Development

Fishers laud beach clinics

Between 2019 and 2020, Amin Sanudi from Makawa Village, Traditional Authority (T/A) Mponda in Mangochi battled with bilharzia.

The 39-year-old fisher says she was passing bloody urine and had pains when urinating.

Fishers and others to benefit from beach clinics

“So, I went to see a doctor where I was given the bilharzia drug. The drug made me nauseous and I developed diarrhoea. But I felt better in the end,” he recalls.

Sanudi, who has been fishing since he was 18, vowed not to quit fishing, notwithstanding the dangers of bilharzia.

The lake, just like for many others, is a source of livelihood.

“I need money to feed my family and to send my children to school. Fishing is the only way I know how to earn money,” he says.

Bilharzia infection comes when one gets in contact with contaminated freshwater where snails that carry schistosomes live.

World Health Organisation (WHO) says transmission happens when those suffering from bilharzia contaminate fresh water sources through urination or defaecation, which carries parasitic eggs that hatch in water.

Studies indicate that fishers and those in remote areas who have no access to safe water sources are mostly at risk of contracting bilharzia.

As one way of protecting people like Sanudi from bilharzia and HIV, Malawi Liverpool Wellcome Trust is identifying ways of delivering integrated bilharzia and HIV services to fishers.

A health official engages a fisher at the beach clinic

The trust is investigating the effects of using social networks, HIV self-test kits and beach clinic services under the creating demand for Fishermen’s Bilharzia and HIV Services study.

Malawi Liverpool Wellcome Trust study leader Augustine Choko estimates the national HIV prevalence in Malawi at around 8.8 percent, adding that in fishing communities such as Mangochi where the study is based, it goes up to 22 percent.

He says bilharzia prevalence ranges widely, from as low as two percent to 50 percent in some fishing communities in Mangochi, according to the study’s preliminary findings.

Choko says that the study is an example of integration of services essential to maximise service provision to fishers often missed by conventional service delivery.

He explains: “For instance, when services are being offered, fishers are unavailable due to fishing during the day or night and some rest in between.

“Thus, having convenient services with added flexibility in terms of timing is essential to tackling these problems.”

Mkumba beach village committee treasurer Bamusi Aladi says many fishers go for HIV and bilharzia testing and get treatment for the two conditions in the beach clinics.

He admits that bilharzia affects the fishers, adding that eradicating it will help them to concentrate better on their economic activities.

On HIV and Aids, Aladi says many people living along the lakeshore rarely protect themselves when engaging in sexual activities.

“Fishers earn a lot from fish sales and other activities that take place on the shores. With that, they tend to go after different women, often sleeping with them without protection,” he says.

Considering that the Malawi Liverpool Wellcome Trust beach clinics are temporary, Aladi is calling for permanent clinic on beaches to bring healthcare services closer to fishers.

Malawi Liverpool Wellcome Trust laboratory technician and team leader for the study in Mkumba area Robert Nyirenda, says the study will help to increase the number of people accessing HIV and services.

He says the clinics were set up closer to the lake to help fishers access the services easily.

“We have also noted that some fishers are not aware of their high exposure to bilharzia infections on the lake; hence, the study targeting them,” exolains Nyirenda.

Ministry of Health bilharzia control programme manager Lazarus Juziwelo said Malawi is fighting tooth and nail to reduce the infection to at least 10 percent in most districts by 2025.

He said: “We had a baseline survey in 2012, 2013 up to 2015 which indicated that the country had more than 60 percent infection in some areas. Almost every district was having the problem in greater lengths.

“Then we started conducting the mass drug administration countrywide. Before this, we were doing test and treat, whereby we would go to schools and test the children and give treatment to those infected with the disease.”

However, Juziwelo observes that those who did not receive the drug were also having problems, meaning that they too had the infection.

He says: “But following another mass drug administration conducted for almost five rounds and a follow up survey indicated that on average, 11 districts had moderate infection rates at about 30 percent.”

Juziwelo has since advised community members to ensure they use latrines and avoid open defaecation to reduce bilharzia infections in the country.

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