Taking aim at cholera from all angles
Desperate times call for desperate measures.
In the context of Malawi, the desperate time I n question could be equated to the cholera epidemic, which shows no sign of relenting after the first case under the current wave was registered in Machinga District in March last year.
Apparently, the persistent nature of the epidemic has culminated in the depletion of the Ministry of Health resource base.
As a result, the government has, through the Presidential Taskforce on Covid and Cholera, been pressing on all buttons, including appealing to stakeholders for material and financial resources.
At the end of last month, the taskforce went around with a begging bowl.
“…The taskforce is further appealing to the public, private sector and non-governmental organisations to support the campaign with resources and donations, in particular the following: Risk communication; medical suppliers including ringers lactate, giving sets, cholera beds, tents, examination gloves, heavy duty gloves, gumboots, solar lamps, buckets with taps, aprons and soap; provision of safe water and sanitation facilities; Chroline and oral rehydration salts and cash.
“The Presidential Taskforce welcomes any donations regardless of quantities and assures the general public that all donations received will be used for the intended purpose and will be accounted for. The secretariat will acknowledge all donations received through it,” the ministry assured in a statement titled ‘Urgent Appeal for Support In The Fight Against Cholera’.
Co-chairperson Khumbize Kandodo Chiponda and Wilfred Chalamira Nkhoma co-signed the statement.
In February, the government disclosed that it needs $45 million (K50 billion) for the provision of water and sanitation services in the country.
Water and Sanitation Minister Abida Mia made the revelation.
“The cholera situation has exposed how vulnerable the country is when it comes to water and sanitation-related diseases. We are in a crisis that needs long a lasting solution,” Mia said.
She said, as one way of addressing problems related to the current cholera crisis, her ministry has chlorinated shallow wells in urban and peri-urban areas, especially where cholera cases were high.
On her part, Kandodo Chiponda indicated that since the launch of Tithetse Kolera campaign by President Lazarus Chakwera on February 13 2023, there has been a decrease in the number of cases.
“Progress being registered since the launch of the campaign is giving hope that Malawi will soon be free from the pandemic,” Kandodo Chiponda said
The minister said the United Nations Children’s Emergency Fund (Unicef) had provided $2 million (K2,053,204,606) to boost campaign activities through the recruitment of more health surveillance assistants (HSAs).
“The central part of this campaign is awareness and we are relying on HSAs to execute this task. We are planning to recruit more HSAs with support from Unicef and we will win this battle,” she said.
Kandodo Chiponda faulted religious leaders who are discouraging followers from accessing healthcare services.
Unicef Country Representative Rudolf Schwenk said the organisation is committed to supporting Malawi in the fight against pandemics such as cholera.
World Health Organisation representative Nima Kimambo said the organisation is working tirelessly to provide technical and other support to the Ministry of Health.
“Our target is that there should be zero cholera-related deaths and this begins with the reduction in reported cases. We are working with government to eradicate cholera,” she said.
More support towards cholera fight
The government’s call for support seems to be falling on welcoming ground.
For instance, the European Union (EU) has provided 1.5 million Euros (about K1,696,500 billion) to the Malawi Government as part of the cholera emergency response.
The EU indicates that the funds are part of its humanitarian support to Malawi in its efforts to address the ongoing cholera epidemic in the country.
It says, considering that the current cholera epidemic “is considered the worst in a decade”, EU member states felt duty-bound to help Malawians address the problem.
By today, cumulative cases have reached the 50,000 mark.
EU Commissioner for Crisis Management Janez Lenarčič said they are hopeful that the funds will go a long way in stemming cholera cases in Malawi.
“Cholera remains a tragic reality for many countries. Unsafe and contaminated water sources and poor hygiene practices are among the main factors increasing the risk of the disease spreading. Our funding will support our humanitarian partners on the ground in controlling and eventually vanquishing the disease,” he says.
The EU has also increased by 500,000 Euros [about K565,500,000] its contribution to an ongoing Unicef project through which life-saving health and water access and sanitation services are being offered to cholera-affected communities to improve case management and reduce deaths.
The initial funding, of 540,000 Euros (about K610,740,000), had been allocated in November 2022 to support the United Nations agency in its efforts to combat cholera.
