A deadly problem looming in a familiar season

The cholera outbreak that affected nearly a thousand people and claimed 30 of them nationally from November last year to May this year was largely due to sanitation challenges.

Many more outbreaks that the country has registered previously have been propped up by the same problem.

Principal Secretary in the Ministry of Health and Population, Dr Dan Namarika, mid this year appealed to a cluster of various committees of Parliament to lobby for more sanitation interventions to prevent possible outbreaks in the future.

At that time, the outbreak had faltered and talk about it seemed to quickly drift into oblivion.

But to communities where the disease had reared its ugliest head, everything was supposed to be done to ensure that the familiar problem does not visit them again.

“It is a dangerous disease. I almost lost my 10-year-old son, Peter. He grew weak after a short diarrhoea one night. The situation got worse at dawn but thank God, he got well when I took him to hospital,” Steria Justin, a resident of Mitengo, a shantytown on the outskirts of Lilongwe City, said.

The location was one of the worst hit by the outbreak which was finally declared over in May this year.

Steria, a mother-of-three, said she was sure her son had contracted the disease from drinking contaminated water which she drew from a nearby well because she had no choice.

She had heard about the dangerous outbreak after the first case was recorded in Karonga in November last year. In Lilongwe alone, it affected 388 people and claimed 18 lives.

Information on how to prevent the disease was not handy to most communities which were worst affected by the outbreak. They continued drawing water from unprotected sources and relieved themselves in ‘illicit’ places, among other things.

“The water from the wells was for everything. We used it for cooking, bathing and drinking. That is how my son got cholera. I don’t want to experience what happened that night again,” Steria recounted.

Now, the Centre for Development Communication (CDC) is striving to ensure communities prone to cholera outbreaks have sufficient information about how to prevent an outbreak of the sanitation-related problem.

CDC believes in prevention superseding cure and wants Malawians to be aware of how they can avoid a possible cholera outbreak as the rainy season sets off in most parts of the country.

By engaging various stakeholders, CDC is spreading relevant messages that are aimed at dealing with any possible outbreak.

“At the centre of any cholera outbreak is the issue of sanitation. Then, information becomes critical because cholera is preventable. People simply need to have sufficient information about how to prevent and have it treated,” CDC Head of Programmes, Charles Simbi, says.

On Wednesday and Thursday, the organisation, with support from the Department for International Development, through Unicef, engaged religious leaders on how they can take part in sensitising their faithful on how they can prevent and treat cholera.

Simbi points out that without concerted efforts of different stakeholders, the battle against cholera becomes fragmented and difficult.

“Religious leaders have a role to play in influencing the adoption of behaviours. They can promote negative behaviours that put people at risk, so we would like them, as opinion leaders, to spread the correct message in terms of cholera prevention and treatment.

“This will ensure that, together, we reduce the risk of cholera and the vulnerability of individuals to cholera. It is all about people knowing the right things regarding the disease,” Simbi says.

He also believes that there are several gaps in cholera prevention and treatment which can be addressed if various stakeholders engage in honest conversations about the disease.

“For instance, perhaps, we should engage in some serious reflection on issues like sanitation in graveyards. People visit these areas during funerals and sometimes spend hours there. They obviously need toilets. This is something traditional leaders should think about,” Simbi says.

And for the religious leaders, caring for their flock means more than just preaching to them.

It also means avoiding propagating doctrines that can put their lives at risk.

“They should encourage their faithful to seek medical attention when they are sick. This includes when they are suffering from cholera. Sometimes, there are delays in seeking treatment when they go to religious leaders for prayers,” Simbi says, adding that cholera is about treatment.

And the religious leaders, under the Pentecostal and Charismatic Network of Malawi (Pechanema) umbrella, who gathered in Blantyre courtesy of CDC, settled on the point that cholera has to be treated by qualified medical personnel.

They agree that in their space, they have a lot of influence in how their flock respond to various problems affecting them including those bordering on health.

Pechanema president, Apostle Willie Chaponda, who was among the religious leaders from 19 districts which were hit by cholera the past three or four years and took part in the training workshop, says the concept that cleanliness is next to godliness must be practical.

“Most of the problems that happen in terms of sickness are due to uncleanliness. This is a very big problem in our cities and towns especially during this rainy season.

“Many people go to church. Politicians, chiefs and others go to church and, therefore, the church is rightly placed to disseminate messages to do with cholera prevention and treatment,” Chaponda says.

He regrets the ignorance which he says compels some people to believe in prayer only, saying religious leaders must teach their flocks about cleanliness because “after all, people cannot live on miracles only”.

Chaponda explains: “God never intended that we should be living by miracles, but naturally following principles that can help us live healthy lives. Thus, we have to teach our faithful this and we must sincerely do it now when the threat of cholera is big.”

And CDC hopes that there will be a change in how various individuals respond to both cholera prevention and treatment.