To many Malawians, Balaka is a storied town on a hill. It is a district that has kept releasing music that has withstood seasons and inspired generations.
But still, not all is rosy in this citadel of music. Just opposite the St Louis Montfort Catholic Church where some of the music Malawians enjoy was born and perfected, is located Balaka District Hospital.
Just outside the hospital, it is a busy day. A steady throb from the stereos of battered public motorbikes is making noise as they bring patients from different parts of the district.
Of course, the skies have just birthed the sun.
It is hot and many are thirsty. Plastic sachets of water are selling highly.
Deep inside the hospital, the sounds of infants crying, machines beeping and nurses pushing trolleys fill the environment.
In a sweltering room in the corner of the emergency children’s ward, Melise Kachingwe is restless.
Cradling her two-year-old son, the 18-year-old is a picture of focus in the ward. Her child Gracian, who is fighting malaria, cried a lot last night. They did not sleep.
Melise sits on the edge of the hospital bed helplessly watching over Gracian who still has a UV deep on his vein. The little boy has just finished a drip less than an hour ago, his fifth since being admitted for malaria some three days ago.
“Today he is a bit better,” she says, adding: “I hope he keeps improving so we can be discharged.”
With her eyes puffy and red, proof of the sleepless night endured, Melise gives a sign to another guardian, three beds away to watch over Gracian. She is thirsty. She goes out to find water and returns less than five minutes later.
Close to the ward entrance, four nurses are putting together their gear for another round of treatments in the ward.
Besides Gracian, Melise is equally concerned about home. She left a basketful of tomatoes that she had just procured to resale at the local market.
“There’s no one to sell them for me,” she says as she tries to caress her son to sleep.
Melise believes most of the tomatoes have gone bad since they were ripe.
With 71 percent of Malawians living in the economic periphery, spending less than $1.90 (about K1 400) a day, the daily economic losses, compounded by high household costs associated with getting treated for malaria constitute a likely major economic burden for the underprivileged.
Considering that she was here with Gracian who had another malaria attack just seven months ago, Melise is trapped by malaria and consistently thrown into the depths of poverty.
Unfortunately, that’s the tale for many people in Balaka District.
“Towards the end of 2018, we distributed long-lasting insecticide-treated nets to fight malaria but ironically, there was no significant change,” says the district’s environmental health officer John Mawaya, whose team of health surveillance assistants (HSAs) plays foot soldiers in the fight.
“So most of our health workers in Balaka spend much time fighting malaria and it is expensive for families and us.”
A report published by the Malaria Journal in 2017 states that “total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively” on treating malaria.
A bulk of these costs is driven by facility management type, patient distance from the health facility, patient age and largely duration of hospital stay.
Based on cases of women such as Melise, World Vision’s Alexander Chikonga appeals to the Malawi Government and development partners to do more to eradicate Malaria.
He says this will not just to save the resources the country spends on treating patients like Gracian, but it will also allow people to have time to improve their livelihoods.
“If you try to think of how many people are admitted for malaria today, or those being nursed from home and the people providing that particular care, you will realise that we cannot develop as a nation if we do not tackle the burden of malaria”, says Chikonga.
Although World Vision distributed around 10.8 million mosquito nets across the country, he says there is a need for the country to dig deep in its efforts to fight malaria.
Says Chikonga: “Because by doing that, we will ease pressure on our health facilities, save resources and ensure that our healthy population is working hard and participating in the economy.”
On his part, Mawaya bemoans the malaria burden, saying it takes away focus on other diseases.
“Malaria causes most of the admissions and even tops diseases treated for outpatients. Our HSAs and clinicians spend most of their time educating people about and treating malaria,” he notes.
World Vision and government, with financial support from the Global Fund, has sprayed over 132 000 houses in Balaka and Melise is among the beneficiaries.
The teen mother is intrigued with the idea of being safe from malaria. She is thirsty for something new.
Says Melise: “Of course, we can always get sick, but if we can be free from malaria, and spend time at home, our lives may improve.”
Similar exercises have been held in Mangochi and Nkhata Bay where 351 000 and 67 000 houses respectively have been sprayed.
Concerted efforts by, among others, the Global Fund and the United States government’s presidential initiative, have contributed to a global reduction in malaria mortality.
According to a 2020 report by the World Health Organisation, over the period 2000–2019, malaria-induced deaths have fallen from 736 000 in 2000 to 409 000 in 2019.
Likewise, the percentage of total malaria deaths among under-five children was 84 percent in 2000 and 67 percent in 2019.
A gentle breeze blows through the trees outside the ward and the clouds are gathering as the sun fades. Rains will soon come. The weather changes quickly in Balaka, but the heat remains, and so does thirst.