Racing against time to save cholera patients

By Lulutani Tembo, contributor:

At Area 18 Health Centre in Lilongwe, the roaring sound of a motorbike at night has become a norm.

It means a cholera patient is being rushed to the facility. The situation is just as critical during the day during which more healthcare workers are also available.

On this cloudy and humid Thursday morning, the workers dressed in protective gowns and masks are working tirelessly to balance between attending to patients seeking regular services at the outpatient department and assisting those with cholera.

A cholera treatment unit (CTU) has been mounted in the vicinity. Every few minutes, patients are rushed in for assistance.

One man is seen carried by his wife and friend, who are frantically trying to get him into a treatment tent that can only hold 16 cholera patients with beds provided.

“We have received close to 30 patients daily in the past month. Most of cholera-related deaths also occur at night. We are extremely overwhelmed,” says Kedson Masiyano, the senior clinical officer at the health centre, says.

In January alone, 500 people in Malawi lost their lives to cholera. Over 160 children have succumbed to the diarrheal disease too since the first case was recorded in March last year.

“Since December, over five children are admitted daily, resulting in about 30 a week. Those in critical condition are referred to Kamuzu Central Hospital for further management since it has more capacity.

“In most cases, children contract the disease from their parents, who are also guardians of patients in CTUs. We are now advising guardians to ensure they practice good hygiene when they go back to their homes to avoid passing on the disease,” Masiyano states.

His colleague, Mercy Mayenje, a senior health worker, adds that the majority of children that they have received for treatment range between five to 14 years old.

“The children are being affected because of poor hygiene in the home and food not being prepared well. Yesterday, we had a seven-year-old who came in already dead. It is sad to see young children dying because of this preventable disease,” Mayenje laments.

In the 19 years that she has been working at the health care, she has not witnessed a cholera outbreak of this magnitude

“I think the misinformation in the community is making cases rise. People are getting sick at home without seeking medical care; they are dying at home and burials are being conducted without adhering to guidelines for buying people who have succumbed to cholera.

“Another big challenge is that resources for disinfecting communities to prevent further spread of the disease are not enough,” Mayenje says.

Health workers also face a lack of personal protective Equipment (PPE). The lack of gumboots is visible in one of the treatment tents where medical personnel are wearing regular shoes wrapped in light blue medical cloth.

Gloves are also running out quickly since both guardians and health workers are using them.

Kedson Mayenje is one of the few health workers wearing large white gumboots to protect him while attending to patients.

“We need a constant flow of PPE for everyone. We also had challenges with medicines such as oral rehydration salts and lactate, as well as staffing, but this has been addressed by the Ministry [of Health] and development partners.

“The one tent we have in operation also does not allow male and female patients to be separated as per health recommendations,” Kedson Mayenje says.

As luck would have it, with support from Unicef, an additional tent was mounted at the CTU the same morning.

The United Nations agency has also supported the Ministry of Health by providing 400 trained nurses to address staff shortages.

In addition, Unicef is on the ground assisting all 29 affected districts with acute watery diarrhoea kits, essential medicines, infection prevention and control supplies, cholera beds and solar lamps.

“To effectively support the Malawi Government’s response, we are appealing for additional funding of $24 million, which will boost efforts to ensure the disease is contained to protect children and families,” Unicef emergency specialist Mira Khadka says.

For now, health workers like Kedson Mayenje have to make the best of their resources to save lives, whether it means working around the clock.

“After working during the day, I sometimes resume work at 11pm up to 5am. I bathe quickly and return to work at 7.30am. I have not felt this tired in a long time. My body needs rest and my children miss spending time with their dad, but they understand my job is demanding.

“Cholera patients must be treated swiftly; we have to drop everything to attend to them. We are racing against time to save their lives,” Mayenje explains.

By Tuesday, Malawi had officially registered 43,434 cholera cases out of which 1,412 have died.

Over 10,000 children have so far contracted the sanitation-related disease whose current outbreak is the worst in two decades.