Tag: Charles Mpaka

Communities Taking a Sting Out of Poaching With Alternative Livelihoods — Global Issues

IFAW recently translocated elephants into Kasungu National Park, which is on the Malawi-Zambia border. IFAW is implementing the Room to Roam initiative so that these elephants can have safe passage in the corridor. Credit: Charles Mpaka/IPS
  • by Charles Mpaka (chipata, zambia)
  • Inter Press Service

CHIPATA, ZAMBIA, Nov 01 (IPS) – As we approach the forest in the village to appreciate Andrew Mbewe’s beekeeping enterprise, a bee from a hive close to the edge of the natural woodland stings him on the cheek.

He steps back quickly, waving everyone away from danger, as he grimaces and grumbles in pain while trying to take out the stinger to prevent his face from swelling.

“That’s one of the duties they are performing,” he says through his gritted teeth about his 18 beehives in this forest.

He examines the tips of his index and thumb fingernails to see if he has taken out the bee’s poison-injecting barb.

“These bees are guardians of this forest,” he says. “They protect it from invaders. That’s one of the reasons this forest is still standing today.”

Across the villages along the Chipata-Lundazi road, which cuts through a landscape that stretches between Kasungu National Park in Malawi and Lukusuzi and Luambe National Parks in Zambia’s Eastern Province, one feature is likely to catch the eye: impressive stands of natural forests among villages and smallholder farms.

Andrew Mbewe (left) explains honey harvesting to a visiting entourage. Credit: Charles Mpaka/IPS

In Mbewe’s village in Chikomeni chiefdom in Lundazi district, these indigenous forests are home to over 700 beehives belonging to more than 140 families.

The forest protection duty that the bees are providing is an unintended consequence of the beekeeping enterprise. Fundamentally, the communities are sucking money out of the honeycombs in these beehives through sales of both raw and processed honey, some of which find space on the shelves of Zambia’s supermarkets.

It is one of the livelihood activities which Community Markets for Conservation (Comaco), in partnership with the International Fund for Animal Welfare (IFAW), are implementing within the broader wildlife conservation strategy in the Malawi-Zambia landscape.

Comaco’s driving force is that conservation can work when rural communities overcome the challenges of hunger and poverty.

It says these problems are often related to farming practices that degrade soils and drive deforestation and biodiversity loss.

Therefore, Comaco works with small-scale farmers to adopt climate-smart agriculture approaches such as making and using organic fertilisers and agroecology to revitalise soils so farmers achieve maximum crop productivity.

It also supports small farmers to add value to their produce and attractively brand the products so they are competitive in the market.

With burgeoning carbon trading as another revenue stream, this wildlife economy is raking in promising sums for both individual members and their groups, communities say.

The cooperative to which Mbewe belongs has used part of its revenue to purchase two vehicles – 5-tonne and 3-tonne trucks – which the group hires out for income. The money is invested in community projects such as building teachers’ houses and hospital shelters.

Luke Japhet Lungu, assistant project manager for the IFAW-Comaco Partnership Project, tells IPS that these activities are making people less and less reliant on exploiting natural resources for a living.

“You will not find a bag of charcoal here,” Lungu challenges.

“Because of the farming practices we adopted, people are realising that if they destroy the forest, they also destroy the productivity of their land and their income will suffer,” he says.

Along the way, people are also learning to live with the animals.

“Animals are able to move from one forest to another without disturbance. For the bigger ones, such as elephants, which would cause damage to our crops, we have a rapid communication system through our community scouts who work with government rangers.

“We have occasions of elephant invasions from the three parks. However, we have learnt to handle them better to minimise conflict. It’s a process,” Lungu says.

One man who has learnt to manage the animals he once hunted is Mbewe himself.

A battle-scared poacher for nearly a decade from the 1980s, he terrorised the 5,000-square-kilometre conservation area on poaching missions.

