Business as usual amid cholera

Despite Malawi continuing to grapple with what is turning out to be the worst cholera outbreak in history, it is business as usual in most markets, including areas regarded as hotspots.

The Nation spot-checks in some markets in Blantyre and Lilongwe, the two cities hardest hit by the outbreak, revealed that there is no change in behaviour among sellers and buyers of different commodities, including foodstuffs such as vegetables, meat, fish, chips and fruits.

Even though the two city councils issued a ban on the sale and distribution of ready-to-eat and unwrapped foods such as fritters, doughnuts, cooked cassava, cooked potatoes, potato chips, cooked and roasted maize, cooked and roasted meat, traditional sweet beer, salads, drinking water packaged by unlicensed producers and any cooked foods prepared and distributed at mass gatherings in unlicensed premises, the trend still continues.

At Makhetha Market in Blantyre, popularly known as ‘Mandaambuzi’, fried and roasted meat vendors yesterday said they have not experienced any change in customers’ behaviour since the outbreak.

“There haven’t been any changes in how customers patronise this place. Business is challenging, yes, but it’s not because of cholera. It’s because of the economic trends we are in,” said one of the vendors who refused to be named.

During the visit to the market, The Nation saw consumers enjoying the roadside prepared potato chips and deep-fried goat meat without washing hands. A majority of the customers were seen using toothpicks to pick pieces of meat and chips.

There is no toilet and tap water in sight.

This is despite the area being a hotspot for cholera where a stone’s throw away lies a cholera treatment centre where some patients are being attended to.

Government also restricted the sale of ready-to-eat food in public places and open markets such as Makhetha where sanitation is a challenge.

In a recent interview, Blantyre City Council director of health and social services Dr. Emmanuel Kanjunjunju said it has been difficult to manage sanitation and hygiene in such markets.

He said that is the reason the council closed the Limbe Market on December 31 2022 for a chlorination campaign following rising numbers of cholera cases around the area.

Kanjunjunju outlined several factors leading to the challenges in reinforcing sanitation and hygiene in such markets.

He said: “We have cleaners in our markets but they are being overwhelmed as our markets are too congested.  We have a backlog of garbage that we failed to collect in the past months due to fuel shortage. We are also working on constructing more toilets and privatizing them for proper management.”

Kanjunjunju faulted vandalism and an aging sewer system that has outlived its lifespan, leading to spillage of sewage in the city.

But Consumers Association of Malawi executive director John Kapito said government must provide adequate sanitation facilities in markets and other business centres to curb the cholera outbreak.

He said: “Government is aware of the poor quality of health care and hygiene within our communities and markets.  Our markets are the worst, unhygienic places where sewer spew is the source of water.

“Over time, authorities have failed to provide basic amenities to prevent these outbreaks and most of the markets and other public places do not have any public toilets and no piped water.”

Malawi reported its largest outbreak of cholera from October 2001 to April 2002, which affected 26 of the country’s 29 districts, with 33 546 cases and 968 deaths.

However, this year’s outbreak is the longest, crossing through the cholera off season. Apart from administering the cholera vaccine in the hotspot districts, the Ministry of Health has been encouraging people to improve on water, sanitation, and hygiene to control the outbreak.

However, it is still a challenge as only 44 percent of households have hand-washing facilities in Malawi. About 52 percent of outpatients in the country’s health facilities present themselves with wash related problems.

As of yesterday, a total of 599 new cases and 28 new deaths were recorded bringing the total number of cases since the onset of the outbreak in February 2022 to 29 364 and 960 deaths, respectively. Some 1 064 cholera patients are being cared for in the treatment centres..n