Not long ago, Senior Chief M’bwana of Nkhata Bay became the first traditional leader in the country to succumb to Covid-19. His death mirrors how Covid-19 has penetrated almost all corners of the country, including the hard-to-reach area of Usisya where he came from. Our reporter JOHN CHIRWA visited Usisya and reports how rural areas are failing to cope with the pandemic.
A district council meeting in Nkhata Bay in July ended tragically for Senior Chief M’bwana, born Francis Nyirenda. Immediately after returning home in Usisya, the chief developed symptoms of Covid-19, a respiratory disease that was first reported in China last year. But his relatives were not sure what had befallen the senior chief responsible for Nkhata Bay North.
It was until day three of his illness that the case was reported to Usisya Health Centre for diagnosis, says the chief’s nephew, Ivor Jennings Nyirenda.
“Hospital staff conducted several tests and all of them came out negative. That’s when we decided to do a Covid-19 test. Unfortunately, the service is not available in Usisya,” says Nyirenda, who is also group village head Bununkhu in the area.
He says they contacted officials at the district health office who sent a team to take samples from the chief.
“Unfortunately, we were late because by the time test results were out later in the day, the chief had already breathed his last,” he says.
Nyirenda describes M’bwana’s death as a blow to the family.
“He had many responsibilities as a family man and as a traditional leader. But we didn’t expect him to depart in such unconventional circumstances. We are at a loss for words,” mourns Nyirenda.
The death of Senior Chief M’bwana has sent shockwaves not only to his family but to the entire district.
Locals believe that if Usisya had a proper road network, the chief could have been saved. They also believe that the chief could have survived the disease if the rural clinic was equipped with Covid-19 testing facilities and services such as oxygen for Covid-19 patients.
“It’s sad that we could not get a test quickly due to mobility challenges. In fact, if we had oxygen services at the facility, the chief could have survived because all he needed was oxygen since he had difficulties in breathing,” says Nyirenda.
Usisya is situated along the northern waters of Lake Malawi. It is accessed both by water and road.
On the waters, Usisya is 46-kilo knots from Nkhata Bay Boma. It is also about 70-kilo knots from Tanzania. A passenger ship, MV Ilala, travels to the area at least once a week.
On the road, it is 70 kilometres to Mzuzu through steep roads up the mountains where there are no bridges across several streams. An alternative route to Nkhata Bay is 130 kilometres.
The road to Usisya is accessible only four months in a year due to an extended rainfall pattern which renders the road impassable.
The area is also cut out from telecommunications. There are no receptions for any television or national radio station except for the intermittent Usisya Community Radio Station.
Surprisingly, the area has a strong reception for radio stations from neighbouring Tanzania.
Nyirenda says this situation has led to misinformation in the area on issues of Covid-19.
“We have a stronger reception from Tanzania. And the messages about
Covid-19 that we have are from Tanzania where their President John Magufuli says there is no Covid-19. Some people in Usisya actually believe such messages.
“Nothing much is heard from Malawi apart from posters at the hospital, but you know most rural Malawians are illiterate,” he says.
He says those who believe that Covid-19 is real have some myths which have bred stigma and discrimination.
“There is a lot of stigma such that people shun my meetings because they believe that if I was in contact with the chief then I am also Covid-19 positive.
“But I came in the open about my status. I got tested twice and both tests came out negative. It is over a month now, but the community believes I am Covid-19 positive. I am stigmatised together with the whole royal family,” he says.
Usisya Ward councillor Brown Chizeze, who tested positive for Covid-19, says most people in the area are not following precautionary measures against Covid-19.
He says this is surprising despite the fact that the chief and himself tested positive after attending a meeting at Nkhata Bay Boma and made their conditions public.
“Our expectation was that people will now believe that Covid-19 is amidst us and adopt guidelines that have been put in place such as wearing of masks. But that is not the case here,” he says.
Nurse and midwife technician at Usisya Health Centre, Edna Chirwa, says the misinformation has impacted the uptake of various medical services as there is a low turnout at the outpatient department (OPD).
“People are afraid to come to the facility just because we treated some Covid-19 patients. They think that they may contract the virus here. They don’t understand what it means if we say the clinic was disinfected,” she says.
Any solutions in sight?
Chizeze says people of Usisya need more information on Covid-19 for a mindset change. He says this would be possible if the area also had receptions for national radio stations.
He also says more non-governmental organisations (NGOs) need to come up with Covid-19 sensitisation programmes in the area.
“I don’t know if Usisya is in Malawi because we are shunned both by these NGOs and government. For instance, we only have Temwa Sustainable Community Organisation based in the area.
“All previous governments have always neglected Usisya in terms of road networks and telecommunications. But a lot of people from Usisya have helped in defining the history of this country. We really need to be considered,” he says.
Temwa Sustainable Community Organisation programmes manager Kondwani Botha says Usisya is one of the hard-to-reach areas in the country, meaning that it is difficult to access some of its specific areas both in the upland and along the lake.
“Roads to different places in the area are in bad shape and the lakeshore areas are only accessed through boats. It is because of this topography that this area is difficult to be accessed with different information regarding developmental issues, including Covid-19 response activities,” he says.
As a solution, Botha says there is need of strengthening local structures such as the area development committees (ADCs) and village development committees (VDCs) so that the coronavirus pandemic is addressed from the grassroots.
“Currently, most of the Covid-19 response activities are done at the central level, with very few done at the district level. As an institution, we would want to see a decentralised approach in terms of addressing Covid-19 pandemic by taking the messages through the local structures.
“These structures should be able to coordinate all Covid-19 activities so that when a case arises in a village people should have something to start with,” he says.
Secondly, Botha says there is a need for raising awareness about the pandemic in the rural areas by engaging people with the right information.
“We have fake news all over, so people need to be aware of the right information concerning Covid-19. We can make use of the Ministry of Civic Education to spearhead this,” he suggests.
Minister of Civic Education and National Unity Timothy Mtambo says the ministry was established after noticing the little attention that was paid to civic education in the country.
“With my leadership as a minister, we are going to embark on what we call transformative civic education where we are going to change the mindset of people. There are priorities that we have such as the present Covid-19 pandemic.
“We understand there is a Presidential Taskforce in place to champion the fight against the pandemic. But my ministry is going to help in terms of content development so that we give the right information to the people.
“Right now, people are looking for information. Much of the work needed to defeat Covid-19 is in prevention. If we invest much in prevention then we as a people can overcome this pandemic,” he says.
As of Wednesday, Malawi had cumulatively recorded 5 579 cases including 175 deaths.