For his operations, he used rifles he rented from some officials within the government of Zambia, he claims.

“They were also my major market for ivory and other wildlife products,” he says.

Apparently, without knowing it, Mbewe was actually supplying a far bigger transnational market.

For over 30 years, from the late 1970s, the Malawi-Zambia conservation area was a major source and transit route for ivory to markets in China and Southeast Asia.

Elephant poaching rocked the landscape resulting in the decline of the species. In Kasungu National Park, for example, according to data from the Department of National Parks and Wildlife in Malawi, elephant numbers dwindled from 1,200 in the 1970s to just 50 in 2015.

In 2017, IFAW launched a five-year Combating Wildlife Crime project whose aim was to see elephant populations stabilise and increase in the landscape through reduced poaching.

The project supported park management operations and constructed or rehabilitated requisite structures such as vehicle workshops and offices.

It trained game rangers and judiciary officers in wildlife crime investigation and prosecution.

It provided game rangers with uniforms, decent housing, field allowances, patrol vehicles and equipment.

It supported community livelihood activities such as beekeeping and climate-friendly farming.

It also thrust communities to the centre of planning wildlife conservation measures.

Erastus Kancheya is the Area Warden for the Department of National Parks and Wildlife for the East Luangwa Area Management unit where Lukusuzi and Luambe National Parks lie.

He says he sees these measures as enabling degraded protected areas like Lukusuzi National Park to “rise from the long-forgotten dust awakening on the long road of meaningful conservation”.

Kancheya says engaging communities in co-management of the protected areas is also proving to be effective in the landscape.

Now, IFAW is leveraging this community partnership to sustain the achievements of the Combating Wildlife Crime project through its flagship Room to Roam initiative.

Patricio Ndadzela, Director for IFAW in Malawi and Zambia, describes Room to Roam as a broad, people-centred conservation strategy.

“This is an initiative that cuts across land use and planning, promotes climate-smart approaches to farming and ensures people and animals co-exist,” he says.

The approach aims to deliver benefits for climate, nature and people through biodiversity protection and restoration.

Room to Roam intends to build landscapes in which both animals and people can thrive.

In the process, some people are being transformed. Mbewe is one such person. From being a notorious poacher, he is now a ploughshare of conservation as chairperson of the Community Forest Management Group in his area. The cooperative enforces wildlife conservation and sustainable land management practices.

It is not easy work, he admits.

“There are hardened attitudes to change, and patience is required to teach. Sometimes, the earnings from the livelihood activities are insufficient or irregular. For instance, you don’t harvest honey every day or every month,” he says.

Yet, he says, the prospects are good and the challenges he faces now rank nowhere near what he encountered when he was a poacher.

One incident still makes him shudder: Stalking a herd of elephants at their drinking spot in Kasungu National Park one day, he came under unexpected gunfire from rangers.

“I was an experienced poacher. I knew at what time of the day to find the elephants and at what location. But the rangers saw me first. I was dead. I don’t understand how I escaped,” he says.

Today, on reflection, he regrets having ever lived the life of a poacher.

“I went into poaching for selfish reasons,” Mbewe says thoughtfully.

“Poaching was benefiting me only; the conservation work I am doing now is benefiting the entire community and future generations,” he tells IPS while rubbing the spot of the bee sting and looking relieved.

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Land Beneficiaries Lament Worsening Poverty in Resettled Areas — Global Issues

People relocated to the Nakadanga Trust in Machinga District, Malawi, bemoan the lack of opportunities and schooling in the area they were relocated to live in.
Credit: Charles Mpaka/IPS
  • by Charles Mpaka (blantyre)
  • Inter Press Service

BLANTYRE, Jun 30 (IPS) – Located between two heavily-deforested mountains, Nakadanga Trust in Machinga District in southern Malawi looks lifeless.

It is isolated away from all other original communities. Here, the houses are made of mud bricks and they are grass thatched. There is no source of potable water in the area. There is no school nearby, no health centre and no shops for groceries.