Apart from these interventions, the EU has supported the World Health Organisation with 1.5 million Euros to support it in procuring essential supplies to strengthen its rapid response capabilities, carry out district-level forecasting for supplies and develop a multi-partner information-sharing system for the best use of resources.
In 2022, the EU also released emergency funding for cholera epidemics in other parts of the world, including Syria, Ethiopia and Haiti.
The EU and its member states are the world’s leading donor of humanitarian aid.
Through the European Commission’s Civil Protection and Humanitarian Aid Operations department, the EU helps millions of victims of conflict and disasters every year.
Tackling cholera through research
With cumulative cholera cases reaching the 50,000 mark, the Ministry of Health (MoH) and Kamuzu University of Health Sciences (Kuhes) are leaving nothing to chance, announcing that they have organised the 9th Extra- Ordinary Think-Tank Meeting in Lilongwe, where they will examine evidence related to the cholera outbreak.
“As part of the ongoing response, the Ministry of Health in collaboration with the Health Economics Policy Unit (Hepu) at Kamuzu University of Health wish to announce the [decision to hold] the ‘9th Extra-Ordinary Think- Tank Meeting’ which will focus on evidence on cholera epidemic, management and potential policy options for the future.
“The overall objective of the Think-Tank platform, jointly coordinated by MoH and Hepu, is to act as a ‘let’s think together’ platform, solely based on existing evidence, to plan, execute and facilitate action on high policy relevant evidence on issues of national importance. In particular, the Think-Tank serves to provide a platform through which evidence is synthesised transparently jointly through engagement among health policy makers, researchers and key stakeholders in the health sector,” the statement reads.
MoH and Kuhes further indicate that at the meeting, scheduled for March 22 2023, stakeholders will discuss cholera trends and explore potential differences with previous epidemics, discuss the current policy response package, review multi-sectoral evidence and assess alignment of policy response to the evidence and review gaps in evidence and agree on mechanisms for a roadmap for future evidence.
When he presented his budget statement to Parliament yesterday, Finance Minister Sosten Gwengwe said the cholera epidemic is one of the problems that have effected national affairs in the 2022-23 national budget.
Gwengwe said, after recognising the intensity of the problem, President Lazarus Chakwera added cholera to the tasks that were given to the Presidential Taskforce on Covid and Cholera.
He further explained that human capacity is being strengthened.
“An additional 1,000 workers have been employed to work in cholera hotspots. Furthermore, the government has been providing prepaid water tokens to communities.
“It [the government] also plans to implement the Malawi Water and Sanitation Project, budgeted at $145 million [about K145 billion] to increase access to water supply in the Blantyre metropolitan area and capacitate Blantyre Water Board. I will, therefore, in the course of the budget meeting, bring to the House a Grant Authorisation Bill of the Project. Upon successful implementation, the project will be extended to other water boards,” Gwengwe said.
Tough position on careless businesses
Earlier last week, the Presidential Taskforce on Covid and Cholera announced that business owners who operate bars, restaurants, lodges, supermarkets, among other facilities, will now be subject to a court fine of K200,000 and two months jail term if they fail to provide handwashing facilities to patrons at their business premises.
Chalamira Nkhoma said they are now familiarising stakeholders with new Integrated Cholera Response mechanisms.
“The rules have been incorporated to make sure that people are following what they are supposed to follow, in terms of water and sanitation protocols in public places. The amendments have not been made to punish people but to help them prevent cholera,” he said.
Some of the rules that have been incorporated in the new Public Health Act require that councils should be ensuring that places such as markets, public halls, shops, schools and others are having proper hygiene and sanitation facilities to stem cholera cases.
Water boards are among institutions that have been targeted by the amendments to ensure that they reconnect all public water kiosks to help people access clean water for drinking and household use.
He further explained that the new Public Health Act is mandating councils to be removing wastes regularly from dumpsites.
Nkhoma was hopeful that, following the introduction of the new rules, cholera cases would drastically reduce in the next 17 days.
“Currently a lot of districts do not have patients admitted to hospitals due to cholera. Others, like Mangochi, have halved cholera cases in the past one week, which is a good thing,” he said.
All these efforts mean one thing; the government is leaving nothing to chance.