Polio vaccination teams share sanitation tips
Good hygiene practices are essential in the fight against polio
When a vaccination team stopped by Edna Matia’s homestead in Savala Village along the eastern bank of the Shire River in Chikwawa district, she released her bewilderment.
“I’m glad my two children have received the polio vaccine because the government cannot approve something that harms its citizens. But vaccines are coming in quick succession. Early this year, the children were vaccinated against cholera; today, it's polio vaccination. What’s next?
However, the mother of two was shocked when health surveillance assistant Charles Bizimaki said both diseases are transmitted through contaminated human stools and could be prevented through sanitation.
Shaking her head in bewilderment, she said people in the country could help cut healthcare spending by insisting on safe water and sanitation.
The Ministry of Health estimates that 52% of outpatients nationwide seek treatment for sanitation-treated diseases.
The 1766 deaths from 58 947 cholera patients since March 2022 personify the hidden cost of sanitation gaps.
The deadliest cholera outbreak coincided with a public health emergency following the confirmation of Malawi’s first polio case in 30 years.
The poliovirus detected in a three-year-old child in Lilongwe put overwhelmed health workers on the move to deliver polio and cholera vaccines alongside routine immunisation and Covid-19 jabs.
The race to make Malawi polio-free again takes Ebenezer Banda over hills and valleys to ensure every health facility in Chikwawa district has enough polio vaccine doses, and no child is skipped.
One chilly Thursday, the rumble on a bike took the district immunisation coordinator to a low-lying strip along the Shire River’s East Bank to monitor the polio vaccination campaign.
“Our teams are vaccinating children in schools, homes, and health facilities because polio has no cure but can be prevented through this simple and safe vaccine,” Banda said.
He joined community health workers at Makhuwira health centre to vaccinate scores of children against polio during a routine immunisation session.
This made it possible for Alesi Frackson, from the neighbouring hills, to have her two children vaccinated.
“I came to seek treatment for the baby found with malaria, but also took advantage of the visit to protect my children from polio, which permanently paralyses children,” she said.
As Banda inked the baby’s little finger of Amos after administering the vaccine, the mother of four pledged to ensure the remaining children received the vaccine from door-to-door teams.
The roaming teams mirror urgent strides to halt polio transmission again.
Malawi last reported a polio case in 1992, thanks to mass vaccination.
But Banda warns: “We cannot win the fight only by vaccinating every child. We must also close sanitation gaps because polio—like cholera—is transmitted through contaminated stools.”
This dials up calls to end open defecation as did communities surrounding Makhuwira health centre.
Traditional Authority Makhuwira’s territory was declared free from open defecation in 2017.
The Ministry of Health confers this status on communities where nearly every household owns adequate sanitation facilities, including a clean latrine with a drop-hole cover and hand-washing facility.
The open defaecation-free (ODF) milestone measures progress in the National Community-led Total Sanitation Policy adopted in 2017.
UNICEF is supporting the Government of Malawi to vaccinate children against polio and improve access to safe water, sanitation, and hygiene (WASH) for all by 2030.
Chief Makhuwira was 17 when Malawi beat polio, a feat he attributes to mass awareness and vaccination campaigns.
“Vaccines help create a safe world for children, but sanitation gaps could slow the renewed fight against polio,” he says.
The traditional leader warns that homesteads without latrines and people who defecate in the open present a setback to the fight against polio.
“Since my enthronement in 2021, I have intensified efforts for every household to have a latrine, a hand-washing facility, a clean kitchen, and other sanitation facilities required to beat preventable disease outbreaks such as cholera and polio,” explains Makhuwura.
The ODF status suffered a setback following the devastation of sanitation facilities by Tropical Storm Ana in January 2022 and Cyclone Freddy in March this year.
The loss and damage in the Shire Valley personify the fury of Cyclone Freddy, which affected more than 2.2 million people in southern Malawi.
Makhuwira explains: “We need to urgently rebuild the lost latrines and sanitation facility to reduce the risk of polio and diarrhoea diseases, including cholera.
“We are sitting on a time bomb. If an unvaccinated child catches poliovirus in unsanitary settings, all children will be at risk of contracting the disease.”
The 14-year-old case in Blantyre a few months after a case was reported in February 2022, the first in 30 years.
This has prompted the Ministry of Health to expand the polio vaccination campaign to children aged up to 15 from under five previously.
Bizimaki's team took it upon itself to vaccinate at least 300 children daily in spaces where they live, learn, and play.
He says: “Sanitation-related disease outbreaks are preventable. Before vaccinating a child, I give household members health tips, including causes and preventive measures. Sanitation saves lives and resources spent in fighting outbreaks such as cholera or polio.