When the members of the trust gathered to speak with IPS last month, one of the outstanding features among them was that there were more babies and children than could be expected.

“Early marriages are rampant here,” said one of the women, Merika Kapachika.

“There is nowhere our children can learn about the dangers of early marriages and early pregnancies. In the homes, there is nothing much to do.”

Kapachika is among the people that relocated to the area in 2006 under a government land resettlement programme.

Between 2004 and 2011, the Ministry of Lands implemented the Community-Based Rural Land Development Project with financial support from the World Bank.

The project involved moving what it described as “poor, land-poor and food insecure families” from the tea-growing districts of Thyolo and Mulanje in the south to Mangochi, Machinga, Balaka and Ntcheu districts in the eastern region.

There, people were resettled on land which the government had acquired from estate owners. The beneficiaries were organised into settlement communities called trusts.

At the time the project ended in 2011, over 15,000 families had been moved.

The World Bank’s Implementation Completion and Results Report Project, dated March 30, 2012, says the programme “fully” achieved its development objectives.

It says the programme succeeded in increasing both incomes and agricultural productivity of the rural families that moved.

According to the report, the incomes of the relocated families had multiplied by six; yields for maize and tobacco reached an average level of 50 to 60 percent higher as compared to communities in the surrounding areas; average maize and tobacco yields multiplied by 4 and 2.6 respectively as compared to the previous situation of the relocated households.

“Based on the promising results of this pilot experience of land acquisition and redistribution for smallholders, the Government of Malawi is willing to scale up the approach to the entire country with an objective of resettling at least 100,000 households,” reads the report in part.

However, alternative assessments expose the social and economic hardships the beneficiaries have suffered.

For example, a study of the project published in the South African Journal of Agriculture Extension in 2015 found that the relocated communities faced greater difficulties to access agricultural inputs, credit, markets and extension services to support their agricultural production and access to social services.

“As a consequence, household food and income security deteriorated after phase out of the project in 2011,” the study says.

In the six trusts which IPS visited in Machinga and Mangochi districts, where 90 percent of the 15,000 families were resettled, stories of regret are prevalent.

Mary Yalale moved from Mulanje District in 2007 and resettled in Mangochi. Initially, it looked promising. The people finally had enough land on which to grow crops. They realised a good harvest in the first few years.

“However, we did not have markets to sell part of our produce for money for us to meet other needs. Vendors took advantage. They would invade the area, buy our produce at exploitative prices, knowing that we were unable to take it to proper markets ourselves where we could earn better prices,” said Yalale of Kuma Trust.

Today, she said, they are poor such that some of them survive on piecework in the homes of the original communities.

“Our land has degraded because we are now turning to forests to produce charcoal and firewood, which our husbands take to town to make money.

“Up to now, we still do not have good relations with the original communities. They say we grabbed the land that should have gone to them. We are outcasts. The government does not give us cheap fertiliser like it does with the others. It makes us feel foolish that we agreed to come,” she said.

In Bweya Trust in Machinga District, there stands a relatively new primary school block.

Chairperson of the trust, Sowani Saidi, who is also chairperson of all the trusts of relocated people in the two districts, said it was not by the design of the government that they have a school in the area.

“We moved here in 2007. It has taken us more than 10 years of fighting with the district council for us to have this school here. We moulded bricks and collected sand for our children to have a school,” he said.

They may have the school now, but they are struggling to have the government build teachers’ houses. To date, there are no teachers’ houses at the school.

Many teachers for the school are based at the trading centre about 10 kilometres away.

“So most of them don’t come most of the time. They can’t walk, or they spend a lot hiring motorbikes to report for duties. When it’s the rainy season, there are no classes on many days because teachers don’t come. We have been asking the government to build the houses; nothing is happening,” he said.

