Scaling up COVID-19 testing

Enhancing testing in the second wave of COVID-19

By Gregory Gondwe
Bwaila Hospital Laboratory Technician Chipiliro Mwanga working on COVID-19 test samples at the Lilongwe District Health Office testing site
UNICEF Malawi/2021/Gumulira
25 February 2021

The demands brought forth by COVID-19, have forced Gloria Kantema Jeremiah, Lilongwe Deputy Health Environmental Officer, to move from her office within the premises of Lilongwe District Health Office. Her new workspace is outside, under a shade of trees.

The bare ground under the tree cover has become a COVID-19 testing centre at Bwaila Hospital. Gloria leads the team attending to people who come for COVID-19 tests. Two lab technicians work from a small grey tent close by, where testing kits and  collected samples are stored.

Gloria supervises testing centre staff from the Laboratory Department, Environmental Health and Clinical Departments.

Besides the pressure of attending to a lot of people that cram the centre, the place also gets noisy because of the busy roads and foot paths crisscrossing around it. The health officials operate over a din of continuous shouting and hooting vehicles from nearby sprawling dusty ground, where minibuses going to different directions within the Lilongwe City operate from.

Gloria says the situation becomes tricky when it is raining.

“We move into the shelter that is at the right-hand side as you enter the gate, to wait for the rain to stop,” she explains.

Although she has worked as an Environmental Health officer for 15 years now, what she has experienced ever since first COVID-19 case broke out in April 2020, is beyond her understanding.

“I have never been as overwhelmed as I am now,” she recounts. “In six weeks, we have tested about 29, 000 people.”

Chipiliro taking a sample from a university student
UNICEF Malawi/2021/Gumulira
Chipiliro taking a sample from a university student

Testing children

At Bwaila Hospital, records show that few children have come for testing. In the past two weeks, less than 10 children with an average age of 12-13 came for testing.

Joseph Bitilinyu-Bango, deputy director in the Ministry of Health, responsible for laboratory services says UNICEF, with support from the UK Foreign and Commonwealth Development Office  procured Taqpath test kits and COVID-19 Rapid Diagnostic Tests (RDT). Which has helped them test between 5000 and 6000 children across the country.

“For example, at one of our major hospitals Kamuzu Central Hospital, over 807 children have been tested,” he said.

Before conducting the tests, Gloria and her team at the Bwaila Hospital testing center talk to their clients about COVID-19, how the sample will be taken and what they should expect and do if the test results come out negative or positive.

Clients are also requested to provide their contact details. The team does the same when children come for tests, to put them at ease and help them understand what is happening.

“When  children come to the hospital, the parents  give us their history. We then talk to the children, explaining why the have to put on a mask and most of them understand this. Then we collect a sample for the COVID-19 test” she says.

Gloria says the biggest assurance they give is that no child has been hospitalised to the extent of needing oxygen and should therefore not be afraid.

A  rapid response team goes around visiting some of those who test positive to assess their situation.  If there is need for hospitalisation, an ambulance is provided.

The rapid response team, comprising environmental health officers, clinicians, nurses and lab officers,  also collects samples from contacts of the patients after contact tracing. Whether the contacts results are negative or positive the contacts are advised to quarantine for 14 days- which is the COVID-19 incubation period.

Dr. Joseph Bangoh from the Ministry of Health explaining the impact of the additional testing kits
UNICEF Malawi/2021/Gumulira
Dr. Joseph Bangoh from the Ministry of Health explaining the impact of the additional testing kits

Sacrificing her family time

For the 50-year-old mother and wife there is no proper knock off time and often no weekend breaks.

Even at home, Gloria attends to COVID-19 issues day or night since her mobile number is one of the Rapid Response numbers to call for Lilongwe.

“I always try to convince my family that someone somewhere is in need of a service or information which may cost a life if not attended to,” she says.

Gloria says balancing work and family life in this pandemic is a big challenge but she keeps assuring her husband and children that thie crisis will pass.