Religious beliefs of not seeking medical care suspected of sabotaging efforts to contain the cholera outbreak 

Minister of Health Khumbize Kandodo Chiponda takes note that some cholera patients are not seeking care early due to religious beliefs resulting in sabotaging efforts to contain the current outbreak — which claimed 16 deaths on December 26.

There were a total of 253 new cases on Boxing Day and the 16 related deaths are from Lilongwe (6); Blantyre (6); Dowa (2) and Machinga (1) — the district which recorded the first confirmation of the disease in March this year.

The Minister said the lack of seeking care early due to religious believes “is making the disease to spread further resulting in unnecessary loss of life in the process” and strongly implored to the faith community “to encourage their members that if anyone has signs and symptoms of cholera, they should seek medical care immediately”.

In her situation report on cholera, the Minister said all 29 health districts have reported cholera cases since the confirmation of the first case in Machinga and the outbreak has been controlled in six districts.

But in the last 14 days, the disease has been reported in 23 districts and the new cases reported on December 26 are from Lilongwe (69); Blantyre (50); Mangochi (47); Dowa (26); Dedza (23); Salima (19); Machinga (10); Phalombe (4); Chiradzulu (2); Mwanza (2) and Karonga (1).

The cumulative confirmed cases and deaths reported since the onset of the outbreak is 15,317 and 486 respectively — with case fatality rate at 3.7% while a total of 14,287 people have recovered and 544 are currently in treatment centres.

Since the onset of the outbreak, Mangochi has reported most of the cases — 3,929 cases and 78 deaths — followed by Salima (1,630 and 42 deaths); Blantyre (1,506 and 71 deaths); Nkhata Bay (1.498 and 44 deaths); Nkhotakota (890 and 21 deaths); Rumphi (1,034 and 17 deaths); Karonga (899 and 21 deaths; Lilongwe (759 and 70 deaths); Mzimba North (465 and 2 deaths); Dedza (235 and 8 deaths); and Chiradzulu (231 and 5 deaths).

“Most of the deaths occurred while in the communities or at health facilities after presenting late for treatment,” said the Minister “The major factors associated with the cholera outbreak in the communities are poor hygiene, lack of safe water and low late ones coverage and usage (open defecation).

When reached out over the Ministry’s assertion that some cholera patients, who are not seeking care early due to religious beliefs, are exacerbating the spread of the disease and sabotaging efforts to contain the outbreak, Consumer Association of Malawi (CAMA) Executive Director John Kapito was skeptical “whether all the deaths are being attributed to religious beliefs.”

On December 22, Kapito issued a scathing attacking on the Ministries of Health and Sanitation as well City Councils — blaming the government institutions for exacerbating the current cholera outbreaks and high number of deaths.

In an interview on Tuesday, December 27, Kapito said he doesn’t agree to the attribution to the deaths as due to religious beliefs, saying CAMA’s concerns are “all about preventative systems that have not been put in place”.

“Cholera is a pandemic that can be eradicated with hygiene and in some communities, municipalities need to take the lead and ensure all the places have proper sanitation facilities.

“Garbage should be properly collected and incinerated and to ensure that people have good running water and that health personnel are in all areas enforcing the guidelines.

“Unfortunately, we have placed so much emphasis on curative measures and that doesn’t reduce the numbers of those infected with cholera.

“I don’t know how these guys can understand that they operating in reverse,” said Kapito, whose December 22 statement maintained that the rising cases are “as a result of Government negligence to maintain and provide adequate sanitation and quality public health care in most parts of the country”.

Kapito blamed Government that it is aware about the poor quality of health care and hygiene within the communities and singles out markets as the “worst unhygienic places with poor sanitation where sewer spew is the source of water in most the markets and other public places”.

He said the authorities are in full knowledge of the terrible conditions of the market and “are pretending to be in shock with the many deaths by cholera as if they are not part of the problems and failures” of the containment of the outbreak.

