The Right to Clean Water: Cholera’s Resurgence in Malawi


In a nation that championed the eradication of Cholera within its borders, the disease has resurged resulting in over 28,000 infections and over 900 deaths, as of March 2022. The Southern African landlocked nation has struggled to combat the rise in infections, which has been exacerbated by its rainy climate. Limited access to clean and safe water continues to impact Malawi as well as other nations, resulting in concurrent Cholera outbreaks around the MENA region. 

As defined by the World Health Organisation, Cholera is an diarrhoeal infection caused by the ingestion of food and water infected with the bacterium, Vibrio Cholerae. While vaccination and sanitation efforts had reduced the infection and death rate in 2021, Malawi is currently struggling due to the lack of basic medical supplies needed to combat the disease. With a rising case fatality rate of 3.4%, Malawi’s national hospital system remains stretched thin with overworked doctors and limited vaccines. Cholera can be safely treated with an oral cholera vaccine (OCV) as well as through an administration of intravenous fluids known as Oral Rehydration Solution (ORS). However a limited global stockpile of the vaccine remains to be insufficient for the two doses that are required. The World Health Organisation has recommended a reduction in the required dosage to one dose instead of two. This one dosage has its limitations, in that it only provides short-term immunity. How long that immunity lasts, is up for debate. 

The causes of this outbreak is widely speculated with public health officials pointing to Malawi’s destructive storms, the ongoing coronavirus pandemic, as well as a decrease in the population’s immunity against Cholera. The economic deprivation, as a result of the pandemic, has worsened hunger levels. This can weaken the immune system. In addition to this, the outbreak has resulted in the delay of primary and secondary school reopenings. Thus, Malawi’s overstretched human capacity has created long lasting effects not only in public health but also in education. 

Malawi is not the only nation devastated by this disease. Other nations in the MENA region such as Haiti, Bangladesh, Syria, and Lebanon have also reported Cholera cases within 2022. The rise in Cholera cases are predominantly found in developing nations, where clean and safe drinking water is not a guarantee. These nations, alongside Cameroon, Kenya, and Somalia, have pre-existing regional challenges such as droughts, population displacement, conflict, and floods that continue to intensify an already inflamed public health crisis.
The answer to this crisis is found in economic development. Access to clean and safe food and water, including adequate sanitation is a fundamental right, embedded in the United Nations’ Sustainable Development Goals. Basic sanitation and the implementation of good hygiene practices are crucial intervention processes that can be easily accomplished. An increase in the production of the medicinal treatment is also necessary, as an immediate response treatment through the provision of ORS can assist in lowering the overall case fatality rate. Cholera continues to devastate families and communities as a public health crisis. Thus, it is of extreme importance that the global community continues to engage amongst one another to survey, understand and combat any potential outbreaks. Clean water and sanitation is not a privilege but must be a right that is accessible to all.


Original Photo Credits: Lars Plougmann — Edited by GorStra team

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