Cholera leaves Chilumba family grieving

The mood is sombre and solemn at Luwe homestead at Mchenga Village in Chilumba, Karonga. 
The family, hurdled on a heap of rocks that form a de facto front pouch, are evidently in grief following the death of the head of the family, Lotani Luwe three weeks ago.
On August 28, 54-year-old Luwe started complaining of high fever and severe diarrhoea. Around 10 am, his condition deteriorated, and he was rushed to Chilumba Health Centre, which is close to his home. By 7 pm, he was dead, leaving behind seven children aged between 33 and 15.
“He was the breadwinner, and we all relied on him,” says his crestfallen wife. “His death means everything has now fallen apart.”
Like most residents of the picturesque town of Chilumba, Luwe was a fisherman who relied on the day’s haul to support his family. 
Following the loss, the family is inconsolable. 
“We have nowhere to turn to,” the widow says.
She says the children now have to step up to take up the responsibility left by the departed parent. 
“I know it is difficult, but what choice do we have?”
The biggest worry for the family is the education needs of two of the youngest children, Patrick, who is 17 and has just sat for Standard eight exams, 15-year-old Standard 7 learner Lotani Junior and Standard four grandchild Moses.
The mother contends that the younger siblings must join the rest of their siblings in paddling the waters to fend for the family.
“They have to balance between fending for the family and their education. They will have to earn money for their school,” she says.
The learners attend Chitende Primary School and hope the predicament will not deter their quest for an education.

The soft-spoken Patrick who dreams of becoming an accountant, says he will try to strike a balance between school and the fishing business. 
Patrick, who had ventured out to the lake on several occasions before his father died, explains that the fishermen head out to the lake at midnight and only return to shore around 6 am. 
He is, however, tongue-tied when asked how he expects to get ready for school in the one-and-a-half hours of returning from the fishing expedition and being in class. 
“I don’t know,” he mutters, barely inaudible.
Ofson Chikuyu is the Assistant Environmental Health Officer at Chilumba Health Centre and says there have been three deaths since the first case broke out in the area on 28th August 2022.
“This is out of the 82 cases that were recorded in the area,” he says.
He says Chilumba’s first recorded case was a contaminated case from Nkhata Bay, where the outbreak was first registered countrywide. 
“The first case was recorded at Chiwere, and it was someone who had travelled from Nkhata Bay BOMA and had contracted cholera there. Since then, there have been sporadic cases, especially at Chiwere, Matambukira, and Babalikuni,” he explains.
Chikuyu says the outbreak peaked on 4 September when the health facility had 34 cases.
Fortunately for the facility, they had received two tents from UNICEF as the outbreak broke out.
“We were lucky because the first tent came when we recorded a suspected cholera case from Tukombo. It turned out to be a false alarm, but the tent had already been dispatched from the Karonga DHO. So, when we eventually started receiving actual cholera cases, we were not really in panic mode,” he says.

Chikuyu notes that the situation would have been dire without the UNICEF tents.
“This is an emergency, and if we didn’t have the tents, the risk would have been worse for the community because we don’t have an isolation ward here, so that would have meant that we would have been forced to admit the cholera patients in the general wards,” he says.
Over the last week, the cholera outbreak in Malawi has been reported in one additional district, bringing the total number of affected communities to 19 since the confirmation of the first case in March. 
As of 12 September, 2,577 cases and 86 deaths have been recorded. 
Most cases are reported in Nkhata Bay, followed by Blantyre, Nsanje, Nkhotakota, Rumphi, Mzimba North, Chikwawa, Neno, and Karonga. 
The major factors associated with the cholera outbreak in communities are poor food hygiene, lack of safe water, and low latrine coverage and usage (open defecation). 
The case fatality ratio is at 3.3 per cent, much higher than the acceptable threshold of one percent. The deaths are being registered at the community level or soon after arriving at health facilities because of delays in admission and treatment. 
The districts are not well equipped with resources to respond to the outbreak. Some districts, like Nkhotakota, are witnessing the outbreak after decades. While other districts had successfully battled cholera in the past, they currently have inadequate supplies and human resources to handle the emergency. 
Access to safe water and latrine coverage is a significant challenge accentuating poor hygiene and sanitation. 
Since the declaration of a cholera outbreak in March 2022, UNICEF has been working closely with the Malawi Government and community members in developing a response plan and coordinating the response ensuring the delivery of essential supplies and services to the families and communities in cholera-affected districts in Malawi.