Malawi’s two tales
In this article, in which reporting has been supported by the International Women’s Media Foundation’s Global Health Reporting Initiative: Vaccines and Immunisation in Africa (iwmf.org), RICHARD CHIROMBO writes on what resulted in high uptake of polio vaccines as opposed to Covid-19 vaccines, where uptake remains a challenge.
Save for the random noise of under-five children pressed by the internal urge to get breast-fed other than suffering from any form of physical discomfort, the scene is relatively silent this Monday, 21 March 2022, at Kasungu District Hospital.
It is one of the public healthcare service facilities where children under five years of age are being vaccinated for polio.
“The polio vaccine is being administered orally, hence there is no discomfort caused to under-fives getting it,” says Ministry of Health spokesperson Adrian Chikumbe.
Linda Sande, one of the women who took their children to Kasungu District Hospital for polio vaccination, agrees.
“My two-and-a-half-year-old child does not like injections. I was not so sure about her response to the vaccine but there have been no issues,” she says of her baby, a girl.
She claims to have heard news about the polio vaccine initiative through the State-run Malawi Broadcasting Corporation.
Elizabeth Sisya, one of the mothers that got their children vaccinated for polio at Nkhata Bay District Hospital, says she has no misgivings about the polio vaccine.
“We have always received this vaccine with open arms because it is has been administered for a long time and there are no myths associated with it,” she says.
However, in Chikwawa District, 32-year-old Elube says she cannot get her child vaccinated because of religion.
“We believe in faith healing at our church,” she says.
However, such cases are rare and isolated and may not have n adverse effect on polio vaccination targets.
The polio vaccination exercise, which started in March this year and targets 2.9 million children aged five and less, is a well-oiled initiative.
The World Health Organisation (WHO) and United Nations Children’s Emergency Fund (Unicef), among other partners, have rendered their support to the campaign after Malawi, which last reported a polio case in 1992, registered a case of wild polio in Lilongwe on February 18 this year.
According to Unicef Country Representative Rudolf Schwenk, the UN agency has, so far, secured 6.8 million doses of polio vaccines that were distributed to all the districts of Malawi.
This time around, the case is different from what transpired between January 2016 and September 2018, when Malawi failed to administer polio vaccines to children, thereby exposing them to the danger of contracting poliomyelitis, which is caused by the poliovirus.
According to WHO, the virus spreads from person to person and can infect a person’s spinal cord, causing paralysis in the worst case scenario.
However, Chikumbe dismisses any suggestion that the two-year absence of polio vaccines in Malawi was sparked by supply chain challenges.
“We were simply making a change so that, unlike in the past, polio vaccines would be administered orally. That is why, when we had successfully done that, we launched a polio vaccination campaign last year and the exercise went on successfully,” he says.
So far, the vaccination exercise has proved successful, with Ministry of Health statistics indicating that, last month alone, it beat its vaccination target and hit the 102 percent vaccination rate mark.
Malawi Health Equity Network Executive Director George Jobe feels that, as opposed to the case with the Covid-19 vaccination exercise, there has been some urgency in the way polio vaccines are being administered.
“When news broke out that a case of polio had been detected in Lilongwe, after all these years, there was a sense of panic, one of urgency. This could be because people, including those in the village, know how dangerous polio is,” he says.
He says the sense of urgency manifested itself when Malawi’s president Lazarus Chakwera declared a national health emergency in February this year.
Nobody openly dismissed the urgency of the matter, let alone the seriousness of the situation, especially after a three-year-old girl was paralysed.
This is in sharp contrast to the situation on March 11 2021, when the President and his vice Saulos Chilima got vaccinated for Covid-19.
In a phone-in programme on ‘Times Radio’, a privately owned radio station in Malawi, up to eight callers openly described the Covid-19 pandemic as a “ploy” by Western scientists and declared that they would not be vaccinated for coronavirus.
Today, Covid-19 vaccine uptake remains low in Malawi, with roughly a million people getting fully vaccinated for Covid-19.
Jobe feels that the urgency with which Chakwera declared the polio emergency sent shivers down people’s spines, hence a positive response from parents to have their children vaccinated.
Health Rights Education Programme Executive Director Maziko Matemba, who is also one of Malawi’s goodwill ambassadors for Covid-19, suggests that the polio campaign has gained ground because one does not need complicated training to administer polio vaccines.
He says that is why Health Minister Khumbize Kandodo Chiponda was able to administer polio vaccines to some children when the exercise was launched in March.
“Unlike the Covid-19 vaccination campaign, which has proved to be a bit expensive as people require training before they can start administering vaccines, even health surveillance assistants can administer polio vaccines.
“This is an advantage because the vaccination target can easily be met,” he says.
Epidemiologist Professor Adamson Muula feels that the polio vaccination exercise is not susceptible to myths, misinformation and disinformation, making it possible for parents and guardians to avail themselves of vaccination centres so that their under-five children can be vaccinated.
He says this is an advantage when it comes to the issue of controlling disease out-breaks.
According to Kamuzu University of Health Sciences-based psychologist Dr Chiwoza Bandawe, myths, misinformation and disinformation created a concoction of fear that affected Covid-19 vaccine administration.
“This [fear], therefore, created an pandemic within a pandemic as people were uncertain about some things,” he says.