Did you know that cholera has claimed a life in every 16 people affected in the past three months?
The Ministry of Health reported on New Year that the diarrhoeal disease had killed 13 of the 217 patients treated since September 8 2024.
This marks the start of another cholera season, about five decades since the disease was first detected in the country.
As fireworks erupted marking the dawn of 2025, three patients were bedridden in cholera treatment sites nationwide.
The resurgent outbreaks, dating back to 1998, expose the country’s struggle to kick out the acute diarrhoea that kills within hours unless treated on time.
According to the World Health Organisation, cholera spreads when one ingests contaminated water or food.
The disease of poverty mainly haunts people with low access to safe water and basic sanitation.
Health workers say every patient is a living example that Malawians are still eating their own faeces, a breakdown fuelled by open defeacation as less than half of homesteads nationwide have latrines.
The Ministry of Health estimates that over half of outpatients seek treatment for preventable diseases fuelled by unsafe water and poor sanitation.
In their narratives, overwhelmed health workers speak of running water and hairy flies carrying human excreta from areas where people defaecate in the open to food, water sources and kitchen utensils, fanning a familiar but neglected public health crisis.
Cholera killed over 1 600 of the 50 000 patients detected from March 2022 to August 2023, the country’s deadliest outbreak, according to the Ministry of Health.
The disease remains a global public health threat and an indicator of inequity, especially in low-income countries across southern Africa.
Malawi is part of the global push to eliminate cholera by 2030, but remains off-track to join as many as 20 countries that could eliminate the disease as a threat to public health by the deadline.
The targets include reducing cholera deaths by 90 percent.
The hotspots include clustered settlements, especially slums and rural areas lacking access to safe water.
In 2023, the populous township of Makhetha in Blantyre was one of the worst hit zones in the country’s deadliest cholera wave which lasted two years.
The outbreak overwhelmed the healthcare system, forcing authorities to halt everyday services at Makhetha Health Centre to concentrate on cholera treatment.
Makhetha resident Chifundo Alumando, 26, says the settlement is not yet out of harm’s way due to neglected water and sanitation gaps.
The nursery school teacher wakes up as early as 3am to fetch water at the roadside health centre, a kilometer away from her home.
“This is a daily routine because the nearest communal tap ran dry in July,” she says. “The taps only run for a few minutes, mostly at night.”
Shakira Bandawe, a mother of six, endured six months without water supplied by Blantyre Water Board.
“The water problems give me sleepless nights as I have to be at the borehole as early as 2am, leaving my husband in bed. This strains my marriage,” she said.
Those who cannot stand the fierce scramble at the hospital water point draw water from Mudi River, which is contaminated by household and factory waste.
“We know this water is not safe, but what can we do? We come here to bathe, wash utensils, and draw water for cooking,” says Ishmael Lipenga, 34.
This is not how a progressive nation ends cholera sooner than later—not even by 2030.
Derrick Saka, clinician in charge of Makhetha Health Centre, warns: “History will repeat itself if nothing is done about water, sanitation and hygiene.
“The battle to eliminate cholera will not be won as most people here don’t have reliable sources of clean water and sanitation facilities.”
This gives a glimpse of a national tragedy.
While the deadliest outbreak renewed the urgency to improve water and sanitation access, it appears the nation did not learn much from it.
If it did, then both the citizenry and policymakers appear to have forgotten what it takes to make the public health crisis history.
Not even the oral vaccination can kick out the deadly diarrhoea at the current pace.
The vaccine is just a small part of the mix. A great deal depends on sealing the gaps in sanitation and hygiene.
