The worst cholera outbreak to hit Malawi in two decades has already claimed 750 lives, a government minister said, while the head of the World Health Organization described the southeast African country as one of the hardest hit in amid ongoing global epidemics that are “more widespread and deadly than normal.”
Malawi’s Health Minister Khumbize Kandodo Chiponda on Thursday ordered the closure of many businesses that lack potable water, toilets and sanitary facilities for waste disposal, and announced restrictions on the sale of convenience foods.
“We continue to register a growing number of cases across the country, despite signs of reduced transmission and deaths in some areas,” Chiponda said in a statement, urging compliance with sanitation and hygiene measures.
On Wednesday, Chiponda said 17 people had died from 589 new cases of the waterborne disease “in the last 24 hours.” He said the country has recorded 22,759 cases since the start of the outbreak in March last year.
Figures show that around 15 people have been dying daily in recent days, with 155 deaths recorded in the last 10 days. Nearly 1,000 people were hospitalized as of Wednesday.
This week, WHO Director-General Tedros Adhanom Ghebreyesus said 31 countries have reported cholera outbreaks since December, an increase of 50% over previous years.
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“While we’ve had large cholera outbreaks before, we haven’t seen such a large number of simultaneous outbreaks,” Tedros said, adding that Malawi, along with Haiti and Syria, are among the hardest-hit countries.
Last year, the WHO and its partners switched to a single dose of the standard cholera vaccine instead of the usual two doses, due to supply problems.
“Production is currently at full capacity, and despite this unprecedented decision, stocks remain very low,” Tedros said, adding that four more countries have ordered vaccines in recent weeks.
The WHO has previously blamed the unprecedented global rise in cholera on complex humanitarian crises in countries with fragile health systems that are being exacerbated by climate change. Warmer temperatures and increased rainfall make it easier for the bacteria that cause cholera to multiply and spread.
A child with cholera is carried by his mother in central Malawi, on January 11, 2023. Malawi’s health minister says the country is suffering its worst cholera outbreak in two decades. Cholera has claimed the lives of 750 people in Malawi since the outbreak began in March.
(AP Photo/Thoko Chikondi)
Africa CDC Director Ahmed Ogwell Ouma told reporters during a weekly online briefing on Thursday that 14 African countries are reporting cholera cases, many of which are due to flooding across the continent. A significant proportion of the continent’s 1.3 billion inhabitants lack access to safe drinking water, sanitation and good hygiene.
Ouma said 393 deaths out of just over 4,000 new cases were reported over the past week in Africa, where Malawi is the epicenter of the outbreak.
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The country of about 20 million people recorded 71% of cases and 88% of deaths last week, Ouma said.
In the capital, Lilongwe, some people blamed the outbreak on a lack of basic services like clean water and sanitation.
“I was eating and drinking in the markets without washing my hands. I was not cautious, but there is no water in these places either,” said Kondwani Malizani, 24, a motor mechanic from Lilongwe’s crowded Ngwenya township. He said that he was hospitalized with cholera last week.
Lilongwe and the city of Blantyre, an economic center in the south of the country, are the most affected. Many public places, such as busy markets, do not have tap water, while people are forced to dig wells in their homes or draw water from unsafe sources, such as rivers and streams, factors that contribute to cholera outbreaks.
Epidemiologist Adamson Muula told the AP that the outbreak is affecting “the very poor” who lack access to clean water and sanitation.
“People who have working toilets, clean water from taps at home and those who get strong by not eating from questionable places are basically not at risk,” said Muula, a professor at the Kamuzu University of Health Sciences in Blantyre. He blamed the ruling elites for not investing in infrastructure.
“People who are not served by the municipal water supply system. People who defecate in bushes and other open spaces, drink from open water sources, and those who live in communities where different water companies may stop providing tap water for days on end are affected,” Muula said. “Such a disease becomes difficult to control as the bourgeois feel carefree”.
Health Minister Chiponda announced on Thursday a ban on selling pre-cooked food on the streets, in local markets, bus stations and schoolyards. He also ordered the closure of all marketing, transportation and travel, sports, religious, and entertainment facilities that lack potable water, functional toilets, and “organized and sanitary” garbage disposal facilities.
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He also said the government plans to expand the network of water pipes, as well as deliver water by truck to people living in the slums of Lilongwe and Blantyre. Schools in the two areas whose opening was delayed in early January will reopen on January 17. This is after the government pledged to provide safe drinking water and reconnect piped water that had been cut off at some schools in Lilongwe and Blantyre, Chiponda said. .
The country this week asked for donations of cholera beds, tents, buckets of water, rehydration salts, medical supplies and cash.
In November, WHO and partners shipped almost 3 million cholera vaccines to Malawi. Cholera is an acute diarrheal disease that is transmitted through contaminated food and water and can cause severe dehydration. It is a bacterial disease that affects both children and adults. If left untreated, up to 30% of cholera cases can be fatal, and in extreme cases, the disease can cause death within hours.
