Water Trucks Shield Flood Survivors from Cholera

When Tropical Storm Ana whirled past southern Malawi, heavy torrents battered thousands of homes to the ground.

Aefi Tokesi, a girl aged seven, escaped to her neighbour's home, but surging water caught up with her and forced her to flee upland to Kalima Camp near her school. 

"My home collapsed and all my clothes and books were destroyed. I only survived with a small bucket for fetching water," she states.

The Standard Two girls' narrow escape personifies the agony of almost 130 000 children displaced by  the rainstorms that affected nearly one million people in southern Malawi.

Aefi soon found herself carrying her beloved "baby bucket" to open canals in the sugarcane fields and stagnant pools around the camp where women and children were drawing water.

UNICEF has provided safe water to the camp to reduce the risk of a potential cholera outbreak the size detected in the neighbouring Nsanje district. Every day, a truck donated by UK Aid brings treated water from Nchalo Trading Centre to the overcrowded camp at risk of waterborne disease outbreaks, including cholera.

Water trucking and the distribution of water treatment chemicals, including door-to-door chlorination, has offered 38 593 people access safe water.

"The water bowser comes twice a day. When it arrives, people, who once endured long walks to fetch water from a treatment plant in the surrounding sugarcane plantain, emerge from their homes to join a forming queue. Each is allowed to fill two buckets only," says Ishmael Banda. 

The 34-year-old man ensures sanitation and order at the water points supplied by the truck.

"At first, there were fierce scrambles for water because the canals increased the risk of dying from cholera. But the tube where we store treated water from the truck has made this history, " he says.

Banda works with the displaced community to keep the tube-like tank and water points clean at all times. Every week, he goes door-to-door, teaching campmates to treat drinking water with chlorine and Water Guard distributed free of charge.

The cholera outbreak in the Shire Valley has made his work pivotal to the well-being of the displaced population, including about 300 children.

The disease thrives on a breakdown in access to safe water, sanitation and hygiene, especially in communities where people defecate in the open.

Banda says the flood survivors initially run a high risk of cholera infection because the overcrowded camp used to rely on just eight latrines at Kalima Primary School.

"The fierce scramble for latrines used to force the 2,452 people from the 563 displaced families to relieve in the bush, from where heavy rains used to wash the human waste into the open water sources we were using," he states.

Cholera has been a chronic public health concern in the Shire Valley since the discovery of Malawi's first-ever case in Nsanje District in 1973.

The outbreaks mostly come in quick succession with flooding, which destroys water points and latrines as well as washing human  excreta into waterways.

"The contaminated water may find its way into the homes of displaced people when safe water is not readily available. As such, we thank UNICEF and its partners for coming to our rescue. Cholera kills fast, but safe water saves lives," states Banda.

The floodplain along the Shire River last recorded cholera patients in 2017, when water trucking proved vital to lessen the outbreak in the worst-hit undeserved townships outside Malawi capital, Lilongwe. 

Banda, who lost five goats, eight chickens and a three-bedroom House to the devastating floods, says the current cholera outbreak in Nsanje and Machinga, which were also hit by Cyclone Ana, have left the camp alert.

He explains: "Since the outbreak of the cholera started in the district next door, we agreed to always use clean water and latrines.

"Previously, families were resorting to open pools and irrigation canals because the only water pump in our midst is salty. But now we have safe water from the bowser."

Women say they shun the saline water because it is bitter and makes cooking take longer. 

Each family is allowed to fill two buckets from the truck before surplus is stored in the tube.

"We are no longer afraid of cholera, which may get out of hand if it hits congested camps which are mostly unsanitary with few latrines," says camp chairperson Ramison Chinkuyu.

He commends Banda and his sanitation committee for taking turns to chlorinate water in the tube and surrounding homes. They also wash the tube using soap to kill germs that cause cholera.

"We feel lucky to be alive because the devastating floods ripped all the houses in our village where people that settled in lowlands took shelter during Cyclone Idai in 2019. The least tragedy we expect is to die from cholera, which is prevented by simple sanitation practices such as washing hands before eating anything and after going to latrines, " Chinkuyu states.