Malawi is currently facing its most severe cholera outbreak to date. The World Health Organization (WHO) reports that there have been 58,557 cases and 1,756 deaths since 7 May 2023. The outbreak began in March 2022, and has spread to all 29 districts of Malawi. Veronica Mukhuna has been on the frontlines of these efforts, and reports on the WHO response to the outbreak.
I joined WHO in Malawi in 2020 as a national UN Volunteer Communications Officer. I am one of over 120 UN Volunteers serving with WHO across 38 countries in Africa through the Africa Women Health Champions (AWHC), a joint initiative of WHO and the United Nations Volunteers (UNV) programme.
The purpose of Africa Women Health Champions (AWHC) initiative is to create a platform for young African women professionals to help drive the region’s health agenda and objectives. Veronica has made a huge contribution at the country and regional level in implementing a wide range of communication strategies that has resulted in positive outcomes for WHO. --Dr Neema Rusibamayila Kimambo, WHO Representative in Malawi
Since the onset of the cholera outbreak, the United Nations has been working with the Malawian government and partners on the emergency response. Effective communication is one of the crucial tools utilized by WHO to promote a comprehensive multi-sectoral response.
As the outbreak unfolded in the country in late 2022 and early 2023, rumours and misinformation started to spread. Misinformation fueled mistrust in health workers, resulting in physical aggression towards doctors and nurses in cholera-affected areas. This undermined the response efforts.
To prevent the spread of misinformation and dangerous rumors, I have been supporting Malawi’s Ministry of Health and partners to support risk communication endeavors.
As a health champion under the AWHC initiative, I was tasked with amplifying messages on the pressing need for cholera control and prevention in the country, ultimately contributing to reduction in mortality rates. I was assigned by WHO to travel throughout Malawi to document the joint response efforts.
Within my capacity, I am responsible for ensuring the visibility of WHO across all aspects of the outbreak response. This includes case management, surveillance, logistics, risk communication, community engagement, water, sanitation and hygiene, as well as oral cholera vaccination.
My day-to-day tasks include working alongside community health workers and volunteers to empower communities in addressing rumours and promoting the adoption of cholera prevention measures. By mid-March 2023, I had participated in 10 community engagement sessions, reaching over 50,000 people with accurate information about cholera. --Veronica Mukhuna, UN Volunteer Communications Officer with WHO, Malawi
To achieve this, I have been creating diverse communication materials that showcase the impact of WHO's contributions to the outbreak response. By disseminating frequent updates through various platforms such as web stories, social media content, multimedia and printed materials like stickers, I strive to keep stakeholders informed.
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In early February, the Government of Malawi launched the "End Cholera/Tithetse Kolera" campaign, strategically aimed at intensifying response at the community level. As part of this campaign, I shared stories of cholera survivors to foster trust within communities, encouraging them to act upon WHO's information, advice and guidance regarding the disease. --Veronica Mukhuna
Travelling around the country, I often witness the devastating effects of the cholera outbreak on families and communities. It is heart-breaking seeing the level to which the emergence of cholera cases in non-cholera hotspots has put significant pressure on already struggling health systems in the country.
For example, when I visited the Tukombo Health Centre in Nkhata Bay District near the shores of Lake Malawi, the majority of cholera patients lay on mats they had brought from home, due to excessive numbers of patients that over-ran the facility.
Patients could be found everywhere at the Centre, seeking shelter from the heat under tents or occupying what used to be the outpatient department section of the facility. In the five-day span when I was there, the facility reported over 200 new cholera cases. Consequently, primary healthcare services were suspended, as the centre was transformed into a dedicated cholera treatment facility.
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During my interviews with healthcare workers, I learnt about the challenges within health facilities that delay patient management in cholera treatment centres. Joseph Munthali, a Medical Assistant at Tukombo Cholera Treatment Centre, shared his experience with me: "I have been a Medical Officer for five years, but this is my first time handling cholera patients or managing an outbreak. It is an overwhelming experience."
Another aspect of my role as a Communications Officer involves partnering with key media outlets in Malawi to enhance their capacity in emergency communication. Through collaboration with the media fraternity, WHO has successfully trained over 50 journalists across the country on effectively crafting proactive messages and news that catalyze positive change in cholera prevention and response. --Veronica Mukhuna
Working as a communications officer in disease response has its unique challenges. Stepping into cholera treatment facilities, conducting interviews with cholera patients and traveling to remote areas with limited access to safe water and food, I often find myself scared and paranoid due to potential exposure to Vibrio cholera— the bacterium causing cholera. Witnessing the loss of life and facing the traumatic realities of this disease has often left me feeling anxious and concerned for my own well-being.
As a United Nations Volunteer, I take pride in the contributions I have made to the cholera outbreak response in Malawi. Since February 2023, the country has been experiencing a decline in both cholera cases and deaths. My work has contributed to increased mobilization of resources, which has improved response efforts across various areas. The Tukombo Health Centre recently achieved 100 days without recording a single cholera case. --Veronica Mukhuna
"As a dedicated communicator, my commitment remains focused on ensuring that individuals at risk and those affected by the outbreak, as well as relevant stakeholders, have access to the vital information necessary to protect their health and safety. By working collaboratively, we strive to achieve the ambitious Global Roadmap to End Cholera by 2030," Veronica concludes.