Malawi is facing its worst cholera outbreak in decades, with the disease already having claimed over 1,000 lives, according to the latest updates from Malawi health officials. The country, which is acknowledged as the epicenter of cholera in Africa, is among the worst hit by the ongoing epidemic globally.
Largely known as the disease of the poor, cholera is an extremely contagious viral disease that spreads through contaminated food and water. It can take between 12 hours to five days before a person starts to show symptoms. Cholera leads to rapid watery diarrhea and an infected person may die within hours from dehydration if they are not treated promptly.
Alarming statistics
Malawi reported the first confirmed cholera case in February 2022. Since then, all its 29 districts have been affected, with the total number of cases reaching 33,023 by January 2023. The number of fatalities has risen alarmingly over the past three months from about 180 in October 2022 to 1,080 in January 2023. The case fatality rate is 3.28%, the highest ever recorded globally compared to the World Health Organization (WHO) benchmark of less than 1%.
Health officials reported in the latest briefing that of all of the country’s 29 districts, the pandemic has only been controlled in one district over the past three weeks. Experts have warned that 10 million people including more than five million children are at risk.
Poverty, natural disasters among main reasons
With over half of the population living in poverty, Malawi is among the poorest nations in the world.
“Unlike Covid-19, cholera affects the very poor…. affects people ‘without names’. 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 (lakes, unprotected wells) and those who live in communities where different water companies can fail to provide tap water for days on end,” writes Editor-in-Chief of the Malawi Medical Journal, Kamuzu University of Health Sciences, Dr. Adamson Muula.
For their part, officials have attributed the spread of cholera to the recent floods from Tropical Storm Ana in January and Cyclone Gombe in March which affected many parts of the country with low access to clean water, sanitation and hygiene facilities. The cyclones also caused the temporary displacement of affected communities which facilitated the rapid spread of the disease.
Government, international response
In an attempt to contain the spread, the country’s Health Ministry has announced the closure of businesses, as well as transport and travel, sporting, religious and entertainment institutions that lack basic hygienic facilities. It has also banned pre-cooked food in schools, on streets and in markets. Schools have also been closed in some of the worst-affected districts.
Concurrently, a massive vaccination campaign was conducted in the worst-hit districts in May 2022, securing coverage of between 40% to 80%. The WHO subsequently donated a batch of 2.9 million cholera jabs but these ran out in January 2023. The Office of the Coordination of Humanitarian Affairs (OCHA) of the United Nations has meanwhile launched an emergency appeal and other international organizations have been working in the country to help the authorities to halt the spread.
This is the second cholera outbreak in Malawi this century with the first occurring in 2009 and 2010 in the districts around Lake Chilwa which affected 1,171 people and killed 21 during the dry season.
Malawi is not the only country to face a prolonged cholera outbreak. Another 28 countries globally have reported cholera cases, a sharp increase from the average of fewer than 20 afflicted countries per year over the past five years, according to The Scientist. The largest outbreaks are now being reported in Haiti, Malawi, and Syria. Globally, other countries affected by the cholera outbreak include, among others, Bangladesh, Lebanon, Pakistan and 15 nations in Africa.
