Addressing supplies bottleneck in Malawi’s cholera response

Bwaila hospital is one of the 61 health facilities in Lilongwe where frontline health workers are working tirelessly to save people’s lives from cholera deaths. The district’s last cholera outbreak was in 2017/18 when it recorded 388 cases and 18 deaths. Currently, cholera cases and deaths in the district are already exceeding 7,650 and 430, respectively, exerting enormous pressure on the facilities to save lives.

“Bwaila admits at least 45 to 60 cholera cases daily and one of our critical challenges is availability of essential supplies to treat the patients,” says Collins Nkhulazi, a Clinical Officer at Bwaila Hospital and focal point of Cholera Treatment Centre.

“Bwaila hospital management has been making efforts to ensure we have stocks of health supplies such as ringer’s lactate but it has not been easy because the cases keep rising and many patients are coming to the hospital with severe dehydration.”

Similar sentiments are heard at the nearby Area 18 Health Centre, located about 8km from Bwaila Hospital. The facility has also faced a challenge with getting adequate cholera treatment supplies like ringer’s lactate.

“We have had situations where there have been no supplies for the entire day – no ringer’s lactate, no ORS – especially in the initial days when we first started receiving cholera patients,” says Kedson Masiyano, Chief Clinical Officer at the facility.

“We would call the district authorities to send us supplies but they too didn’t have enough as Bwaila and other health facilities were also in dire need of the same supplies, and they had more patients than us.”

To help the health facilities cope with the pressure of responding to the country’s worst cholera outbreak in decades that has since claimed more than 1,400 lives, UNICEF alongside partners is supporting the Government of Malawi with essential cholera supplies. UNICEF has, so far, supported the Ministry of Health with lifesaving health and water, sanitation and hygiene supplies worth over US$ 470,000, and more supplies worth about US$ 1.2 million have been ordered.

“We stand in solidarity with Malawi at this time of need. Since the very beginning, when the outbreak was announced now almost a year ago, UNICEF has been working closely with national authorities and other partners to support the government with its cholera response,” said UNICEF Representative, Rudolf Schwenk.

“This includes training response teams at all levels, support in setting up cholera treatment units, providing health, hygiene and sanitation kits, oral cholera vaccines, lifesaving drugs and other essential supplies at the health facility and community level. We have also been supporting the dissemination of cholera prevention, treatment, and hygiene promotion messages in cholera-affected and cholera-prone areas,” he added.

Bwaila Hospital is one of the health facilities that has received support from UNICEF. On 7 February, the facility received part of the health, water, sanitation, and hygiene (WASH) and medical supplies worth US$ 850,000 (about MWK 880 million) from UNICEF.

Minister of Water and Sanitation, Abida Mia, received the supplies at the hospital and commended the many efforts from UNICEF to scale up the cholera response in Malawi.

“On behalf of the Presidential Taskforce on the Response to COVID-19 and Cholera, we would like to appreciate the support from UNICEF. This is a timely intervention that will help us save lives and combat the outbreak,” said Mia.

While handing over the supplies, the UNICEF Representative emphasized on the need to be extra vigilant of the limited resources and utilize them in the best way possible.

“We can do this through proper planning and estimating of quantities required in districts and strengthening the tracking and monitoring of supplies to ensure unimpeded and timely access to quality products and services. Frequent data sharing on supplies can also help in identifying the need and for prompt action and harmonized approach. A mechanism can be put in place for those districts that can control the outbreak to support other districts in need by sharing the remaining supplies,” suggested the Representative.

With the support Bwaila and Area 18 Cholera Treatment Centres have been receiving from partners like UNICEF, Nkhulazi and Masiyano say their supply stocks have improved, enabling health teams at the two facilities to reduce cholera deaths.

“We thank our health authorities and partners for giving us supplies and tents. Now we have the supplies that we need to scale up the response to the outbreak,” said Nkhulazi.