Cholera outbreak wipes out families

While the Health Ministry is celebrating a 13 percent decrease of cholera cases, nobody is mentioning how the outbreak has wiped out households and separated families amid shortage of supplies.  

One of the sad stories that the outbreak has birthed is that of a Lilongwe-based woman Lifika Sandram, 70.

She is a broken soul. She has experienced her peak of grief as the cholera outbreak has pierced her heart.

As she was engaged in a fight for her life against cholera at Area 18 Health Centre, little did she know that  her two children and brother were losing the fight against the disease.

“I was gravely sick so much that I didn’t know about the deaths. I only learnt about the calamity after I got discharged.

“I am still in deep pain,” she told Nation on Sunday team at her home in Area 50, a generally impoverished neighbourhood.

The deaths happened in quick succession. Her first-born daughter died on February 10, her 22-year-old son followed two days later and her brother died on February 14, according to Sandram’s other daughter.

Seated on the floor of a tiny, semi-lit living room which is as silent as an ambience of death, Sandram still looked pale. She was discharged last week.

“I will never forget cholera. I am yet to come to terms with the deaths. I just feel like they have gone somewhere and they will be back soon,” she mourns, her voice hugely constrained.

Sandram says she looked up to her children for help as she doesn’t have a stable livelihood. She doubts her life will return to normalcy.

 “I will now have to look after four grandchildren left behind by my children. It’s not going to be easy,” she forecasts.

Father and son deaths

In Mchepa Village in Traditional Authority Chitukula on the outskirts of Lilongwe, Mageni Mchepa, who is in her 70s, is still struggling to come to terms with the deaths of a son and a husband.

Her son Lumbe, 39, died of cholera at Blessings Hospital on 23 January this year and her husband Ismaili followed a day later after suffering a heart attack upon learning about their son’s death, according to the family.

“The loss was so overwhelming. My son used to support me. He was our breadwinner. It really hurt me to bury him. He only complained about stomachache and the next thing, he was gone,” she recalls with her face down.

Mchepa, a crowded village near Kamuzu International Airport, is served by one borehole. Most houses are closer to Lumbadzi River than they are to potable water.  

For Jonathan Banda from Kachere Township in Blantyre, his situation was worsened by the death of his wife at Limbe Health Centre in December.

“We both were diagnosed with cholera but my wife died later the same day we got admitted. It was a challenging situation for me and my three sons,” he said.

Banda said much as he tries to move on, he struggles to face negative sentiments from people within his neighbourhood.

His neighbours despise him and his children that they would spread cholera.

Esther Luhanga, 31, of Manje Township in Blantyre, who was admitted to Limbe Health Centre in January 2023.

The single mother of two said: “Everything in my household came to a standstill. My eldest child is 15 and she was my guardian and my five-year-old son was looked after by my neighbour.”

Luhanga, who sells second hand clothes at Limbe Market, said after she got discharged, people in her locality started discriminating against her.

Nevertheless, this did not draw her back as she resumed her business two weeks after getting discharged.

Dirty neighbourhood

The country is battling against a far more brutal cholera outbreak than any of the previous episodes. The Ministry of Health has recorded around 48 000 cases and 1 513 deaths as of Friday.

That, by far, beats the 32 546 cases and 968 fatalities registered in 2002 which was regarded as the worst outbreak in history before the current one broke out with the first case recorded in Machinga District in March last year.

All the 29 districts have reported cases but Lilongwe tops the standings with 8 815 cases and 466 deaths. Experts have blamed its rapid spread on poor hygiene, sanitation and usage of unsafe water.

And, Sandram’s neighbourhood ticks all these boxes. It is crammed with mud-brick houses, dotted with rubbish-pits, some almost full that they attract flies with utmost ease.

There is no safe water here and this mirrors the lives of four million Malawians, which is 20 percent of the population that does not have access to potable water, according to USaid Malawi.

“The borehole we were using broke down years ago. People use water from wells,” village head Makhanga, whose jurisdiction stretches to Sandram’s neighbourhood, tells Nation on Sunday.

While Adamson Muula, a professor of public health and epidemiology at Kamuzu University of Health Sceinces says such wells should be constructed 30 metres away from pit latrines, it is not the case here.

Our inspection of the neighbourhood established that most wells are barely 10 metres away from pit latrines and are not thoroughly covered.

 “It’s likely the residents drink contaminated water. It makes it difficult to contain the outbreak under those circumstances,” Muula said.

Makhanga revealed that his village of 200 households has recorded 15 cholera cases, resulting in five deaths.

He adds that the Ministry of Health has not distributed chlorine to help them protect the water.

“We are prone but yet we don’t even get the support to fight the disease. I have tried to source chlorine from Area 18 hospital but I was told they do not have enough,” claims Makhanga.

Muula said it was unfortunate that despite the government launching a campaign to contain the outbreak, the interventions are not being implemented with urgency and enthusiasm.

 “Distribution of chlorine is the best preventive measure for now because decongesting the communities is a long term solution. However, you would discover that not many communities are receiving free chlorine,” he said.

Cholera supplies shortages  

Sandram’s daughter Emily Mumba was a guardian of the three deceased relatives and her mother during their admission at Area 18 Health Centre, an auxiliary battlefield for cholera.

She is not impressed with the support the patients were getting, disclosing that the facility ran out of supplies such as oral rehydration solution (ORS), a fluid replacement used to prevent and treat dehydration, especially due to diarrhoea.

“The patients were being asked to buy ORS. This showed me that authorities aren’t investing much effort in the fight against cholera. Maybe, because it is regarded as a disease for the poor people,” she charged.

While authorities at Area 18 Health Centre said they could not comment on the cholera situation as they have no mandate, a worker, who asked for anonymity, confirmed that they suffered shortage of provisions.

The source attributed it to the closure of nearby Area 25 Health Centre after some community members attacked it for causing the death of their relative.

“The closure resulted in patients from that side flooding our facility. All of a sudden, we were keeping, on average, 60 patients which was double  what we used to have.

“This affected our resource base. We became beggars going from hospital to hospital looking for ORS and chlorine. Now we are well stocked as we have received massive help from the World Health Organisation and others,” said the source.

Cholera campaign: Is it working?

President Lazarus Chakwera launched the anti-cholera initiative to tackle the outbreak and ease the suffering that families and the health system is enduring.

Despite critics saying the campaign is not effective enough, Minister of Health Khumbize Kandodo-Chiponda defended the initiative.

Speaking during Face the Press in Lilongwe on Friday, she said: “Since the launch by His Excellency the State President, we have observed a 13.8% decrease in the number of cases in epi week 7 (3263) compared to epi week 6 (3786).”

She added that through the campaign, they have put in place measures to tackle major cholera triggers.

 “Poor water and sanitation are one of the risk factors in the spread of cholera, to address this; through the volunteers they are promoting water and sanitation at community and household level.

“Community volunteers are tasked to identify communal water points for routine water quality testing (monitoring), provide chlorine solutions or water purification tablets/sachets to households, train households on the chlorine solution storage and dilution of chlorine solutions to water,” she stated.