Health officials in Malawi are struggling to contain one of the worst cholera outbreaks in years. The outbreak has spread to nearly all of the country’s 28 districts, killing more than 250 people and infecting more than 8,000.

“The cholera situation as of currently, we are receiving a lot of cases every day, the numbers have spiked at the moment, we are getting about four or three cases per day,” said Dora Mwafulirwa, who is in charge of the Limbe Clinic in Blantyre.  

The situation is more critical in areas where residents use water from untreated sources like rivers, where bacteria can spread the diarrheal illness. 

“We used to have tap water in my area, but all the taps were vandalized, and also it’s very hard to access water from boreholes because most of them are not working,” said Elida Phiri, a resident of Blantyre’s Chigumula Township.  

Heath workers fear the increase in cases will overwhelm clinics. 

“Our camp has got only four beds and one room. And the four beds in the other room,” Mwafulirwa said. “And in most cases, it is getting full, and this is in dry season when the cholera season is not started. So, we should expect more cases and we may not have enough space for everyone when the rainy season starts.” 

Malawi started vaccinating against cholera in May with support from the World Health Organization. But community health workers say the uptake has been slow because many people shun the vaccine. 

“They often ask why we are bringing so many vaccines,” said Thamu Chinula, a senior health surveillance assistant at Ndirande Clinic, in Blantyre. “They fear the vaccine might cause infertility. They say the vaccine is meant for children, without knowing that anyone can receive the vaccine, depending on the gravity of the outbreak at hand.” 

Malawi this month received nearly three million doses of cholera vaccine with support from the WHO, the Global Vaccine Alliance and the U.N. Children’s Fund (UNICEF). 

In the meantime, health workers are educating communities on the need to get the vaccine and how to sanitize water supplies to make them safe for drinking. 

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