Frontline workers at risk

Uncertainty is spreading among health workers in Malawi as seven have caught Covid-19, the novel coronavirus disease detected in China last year.

The worldwide outbreak has killed thousands of health workers in China, Italy, the United Kingdom and other worst-hit spots.

Now, overwhelmed Malawian health workers  are asking: If Europe’s strong healthcare system cannot protect its frontline workers, what will happen to Malawi’s fragile, donor-dependent healthcare system?

But the worry for their occupational safety and demands for flawless personal protective props have coincided with a growing challenge.

Health workers in the country are not receiving groveling handclaps and songs of gratitude for risking their lives while fighting the pandemic—as is the case in other countries—but hostile scepticism from community members they serve.

“You, health workers, are just faking these results. There is no coronavirus here. Go away. Or else we will torch your ambulance,” screamed an antagonistic marcher in Mzirawayinge when health workers visited the township to trace contacts of Mzuzu City’s first confirmed case on April 29.

The Ministry of Health reports that the 40-year-old man, who had returned from Tanzania two days earlier, is one of 25 imported cases.

Mzimba North district health office spokesperson Lovemore Kabaghe says when they learned the case’s travel history, they promptly traced him.

He recounts: “We collected the samples and tests came out positive. We brought the patient to our isolation unit without facing any resistance. However, the problem arose when tracing his contacts, especially after one of them tested positive.

“She didn’t accept the results and mobilised the community who confronted us when we went to deliver the results.”

The irate group, says Kabaghe, included a block leader who threatened to torch an ambulance in a clip that went viral on social media.”

Since the incident, health workers have not returned to the area for fear of their lives.

“We want an assurance from the block leaders before we resume contact tracing,” he says.

This is just one of the Covid-related attacks on health workers at a time they need solidarity, not stigma.

Recently, some have been evicted from rented homes and others excluded from public transport on the false belief that they are spreaders of the fast-spreading virus.

This has compelled the Ministry of Health to hire coaches from the State-owned Malawi Post Corporation Coaches for shuttling its at-risk staff.

Mzimba district health officer Lumbani Munthali says the persisting attacks may undermine the national response to the virus transmitted through droplets when speaking, sneezing and coughing. It also spreads through direct contact with surfaces where it lands, especially frequently touched surfaces.

“Whenever we have a case, we are required to trace people who came into contact with the patient. If community resistance prevents us from doing the needful, the consequences are disastrous as we can’t test, diagnose and isolate positive cases,” he explains.

Munthali calls for massive mass awareness campaigns to close the knowledge gaps slowing the Covid-19 response.

He says: “Both urban and rural Malawians don’t understand this disease and this includes people with credible education.

“When we find them with the virus, they say they are neither sick nor showing any sign. But we need to understand that it’s like HIV: You may have the virus, but not show any sign that you are infected.”

World Health Organisation (WHO) estimates that 80 percent of confirmed coronavirus cases do not fall sick or show severe symptoms.

The disease prevented by regularly washing hands with soap and keeping distance has claimed over 317 000 people from over 4.8 million cases globally.

Three of these deaths have occurred in Malawi, where 70 cases had been detected by Monday.

“Coronavirus is real and Malawi has not been spared,” says Munthali.

Adamson Muula, professor of epidemiology and public health at the University of Malawi’s College of Medicine, is worried that the majority of the population lack vital information about stages of the disease.

“I have noticed that most of us do not have all the information that we should have to make an informed decision,” he says.

However, Muula reckons the outbreak presents ongoing lessons to politicians, civil servants, journalists, government and the general community.

“I believe everyone is learning. No one living now has ever experienced anything like this. But the government needs to learn fast,” he states.

Ambere Gogwe, project manager at the Story Workshop Education Trust, says the coronavirus outbreak has ramped up myths and misconceptions fuelling stigma and discrimination.

“Some people think the figures are cooked up to prevent people from voting in the forthcoming election [slated for July 2]. To win the fight against the virus, we need to uproot these misconceptions fast,” she says.

The WHO communication guidelines challenges countries to strengthen their public health systems to effectively communicate with their populations.

“Failure to communicate will lead to a loss of trust and reputation, economic impacts, and – in the worst-case – loss of lives,” it reads.

Critics, including Vice-President Saulos Chilima, have faulted government for fronting politicians in the national response.

To raise awareness, the Public Health Institute of Malawi has been airing Covid-19 messages on community and national radio stations as well as daily newspapers.

Other strategies includes press briefings on emerging cases as well as interactive messages, fact sheets, posters and roll-up banners delivered in both English and vernacular.

But Kabaghe warns: “The raging mistrust in communities could be a testimony that the messages are not reaching everyone.

“We need to do more and find innovative ways of reaching out to everybody with the restrictions on public gatherings.”