”Over time, [the authorities] have failed to provide basic amenities to prevent these outbreaks and most of the markets and other public places do not have any public toilets and there is no provision of running piped water.

“The very same authorities have allowed the sale of unclean water from sources such as pit latrines and various unreliable sources including the sale of perishables in the markets that are washed by water mixed with sewer.

“Ministries of Health, Sanitation and the City Councils abandoned their responsibilities and mandates to protect people. The City Councils and Ministry of Health must realize that allowing the uncontrolled influx of unhealthy and unhygienic products — such as fresh food and other perishables from unregulated and every corner of the streets — is a source of the many disease outbreaks that are affecting the lives of innocent people.”

Thus CAMA maintained that Ministries of Health, Sanitation and the City Councils have made “markets and other public places to become major sources of dangerous disease outbreaks such as cholera and they must be held responsible for the high cholera deaths”.

The three government institutions have since been asked to ban any sale of perishables such as fruits (mangoes etc.) vegetables, fresh maize and others from any unregulated places and to stop the spewing of sewage in most markets.

“CAMA is calling on the Government to take immediate action to ensure that further deaths are prevented through the supply of safe water, good sanitation, food safety controls are adequately provided in all markets.”

Thus CAMA also appealed to Government to immediately do the following;

1. All goods and services offered in the markets should be verified by the City Public Health inspection teams and Ministry of health to ensure that they are safe for human consumption;

2. All markets to be provided with adequate public toilet facilities, piped running water with proper and safe structures for product display;

3. The Ministry of Health and Sanitation to coordinate with City Councils to ensure that sewer pipes and sewer leakages works are rehabilitated;

4. Strengthen disease surveillance, monitor water quality and chlorinate public water supplies, and promote health education and hygiene among those affected and at-risk communities; and

5. The authorities must invest in proper sanitation and health infrastructure and ensure universal access to health care.

Meanwhile, measures which the Ministry of Health announced months ago include:

* Setting up of treatment centres in all affected areas so that patients do not travel long distances for treatment. Cholera treatment near the affected areas and supply of medicines;

* Pot to pot chlorination of water in the communities where there is no safe water. The Ministry of Water is also in the process of putting safe water sources in the communities;

* Administration of oral cholera vaccinations (OCV);

* Contact tracing of cholera cases;

* Engagements with local leaders to facilitate latrine and use, including general sanitation and hygiene issues; and

* Community sensitization on prevention and control of cholera being done in all districts of the country.

Chiponda also keeps reminding the general public that cholera is a preventable and treatable disease and emphasized that drinking safe water is paramount as well as proper use of latrines; washing hands with soap after visiting the toilet and before handling food; using safe & treated water all the time and practising food hygiene.

In October — in the interest public health — Malawi Health Equity Network (MHEN) appealed to the government to put some strict measures so that faith groups should comply in seeking medical attention to increase the population’s immunity — hence advancing the right to life.

In an interview with Malawi News Agency (MANA), Executive Director, George Jobe made appeal after observing that faith leaders bar women and children from accessing medical help and has since asked them to stop the malpractice.

Thus Jobe said it is necessary for the government to ensure that everyone is accessing medical help more especially in this time when the country is under siege of different pandemics like cholera and polio.

“It is very pathetic that there are some religious leaders in the country who are frustrating the efforts of defeating diseases like cholera and polio by instructing their members not to access medical help like vaccine because it is against their beliefs,” Jobe had said.

He thus appealed to government to put the strong measures for compliance, saying “all members who belong to such faith groups must start going to hospital to be vaccinated against different diseases like polio and also seek medical assistance when they are sick”.

However, Reverend Amos Batumeyo of Zion Apostolic Church, whose domination discourages congregants from accessing medical attention, argued that their church doctrine cannot change just because they want to accommodate the demands of other people.

He also said they do not stop their members from taking their children to hospital but they tell them that it is only God who heals — hence, no need to seek intervention from a fellow being.

“Disease are a part of punishment which God struck mankind because of disobedience — therefore, it is the same God who can cure it,” Batumeyo had said.

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