IPS reached out to the Ministry of Lands, which implemented the programme, for its comment on these concerns. Its spokesperson, Enock Chingoni, did not respond.

However, senior officials at Mangochi and Machinga district councils, speaking on condition of anonymity as they are not authorised to speak on behalf of the government on the project, said the project did not have any integrated social and economic development activities.

The design was that once people resettled, another government programme, the Malawi Social Action Fund (Masaf), which was also financed by the World Bank, would bring public services.

“However, Masaf failed to deliver,” said one official who was part of the implementation of the programme in 2010 in Mangochi District.

Masaf, a product of the Malawi Poverty Reduction Strategy, was meant to ensure poverty reduction through activities implemented by local councils under the decentralisation policy. But decentralisation itself is generally considered as failed thus far.

“Up to now, the central government still controls much of the work of the government. We are on the receiving end of most of its decisions,” he said.

Asked if the council has any specific interventions in the resettled communities, he said there is none.

“Yes, we have development plans as a council; but we treat those people like anyone else. There is not going to be any development specific to them. At least not from the government,” said the official.

Gift Trapence, the chairperson of the Human Right Defenders Coalition (HRDC), a local organisation, faulted the project for not considering social services as a core component in its implementation.

“Such projects should not be breeding grounds for poverty. Rather they should empower citizens socially and economically,” Trapence said.

He urged the government to assess the settlements and come up with an actionable plan to address the public service access challenges they are facing.

For Kapachika of Nakadanga Trust they are no longer interested in such interventions.

“We have been here for more than 10 years now. All along, the government has known that we are suffering; it has done nothing.

“What we want now is it should take us back to where it uprooted us. There we had health centres. We had good roads and markets. We did not have to wait for our children to reach 8 years for them to start primary school. We were delivering our babies in hospitals, not in the bush. Government should take us back to our villages,” she said.

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Cyclone Freddy Devastates Communities, Farmers, Heightens Food Insecurity — Global Issues

Malawi’s Department of Disaster Management Affairs shows that 2.2 million people have been affected, with 676 killed and 538 missing after Cyclone Freddy hit Malawi earlier this month. Credit: Red Cross
  • by Charles Mpaka (sonjeke, malawi)
  • Inter Press Service

SONJEKE, MALAWI, Mar 30 (IPS) – In Sonjeka village in Mulanje district, which lies on the border with Mozambique in southern Malawi, destroyed crop fields stretch almost interminably after floods ripped through them when Tropical Cyclone Freddy pounded the country.

One of those fields lying in waste with its drying maize stalks flattened to the ground, if not ripped off altogether, belongs to Eliza Mponya.

A field close to a hectare in size, this has been the lifeline for the single mother and her four children.

Not that it gives her all the maize which the family needs for the whole year, but it still gets Mponya and her children enough to carry them close to the next harvesting season.

By her estimation, this year, she would have harvested maize that would have lasted the family until the end of November.

Crops destroyed by Cyclone Freddy, which left at least 676 dead and 650 000 displaced. Credit: Charles Mpaka/IPS
Crops destroyed by Cyclone Freddy, which left at least 676 dead and 650 000 displaced. Credit: Charles Mpaka/IPS

“We had good rains here, and we were lucky because my son found piece work in Mozambique, and we managed some fertiliser through what he earned.

“But now, after all the hard work and just when we were close to reaping the rewards, we have this damage. It’s heartbreaking,” she says.

Malawi is in a mourning period, courtesy of the worst natural disaster to have struck the country in recent memory.

Exactly a year after the battering by tropical storms Ana and Gombe, whose devastation the country is yet to recover from, Tropical Freddy hit rather more brutally.

After barreling through Madagascar and Mozambique, the cyclone stormed into Malawi on March 11, 2023. From the afternoon of March 12, rain poured over 10 of the 13 districts in the southern region of the country for the next 72 hours.

