UNICEF Responds to Cholera Emergency in Malawi

January 25, 2023

UNICEF is moving fast to scale up support of Malawi's response to the country's massive cholera outbreak as more and more people fall sick and die.

As of Jan. 22, UNICEF reported, 960 people had died — including 144 children. Registered cases have exceeded 29,000 since March 2022, with children representing 35 percent of the total.

Health workers tend to a young patient at Tukombo Health Center in Nkhatabay, Malawi. UNICEF is providing high-performance tents, acute watery diarrhea treatment kits and other emergency supplies to support Malawi's response to the worst cholera outbreak in years. © UNICEF Malawi/2022/HD Plus

UNICEF has been shipping emergency medical, sanitation and hygiene supplies to the country and helping communities implement prevention measures to contain the spread. When a year-end surge in cholera cases prompted schools in the cities of Lilongwe and Blantyre to close, classrooms were able to reopen with UNICEF's support after two weeks.

Malawi's cholera outbreak is a "threat to the health and well-being of children," UNICEF Malawi Representative Rudolf Schwenk said. "We will continue to support the Ministry of Health to scale up the cholera response. We appreciate the tireless efforts from frontline health and community workers to manage the influx of cholera cases." 

UNICEF began stepping up its response last August as cases began to spread from the southern part of the country into the northern and central regions, threatening to further overwhelm the country's already over-burdened health system. "The good news is that we know the solutions," Schenk said. 

Strengthening WASH services — a pillar UNICEF program — is critical to fighting cholera 

Cholera — an infectious disease spread through contact with contaminated food or water — is both preventable and treatable. Yet the disease continues to be a public health threat in places that lack sufficient water and sanitation services and/or infrastructure. Malawi is one of several countries hit by a cholera resurgence in recent months despite having recently all but eradicated the disease

Maintaining reliable access to clean, safe water for drinking, cooking and personal hygiene; promoting best practices such as regular handwashing with soap and water; and ensuring sufficient sanitation, including toilet use (vs. open defecation) — all UNICEF areas of expertise — are all critical to helping to prevent cholera and other waterborne diseases. There is also a cholera vaccine.

Cholera is treatable as well. With timely and appropriate care, many patients recover. For children who are malnourished and have weakened immune systems, however, fighting off the infection is more of a struggle. Diarrhea, a common cholera symptom, can lead to severe dehydration. Diarrheal disease is one of the leading causes of preventable deaths in children under age 5 worldwide.

Mary Nafodi gives her 9-year-old daughter, Alepha, the oral vaccine for cholera during a UNICEF-supported campaign at Misili Village in Chikwawa district, Malawi. © UNICEF/UN0655373

UNICEF appeals for more support to help Malawi fight cholera outbreak, helping communities strengthen prevention, control and response

UNICEF is on the ground supporting the Malawi government's response to the outbreak, focusing on strengthening disease prevention and control and improving case management. Working closely with the World Health Organization (WHO) and other partners, UNICEF is helping to set up and equip treatment facilities, provide acute watery diarrhea treatment kits and other items, supply safe water to communities in need and distribute hygiene and sanitation kits to health facilities and schools.

Response teams have been going door to door in high-risk districts to counsel families about how to effectively prevent cholera from spreading. A mobile van is rolling through communities making public announcements. A second national vaccination campaign launched in November aims to reach 2.9 million Malawians — adults and children age 1 and older.

UNICEF Malawi requires more support to sustain lifesaving services for vulnerable children and women; to increase delivery of WASH and health services; and to provide psychosocial support for children and caregivers who have suffered the loss of loved ones.

Robert Mwale, 29, left, a fisherman based in Tukombo — a community where all 2,000 or so households rely on a single borehole as their source of potable water, and where several families will share a single latrine — celebrates his recovery from cholera at the home of his mother (far right) in Chintheche, where he has been staying with his wife and twin daughters since being discharged from the hospital. "It's actually a miracle that I survived," Mwale said. © UNICEF/UN0692296/

"Every death from cholera is preventable with the tools we have today," WHO Country Representative Dr. Neema Rusibamayila Kimambo said. WHO's efforts alongside UNICEF and other partners will continue, Kimambo added, to ensure that "lives continue to be saved, and a resilient health system is maintained during and beyond the current outbreak." 

How UNICEF helps children stay in school — and safe from cholera

To make sure children can continue to go to school safely — despite a major public health crisis — UNICEF is helping schools implement safety protocols, like having soap and buckets on hand so that students can wash hands; conducting hygiene awareness campaigns to communicate the importance of handwashing and other hygiene practices to stop the spread of cholera and other diseases; and training teachers in infection prevention, cholera response and management; and providing access to education for children living in cholera hot spots. 

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Top photo: Two weeks after schools closed to prevent the spread of cholera, more than 200,000 students at 89 schools in Malawi's two largest cities, Blantyre and Lilongwe, were able to return to their classrooms when schools reopened with support from UNICEF. Supplies provided included soap, buckets and chlorine for water purification and infection control. "We can no longer afford to withhold children's access to in-person education, especially in light of the learning loss caused by the COVID-19 pandemic," UNICEF Malawi Representative Rudolf Schwenk said during a handover event at Chiwoko Primary School in Lilongwe. "No effort should be wasted in reopening schools better than before, getting every child back to the classroom and keeping schools open." © UNICEF Malawi/January 2023