Healthcare workers launch the second phase of cholera vaccination amid a raging outbreak. Our Staff Writer JAMES CHAVULA explains why the emergency campaign matters. January 8 was a dark Thursday in Chilomoni Township at the foot of Michiru Mountain in Blantyre. A 46-year-old man became the first person to succumb to the raging cholera outbreak that had killed two of the 102 confirmed cases since December 11.
“He was vomiting and too weak to walk when he arrived on a motorbike at Chilomoni Health Centre. He died around 7pm,” says community health worker Thandiwe Chisi.
The tragedy has sent ripples of fear across the sprawling cholera hotspot, where waste, including human excreta and soiled diapers, litter open space and streams. At Chilomoni Nthukwa Market, a rising heap of uncollected waste welcomes visitors destined for the residence of Group Village Head Chibwana of the densely populated Mulunguzi section, the hardest hit.
The community leader recalls: “When I heard that the city’s first cholera case had occurred in my area, I was shocked and ashamed, but quickly gathered my community to remind each other that we need to fix the breakdown in sanitation, hygiene and access to safe water.
“During the meeting at Mulunguzi Ground, I stressed that the fast-spreading disease fuelled by poor sanitation does not discriminate, but kills fast if neglected. Then I invited health authorities who stressed the importance of safe water, sanitation and hygiene as well as oral cholera vaccine to roll back the outbreak.”
The rally, coupled with the highly publicised death, birthed one of the remarkable immunisation stories as the affected community and its at-risk neighbours consumed 24 000 oral cholera vaccine doses within three days.
“When I heard about the cholera vaccine, I encouraged my people to get the shots to stop the outbreak. I’m glad that many people heeded the message and we need some more doses to leave no one behind. However, the vaccine won’t stop cholera unless we improve sanitation and hygiene,” he says.
Chibwana and his village development committee have banned the dumping of soiled diapers in open spaces and emptying pit latrines and sceptic tanks into rivers
“We had to do something about sanitation gaps because all the streams turned into dumpsites, even for human waste, flow to Mulunguzi, where many people fetch contaminated water from shallow wells and pools because they cannot afford a bucketful from communal kiosks where taps often run dry,” says the community leader.
The breakdown in sanitation and access to water partly persuaded Dorothy Chipala to receive the cholera vaccine supported by Unicef.
“It wasn’t the first time, but I had to protect myself from the ticking bomb,” she says.
Chipala belongs to a household of eight. They first got vaccinated three years ago when cholera claimed 1770 lives from nearly 59 000 confirmed cases.
“No one in my homestead has contracted cholera since the deadliest outbreak. This shows that the vaccine works. This encouraged me to boost my body defence realising that current outbreak and poor sanitation put our lives in danger,” she says.
Chisi hopes the vaccine shots will lessen healthcare workers’ workload.
“The cholera deaths have stirred fear that forced many people to scramble for the vaccine. I hope the climate of fear will trigger lasting solutions to sanitation gaps and perennial cholera outbreaks,” says the community health worker responsible for disease surveillance and control.
From January 21 to 25, the Expanded Programme on Immunisation (EPI) in the Ministry of Health and Sanitation released 94 151 oral cholera vaccine doses to halt cholera transmission.
They distributed 26 000 doses in Blantyre, 24 124 in Kasungu, 27 076 in Neno and 2003 in Mwanza.
“These vaccines were carryovers from the previous campaign held in 25 target districts in 2004,” says EPI national surveillance officer Joyce Beyamu. “For the first time, we achieved 99.7 percent coverage in the target hotspots. The high acceptance shows that people in hotspots know that cholera is deadly and they are highly at risk, so they want to protect themselves.”
The Ministry of Health and Sanitation and its partners, including the World Health Organisation and Unicef, will roll out a new cholera vaccination campaign from today to Friday.
“Preperations for the second phase are complete and we are targeting new hotspots in Blantyre, Chikwawa, Mulanje and Chiradzulu. The key message is we have an ongoing cholera outbreak and we are going to respond by vaccinating people in hotspots while addressing Wash gaps,” says Mavuto Thomas, deputy director for community and promotive health in the ministry.
Amid the outbreak underway in 14 districts, GVH Macheso, whose community of about 700 households was the epicentre of the deadliest outbreak, says vaccines work—but not without addressing sanitation gaps.
“Cholera vaccine works,” says the community leader. “In 2023, Limbe Health Centre was receiving over a dozen cases daily from Macheso, but the vaccines helped slow the spread until we got to zero within two months. We also banned unsanitary practices, especially piping human waste from pit latrines and sewers into waterways.”
