Taking stock on Covid-19

On April 2 2020, Malawi registered the first Covid-19 case, three months after the World Health Organisation (WHO) made an official announcement of the novel Covid-19. Around March, President Peter Mutharika declared a state of disaster followed by the lockdown announcement which was challenged in court. Not so long ago, there was a spike in Covid-19 cases mainly because of returning residents who were stuck in South Africa. Mathews Malata Jr talks to Red Cross Malawi director of programmes and development Prisca Chisala on preparedness and response. Excerpts:

Q

How do you describe the country’s level of preparedness then and now?

A

The preparations were relatively sluggish due to late identification and renovation of emergency treatment units coupled with late training of health personnel, late closure of airports and the country’s borders. On the other hand, declaring Malawi a state of disaster even before any confirmed case and putting in place preventive measures such as the closing of schools and banning meetings of more than 100 people among other measures were quite positive. On the resilience of the health sector, I think we have a lot of work to cover. We were faced with a scenario where we had no capacity to conduct tests three months after the WHO announcement, at least we now have 14 labs conducting tests, PPE, were a big issue, shortage of health workers, no ready beds in hospitals, so all these and many others posed a big threat to the day-to-day functions of the health system. It looks like we are managing, but we must not relax.

Q

Does Malawi have relevant legislation and policies to guide preparedness and response of such an unprecedented pandemic?

A

The Public Health Act, though outdated, gives the country the required legal framework to respond to disease outbreaks. This provision has been used to respond to cholera and other outbreaks. We also have the Disaster Preparedness and Relief Act (1991) which the President used to declare the state of disaster. I am aware the Act has been revised and ready for Parliament, however, it may be appropriate if the process is expedited and that is the expectation of most players in the sector.

Q

How do you describe the role of Dodma in responding to the pandemic?

A

Much as this is an institution that coordinates national disaster response, it appears they were not given the space to coordinate the preparedness and response to Covid-19, instead the mandate was given to Ministry of Health before being reassigned to an inclusive presidential task force. One cannot exactly make out Dodma’s role in this operation. Ideally, Dodma should have occupied the front seat to coordinate all activities with the support of all other sectors. A court ruling also made some interesting observations on the same and the ruling remains a public document for all to read.

Q

On April 8, Malawi Government launched the National Covid-19 Preparedness and Response Plan, with a budget of US$213 million (K157 billion). Is the plan comprehensive enough?

A

Great package with a cluster approach even though this was finalised rather late and resource envelope not exactly guaranteed considering the traditional donors have been heavily hit by this pandemic.

Q

This year, some communities, especially up North, were hit by floods. The March 2019 Cyclone Idai wounds remain fresh and many are yet to recover. How is the pandemic affecting recovery of those hit by previous disasters and preparation of new ones likely to come?

A

These communities are yet to recover and the pandemic is pushing them deep into the vulnerability state as livelihoods, employment, cost of goods and services have all been affected by the pandemic. We must pay attention to those in need and support their recovery process.

Q

Without lockdown and change of social behaviour, are we going to win the Covid-19 fight?

A

Well, if this is unchecked the country should brace for tough times ahead for not following public health precautions. The business-as-usual way of living is not doing the country good. Unfortunately, the pandemic is being looked at with different political lens. It’s also sad that even our politicians (all of them) have chosen to act indifferently by conducting mass rallies. This could be a time bomb if we remain careless like that.

Q

With emerging trends/statistics should the country still prepare for the worst scenario …since many think the figures seem to defy most of the alarming scientific projections including the mathematical model by the Ministry of Health?

A

The situation should still be regarded with worst scenario lens. The figures might be perceived as not alarming mainly due to inadequacies in testing. There could be more people infected in the country only if testing can be scaled up. The best is to practice all health precautionary measures and be safe. We can’t afford taking chances at this stake. That will be a great mistake.

Q

Is the country doing enough in ensuring that the poor and most vulnerable groups are cautioned from the painful impacts of the pandemic?

A

The pandemic is silently impacting negatively on the poor. The country needs a livelihood support package for vulnerable people – in-kind or cash transfers.

Q

In all this, what’s your role as Red Cross Malawi ?

A

MRCS is on the ground with a nationwide response package on Covid-19 as an auxiliary to government. We are building the capacity of Red Cross staff, volunteers and selected health workers. We are also doing door-to-door community sensitisation, hand washing sensitisation in strategic places, community feedback data collection to inform response, mobile van publicity, renovation of emergency treatment units in public hospitals in Dedza and Lilongwe. We have also extended our efforts to Mangochi and Mzimba supporting coordination meetings, providing mental and psycho-social support and preparedness for cash transfers to support most vulnerable people affected by the pandemic. However, the package is not fully funded which calls for financial support.

Q

Thousands of Malawians trapped abroad especially from RSA have been coming back into the country, are you in a way helping out in these special operations to ensure all returnees settle and get a dignified welcome?

A

MRC has mobilised over 800 volunteers for Covid-19 across the country. We supported 280 (RSA) returnees lodged at Nalikule Technical Collge with first aid and psycho-social support, free phone services, distribution of food items. We also gave them blankets, sleeping mats, mosquito nets, salt and soap. We did the same for 300 returnees in Blantyre only that we added face masks to the package. This has been made possible with support from Red Cross movement partners which include IFRC, ICRC, Belgium, Swiss and a consortium of red Danish Red Cross led PNSs), Unicef, GIZ, ATI, Ministry of Health, and MoDMA.

Q

Any plans to do more?

A

You may also wish to note that we contributed towards the establishment of standard emergency treatment units at KCH, Dedza District Hospital, Mangochi and Mzimba districts. We are also supporting strategic hand-washing in crowded places such as markets, big shops, roadblocks etc reaching over 10 000 people. MRCS volunteers conducting door-to-door visits with Covid-19 messages are reaching over 80 000 households in Chitipa, Karonga, Mchinji, Lilongwe Mangochi, Mwanza, Chikwawa, Zomba, Salima, Mzimba, Blantyre, Ntcheu, Mulanje, Nkhotakota, Neno, Nsanje, Dedza, Mzuzu and Machinga.

Q

Moving forward, what are the gaps we need to work on as a nation?

A

Prompt preparedness without necessarily waiting for a case i.e. infrastructure, training, mapping of hotpots, quick decisions in closing airports, all borders and above all raising public awareness bar on the pandemic.