At 14, Mercy knows what the remote lakeside population appears not to worry about.
“Even adults defaecate in the open,” says the girl from Kakhongwe in Traditional Authority Mankhambira, Nkhata Bay. “When I’m pressed, I just go to the lake and pretend to swim when actually I’m relieving myself.”
People in the strip along the northern shoreline of Lake Malawi are at risk of contracting cholera due to lack of latrines.
Their girl’s fears personify the vulnerability of the majority of Malawians defaecating in the open and scanty bushes.
She lives almost 150 metres from the continent’s third-largest freshwater lake.
In her fishing community, almost all households have no latrine. Like her neighbours, the teenager worries about her health and privacy.
She narrates: “When people see you going to the lake, they know you are going to answer the call of nature.
“It is hard to cope with the situation. At night, people just walk a few metres behind their houses and dig holes. We are afraid of snakes and sexual harassment in the bush.”
The girl appeals to authorities to ensure every household owns and uses a sanitary latrine.
But the ongoing outbreak in lakeside villages in Nkhata Bay and Karonga shows the Community-Led Total Sanitation Policy government adopted in 2008 remains far from fruition.
Nine years on, the Ministry of Health reports that just about 70 percent of homes and 40 percent of villages have achieved total sanitation.
Last June, assessments of water, sanitation and hygiene (Wash) by Nkhata Bay District Council showed only 64 percent of households in the district own latrines.
At Ruarwe in Nkhata Bay, Peter Msuku walks past 15 houses to access a pit latrine in his grandparents’ home.
“All these families do not have latrines. They rely on my grandparents’ makeshift toilet,” he says.
It comprises grass walls, a mud floor, no roof and no hand washing facility.
When it is occupied, the villagers either go behind a massive rock in the vicinity or rush to the beach where they bury human waste in sand.
Group village head Kakhongwe is worried with the situation in his area, but says constructing a toilet is never easy.
“The lakeshore area is sandy. When constructing latrines, the pits and the walls collapse in no time. The villagers find it easy to defaecate in bushes and on the beach than building latrines,” says he.
The village head reckons providing the have-nots with cement and bricks will help make the latrines resilient.
There are similar concerns in the shoreline parts of Karonga, Rumphi, Nkhotakota, Salima and Mangochi where open defaecation is widespread.
Sanitation-related infections account for over half of the disease burden in the country’s clinics.
Nationwide, a campaign is underway to sensitise citizens to the importance of sanitation and hygiene, especially using latrines.
“Prevention is better than cure,” says Nkhata Bay district health promotion officer Christopher Singini. “People need to change their mindset and embrace sanitation and hygiene to combat cholera,” he says.
District water officer Alex Mwakikunga is concerned that despite many sanitation projects funded by government and its partners, Nkhata Bay has not achieved the open defaecation-free (ODF) status in line with the Community-Led Total Sanitation Policy.
Canadian Physicians for Aid and Relief (Cpar) is running an initiative to eliminate open defaecation in T/A Malenga Mzoma, Nkhata Bay.
Cpar district Wash coordinator Rodney Rajab says they are winning the fight.
“We have achieved our targets. Malenga Mzoma is now open defecation-free. We are just waiting for the national taskforce to come, verify and declare the ODF status,” he says.
Apart from triggering the desired status, Cpar plans to construct latrines and hand washing facilities in community-based childcare centres and schools.
In the 2015/16 rainy season, Nkhata Bay registered 50 cases of cholera—all of them in GVH Kakhongwe’s area.
This year, it has recorded 18 in T/A Mkumbira and no death.
Since the onset of the cholera season in November, the country has registered almost 200 cases and four deaths, according to Ministry of Health spokesperson Joshua Malango.
Karonga is the worst hit, with 158 cases.
Eliminating waterborne diseases remains a hard and long battle.