A swampy field outside the western banks of Shire River in Mitengo Village, Traditional Authority Malemia in Nsanje, forms part of a busy route to farms Mozambicans rent out to farmers from Malawi’s southernmost district.
In their desperate search for fertile farmland, some Nsanje residents cross into the former Portuguese colony, especially stretches along the borderline.
At the entry point of the swamp—which is often crossed using a dugout canoe propelled by standing paddlers— Mishoni Wetasoni bought cooked but cold cassava he believes got contaminated with cholera-causing germs.
He regularly crosses into Mozambique where his family does most of the farming and repeated the pattern on July 20 this year.
“I consumed the cassava after sometime and returned home. In the evening I fell ill, uncontrollably opened my bowels and vomited,” Wetasoni, 43, says.
He suspects the food got contaminated in that foreign land.
Wetasoni admits that most farming families there do not have toilets and relieve themselves in bushes or rivers.
The time he had been diagnosed with the acute diarrhoeal illness, Nsanje, the first district to record a cholera case in Malawi in 1973, was among the 10 that had registered cases.
“It was scary especially because I suspected I had contracted cholera and knew it can kill within hours if not quickly treated,” the father of six states.
His believes his swift decision to seek medical attention saved his life.
The World Health Organisation (WHO) says the majority of cholera cases can be treated successfully through prompt administration of oral rehydration.
At Nsanje District Hospital treatment tent, Wetasoni received oral and intravenous hydration plus antibiotics which stabilised his condition.
“I was discharged the following morning with a stern lesson. Ever since, I have been very cautious about sanitation and hygiene in my family,” he says.
Wetasoni’s brief illness provided significant reference points for locals in his community who got reminded that an outbreak that had last been recorded about six years ago had returned.
Healthcare workers were also supported by organisations such as Save the Children to take cholera messages throughout Mitengo Village and the rest of the border district.
The child-centred organisation has been providing logistical support crucial in putting the outbreak under control.
“They have also assisted in procuring medication for patients and treating contaminated boreholes with chlorine to protect people who draw water from such sources,” Hanleck Kaufa, a disease surveillance assistant in whose catchment area Wetasoni’s village lies, says.
During our recent visit to the Shire Valley district, which has not registered a new case the past weeks, we came across meetings organised by Save the Children in various sections to spread cholera prevention messages.
Kaufa admits the challenge of taking the messages and medication to locals at risk of contracting the disease without partners’ support is huge.
“Wherever people gather, be it in schools or churches, at funerals or weddings, we are spreading the message that cholera is in our midst and that we must engage in good sanitation and hygiene practices to contain the outbreak,” he says.
The messages are also flowing handily to fishers and others who often assemble at docks dotting both banks of the Shire.
Save the Children Humanitarian Health Officer Isabel Stambuli says during the first days of the outbreak in Nsanje, in March, most patients were reporting to health facilities late.
“In the process, some lost their lives. It was all because of knowledge gaps, something that we have managed to address.
“Correct and timely treatment is crucial. So, we have also assisted in repairing tents which were used during Covid to ensure patients are not helped under trees,” Stambuli states.
In Nsanje’s eastern section, Save the Children has trained over 100 healthcare workers in proper management of cholera, which has mostly affected children.
Stambuli says the interventions that the organisation has taken to the district will be significant in checking possible future outbreaks of the disease that has so far killed at least 110 people nationwide and at least 14 in Nsanje.
At the time of our visit, there was no patient in treatment tents, a development Nsanje District Health Office spokesperson George Mbotwa attributed to interventions by organisations such as Save the Children.
Mbotwa touted the change of behaviour in the district, which he says has pushed Nsanje away from being one of the areas with the biggest number of cholera cases in the country.
“Everyone can get cholera. Of course, not everyone who gets it falls sick. But prevention is always the best remedy,” he says.
Now, with the Ministry of Health unveiling a national cholera response plan to eliminate the outbreak before the rains start, enlightened locals like Wetasoni feel they are part of the good story.
Their illnesses cast a spotlight on the threat posed by this epidemic and compelled others to be vigilant.
“Without the prevention knowledge and tools that we have now, it would be a catastrophe. Perhaps, things would be worse when rains fall, but we are alert,” Wetasoni’s wife Fyness says.
Alick Ponje is a features writer at The Times Group. He graduated from the University of Malawi with a bachelor’s degree in education, majoring in literature in English. Follow him on Twitter @aponje