In Malawi, health workers bring hope and experience to COVID-19 fight

As the country endures a new wave of COVID-19, health workers share their experiences from earlier in the pandemic – and explain why vaccines are a crucial step towards ending it.

Malawi. A health worker speaks with a woman holding a child.
27 July 2021

LILONGWE, Malawi – “The third wave is hitting Malawi hard,” says Steve Macheso, a UNICEF Malawi Health Specialist. “It’s stressing the health system, stressing the health workforce, and leading to serious disruption in the lives of people in the country.”

Cases have surged across Malawi in recent weeks, but particularly in Blantyre and Lilongwe, the two largest cities. By late July, almost 50,000 cases of COVID-19 had been confirmed in the country.

Macheso says Malawi “saw the third wave coming,” giving the government and partners, including UNICEF, a chance to ramp up preparedness. “So we’re better off in terms of the oxygen supply situation, in terms of PPE supplies, in terms of testing capabilities.”

Yet, a rapidly rising positivity rate over the past couple of weeks – from less than 5 per cent in May to over 25 per cent by the third week of July – underscores the challenge still facing the country. Even with additional supplies in place, some districts and health facilities are running short of testing kits and protective gear. “[We’re] also having problems with supplies for treating comorbidities,” Macheso adds.

Malawi. A UNICEF health specialist visits a vaccine storage area.
Steve Macheso (left), a UNICEF Health Specialist, visits a vaccine store room at Chikande Health Centre in Ntcheu, Malawi.

All these issues pose a multifaceted threat to the country’s children, who have lost parents, had their education disrupted and been left more vulnerable to exploitation during the pandemic.

“Although the number of cases affecting children remains relatively low, these people dying from COVID have children, they have families,” Macheso says. “We’re seeing tremendous suffering and neglect among children and adolescents.”

Malawi. A nurse sorts through supplies at an emergency treatment unit.
Gilbertha Bayira, a nurse, sorts through supplies at the Kameza Emergency Treatment Unit in Blantyre, Malawi.

UNICEF has provided financial and technical support for Malawi’s response to this latest wave; including by mobilizing resources; building capacity among rapid response teams; providing  supplies such as PPE, test kits, oxygen concentrators and ventilators; and undertaking risk communication and community engagement activities. With funding from the UK Foreign Commonwealth and Development Office, UNICEF has also supported the Ministry of Health in establishing an oxygen plant to ensure hospitals have the supplies they need to treat patients with severe cases of COVID-19.

Duncan Banda, a physiotherapist, knows all too well the urgency of ensuring adequate oxygen supplies. He was working at a COVID-19 field hospital in Lilongwe, Malawi’s capital, when the facility ran out of oxygen cylinders. There were just four physiotherapists to help around 60 patients experiencing breathing difficulties.

“We had to reposition patients, do deep breathing techniques and intensive physiotherapy. We lost four patients in four hours that day,” Banda says.

Malawi. An oxygen plant at a hospital.
An oxygen plant at a hospital in Lilongwe is pictured in November 2020.

Physiotherapy has played an important role in managing COVID-19 care in Malawi, particularly for patients with breathing difficulties. “We only admit those who are unable to breathe independently,” Banda says. “For those on machines, physiotherapy helps as we try to wean the patients off. Using chest physiotherapy techniques, we can train patients to breathe properly and return to normal without a machine. We help them breathe and expand their lungs.”

UNICEF has also played a central role in the COVID-19 vaccine rollout, helping the Government secure vaccines and assisting in their distribution. The most recent vaccination drive ended on 26 June 2021, when the country ran out of vaccine doses. Stocks ran out just as vaccine uptake started to improve, although 192,000 vaccines donated by the French Government arrived via the COVAX Facility on 24 July, and more are expected in August.

The initial focus of the vaccine programme has been on reaching health and social workers, the elderly and other vulnerable populations, including those with underlying health risks. Tamara Katuli, a health surveillance assistant, is one of those who has already received the vaccine. “We were so afraid of COVID-19,” she says, recalling how she and her family felt in the early days of the COVID-19 pandemic. “But after getting vaccinated, we feel safer.”

By the end of June, around 385,000 people had received the first COVID-19 vaccine dose – an important achievement, but only about 2 per cent of the population. Meanwhile, by 25 July, only 43,165 people had been fully vaccinated with the recommended two doses.

Malawi. A health worker shares information about the COVID-19 vaccine.
Wellington Kaima (right), a health worker at Makata Health Center in Blantyre, has been sharing information about the COVID-19 vaccine with patients.

Wellington Kaima, a health surveillance assistant at a health centre on the outskirts of Blantyre, in southern Malawi, has also been urging more people to get vaccinated. “The development of our country will be affected if the population is unhealthy,” he says. “I am encouraging everyone to go to their nearest health centre and get vaccinated. Don’t hesitate, the vaccine is safe and effective. It is provided for free at vaccination centres.”