving treatment due to shortage of personnel as more attention was being paid to the Covid-19 pandemic.

The research also found that Covid-19-related restrictions in public health facilities denied people with NCDs access to quality and timely health services.

Apart from that, some health personnel were reportedly confusing NCD symptoms with those related to the pandemic.

Financial challenges and high transport costs as a result of Covid-19 restrictions on gatherings are also cited in the study as some of the factors that made it almost impossible for people living with NCDs to access healthcare services.

The research was conducted in Nsanje, Zomba, Thyolo, Lilongwe, Blantyre, Mulanje and Mzimba districts and was part of an initiative by the Non-Communicable Disease Alliance (NCDA) to find the link between Covid-19 and NCDs.

“We now know that there is need for the government, civil society organisations, non-govermental organisations and development partners, including the youth, to create a broad network that fights and addreses NCDs as we spend time spreading awareness messages on NCDs and Covid-19, the relationship between the two and respective preventinve measures,”Mwakasungula says.

Health rights activist George Jobe says the Covid-19 pandemic has brought to light challenges that Malawi’s healthcare service delivery system has been facing for a long time.

Jobe notes that although the challenge of inadequate staff is not new to the country’s health system, the pandemic has worsened the situation as most healthcare workers have been called in from other services to aid the fight against the pandemic.

He calls on the government and other stakeholders to consider providing more resources to the fight against NCDs.

“We also need to bear in mind that NCDs are underlying conditions to the extent that people living with NCDs are more susceptible to Covid-19 than the rest; so we need to ensure that more resources are poured in to ensure that they, together with other people with underlying factors, are well protected from the disease,” Jobe says.

He also suggests that, where resources are available, government should provide support such as transportation so that healthcare workers are able to treat people with NCDs right in their homes.

“Despite all the challenges we are facing, arrangements can be made where resources are available to have people with NCDs, the elderly and people with other underlying conditions, checked in their homes so that they are protected from other infections,” Jobe says.

Another health rights activist Maziko Matemba says Malawi cannot ably handle the Covid-19 pandemic without disrupting other healthcare services unless government and stakeholders and people themselves agree to follow what is key in containing the virus.

“The bigger question is how are we supporting our healthcare service delivery system so that it effectively fights the virus without leaving out other conditions? We need state-of-the art isolation centres at our borders because most of the cases in Malawi are imported. I think Malawi must make sure that the Covid-19 response plan is integrated into our public health system to ensure efficiency,” Matemba says.

During her recent visit to Queen Elizabeth Central Hospital, Minister of Health Khumbize Kandodo Chiponda, while expressing satisfaction with the way the facility is handling the Covid-19 situation, admitted to challenges the country’s health facilities are facing as a result of the pandemic.

Chiponda reminded healthcare workers in the country not to forget other patients in the wake of the pandemic.

“It is important that, while we are helping Covid-19 patients, we do no lose sight of other ailments affecting Malawians,” Kandodo said.

Last year, the Malawi NCDs Alliance received two grants from Global NCDs Alliance to build capacity and provide support to people living with NCDs during the Covid-19 pandemic.

The alliance has been working with stakeholders including the government of Malawi, in assessing the policy landscape to advance rights of people living with NCDs in the country.

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