Since writing my first piece on Africa on 20 April 2020 (click here to read), there have now been 386,947 confirmed COVID-19 cases in Africa and a documented 9,736 deaths. (1)
Both figures are likely to be enormous under-estimates with concerns being voiced by the healthcare staff of many countries as well as outside agencies, including the United Nations African Union Mission and the WHO (World Health Organisation), that the virus is spreading rapidly and invisibly across the continent.
Doctor Matshidiso Moeti, the WHO’s regional director for Africa, said, “It took 98 days to reach the first 100,000 cases, and only 18 days to move to 200,000 cases..... Even though these cases in Africa account for less than 3% of the global total, it’s clear that the pandemic is accelerating.” (2)
There have been varied responses to the pandemic across the different countries of Africa. In some countries there is no official recognition or even acknowledgement that there is a pandemic, whilst in others they are facing the combined threats of COVID-19, other disease outbreaks and terror attacks by extremist groups eager to take advantage of the vacuum created as armies are redeployed to tackle the outbreak.
This piece looks at Malawi.
There are pieces here on DRC (Democratic Republic of Congo) & South Africa
and here on Tanzania & Nigeria.
Malawi
Malawi is one of the poorest countries in the world, ranking 172 out of 189 countries. (3)
The first three cases of COVID-19 were confirmed in Malawi on 2 April 2020 and the first death on 7 April 2020.
The country has now documented 1,146 confirmed cases and 13 deaths. The Ministry of Health also gives a figure for suspected cases which is currently 13,660. (4)
Cases have been confirmed in every district throughout the country. As in so many other countries, both in Africa and beyond, a lack of testing capacity is an ongoing problem and the true number of cases is likely to be much higher.
Worryingly confirmed cases have been rising rapidly in recent weeks. It took eight weeks from the first confirmed case (2 April until 27 May 2020) to reach 101 total cases but only another four weeks for the number to have risen more than tenfold to the current 1,146. (5)
The government wanted to impose a lockdown at the beginning of the outbreak for a period of three weeks but this was blocked on 20 April 2020 by the High Court who said the country could not withstand the economic fallout from such measures. (6)
The then president, Peter Mutharika, announced an emergency cash transfer programme for the poorest people of the equivalent of £40 each month. The money for this came as part of a £30M to Malawi fund approved by the World Bank. (7)
Concerns were raised at the beginning of June 2020 that Malawi would see a surge in cases as people returned home from South Africa, the worst hit country on the African continent. Of the first 1,000 returning Malawian migrant workers 134 tested positive for COVID-19. (Workers were stranded in South Africa during its lockdown but began to return en masse to Malawi once South Africa eased its travel restrictions.)
Throughout June the majority of new cases in Malawai were in citizens returning from South Africa. Efforts were made to quarantine those returning but 400 returnees escaped from a stadium where they were being held in an effort to get back to their own homes. (8)
Malawi also had presidential elections on 23 June 2020. Rallies held in the run up to the election may have contributed to the spread of the virus as large crowds gathered together and the opposition accused the government of exaggerating the extent of the pandemic and lying about positive coronavirus tests. (9)
At the time the then president Peter Mutharika said “Our fight against coronavirus is being undermined by politics and politicians. The courts stopped us from going on a lockdown. The same courts want us to go to an election. Now, we have a situation that is encouraging everybody to campaign and undermining social distancing.”
Of particular concern to the country’s health experts was the vice president, Saulos Chilima, who encouraged the populace to continue to meet in large numbers saying, “When we are walking, if you meet someone putting on MCP (Malawi Congress Party) clothes, hug them. And if you meet someone in PP (People’s Party) clothes hug them, they are your relations...you cannot contract diseases hugging one another.” (10)
In fact, one of the main ways of transmission of coronavirus is through touching which is why so many countries have implemented social distancing and frequent hand washing as measures to try and curb spread of the disease.
Although Peter Mutharika lost the election to Lazarus Chakwera of the MCP, Chilima continues as vice-president because he is the leader of the United Transformation Movement (UTM) party which in turn is part of an electoral alliance that includes the Malawi Congress Party and the People's Party, and he ran as Chakwera’s running mate.
The UN Resident Coordinator, Maria Jose Torres, has expressed grave concerns for the country explaining that “Covid-19 could have a disastrously high toll in Malawi. Even a fairly low number of cases could overwhelm the health system, cause food shortages, and reverse the path of progress the country has been on in recent years.”
Torres went on to say, “We’ve got to make sure that people have the supplies and knowledge they need to stay safe.”
In 2019 Cyclone Idai left 90,000 Malawians homeless after dams burst and widespread flooding occurred. Many people remain displaced within the country.
The World Food Programme (WFP) has distributed money to 350,000 of the most vulnerable people in the country. The assistance payments are supported by the US and UK governments and when people collect the money they are also given information and advice about COVID-19. The United Nations Children’s Fund (UNICEF) is also working to deliver water, sanitation, and hygiene supplies. Together with the World Health Organisation and aid agencies they are trying to reach the rural and poor communities. (11)
Meanwhile, doctors and nurses have been protesting about their poor pay and lack of PPE. They are also finding themselves stigmatised and shunned by people who fear catching COVID-19 from them. Some have been evicted from their homes by landlords and those who have been able to remain in their own homes have found themselves surrounded and attacked by mobs. Doctors and nurses alike have requested accommodation at the hospitals they work in and designated buses to transport them to and from work. (12)
Malawi has only 25 intensive care unit beds and seven ventilators for the entire population of 18 million people and diseases such as malaria, HIV infection and tuberculosis are endemic in the country. It is ill equipped to cope with a COVID-19 outbreak on the scale of that seen in places such as Italy, Spain and the UK, a fact that health workers and aid agencies alike are very aware of. (13)