Rivers broke their banks; furious waters gorged through unlikely landscapes, and, beyond anyone’s expectation, several mud avalanches pushed down giant boulders from mountainous areas that, in some cases, swept away entire villages and crushed homes and people below at night.

President Lazarus Chakwera declared it a state of disaster, calling for help, a plea to which both local and the international community have responded generously.

The scale of the destruction is unprecedented in any natural disaster Malawi has experienced. A draft situation report which the Department of Disaster Management Affairs (DoDMA), a government agency, released on Wednesday, March 29, shows that up to 2.2 million people have been affected thus far; 676 have been killed, and 538 are missing – many of them feared to have been buried in the mudslides and rubble of collapsed buildings or washed away to unknown lands.

At the appropriate time, the police will declare the missing people dead, DoDMA says.

According to the report, up to 2,000 people are nursing various degrees of injuries, some while still in the over 760 evacuation camps that are hosting over 650,000 that have been displaced in the affected districts.

Up to 405 kilometres of road infrastructure have been damaged, and 63 health facilities and close to a million water and sanitation facilities have been affected.

The worst hit of all sectors, according to the report, is agriculture, the mainstay of Malawi’s economy. Over 2 million farmers have lost their crops and livestock, and over 179,000 hectares of crop fields have been destroyed.

Mponya’s field is among those counted.

Her maize crop would have been ready for harvest sometime towards the end of April. Now floods have harvested it, and Mponya is broken.

“I have never experienced anything like this in my life,” she tells IPS.

On March 23, 2023, the Ministry of Agriculture launched its own assessment of the damage the cyclone has caused to the agriculture sector in the region. It is yet to release its report on the assessment and the interventions that it will undertake to bail out the affected farmers.

However, in effect, the cyclone has worsened the food security situation for millions of people for the year. This comes against the backdrop of the government distributing food to 3.8 million food-insecure households, an exercise meant to see them through to the next harvest, which is now struck by the storm.

In an earlier forecast, the Famine Early Warning Systems Network (FEWSNET), a USAID-supported global food security monitoring activity, said the southern region could register a decrease ranging between 30 and 50 percent in the harvest of maize, Malawi’s staple crop and a key factor in the economy.

This, it said, would leave poor households running out of food stocks by end of August instead of October, as it usually happens with most such households in a good harvest year.

FEWSNET cited limited and delayed access to fertiliser for most subsistence farmers who rely on the government’s fertiliser subsidy programme that was rocked by logistical and procurement challenges in this growing season and due to high prices of the commodity on the normal market, which drove the farm input out of reach for most of them.

FEWSNET compiled the report before Cyclone Freddy lashed the country.

Christone Nyondo, a research fellow at MwAPATA Institute, a local independent agricultural policy think-tank, says the cyclone has effectively struck a blow on household food security in the region and the country.

According to Nyondo, families that have lost their food crops will struggle to cope without external help. He, therefore, suggests assistance for the affected farmers to replant short-duration maize varieties.

He further says crops that can still do well when planted under residual moisture should be promoted to provide a short-term coping mechanism for the households as they recover.

However, Nyondo argues that Malawi needs to invest in long-term and enduring disaster-proactive measures considering that these natural shocks will keep occurring in the face of climate change.

According to Nyondo, an agricultural economist, for a long time, Malawi has focused much of its efforts on post-disaster recovery. It is high time the country did a deep rethink of its policies and invest significantly in early warning systems and forward planning based on intelligence gathered from these early warning systems, he says.

“The specific interventions to safeguard food security will vary by season by the nature of the predicted disaster. If the predicted disaster is a widespread drought, then forward planning in terms of strategic investments in irrigation infrastructure will be key,” Nyondo tells IPS via email.

He adds: “But, in any case, we need to invest more in irrigation, storage and other critical infrastructure without waiting for disasters. That’s the surest way of safeguarding our food security. Yes, it will be expensive but it will also be necessary.”

Back in Mulanje district, Mponya has no idea how she will recover.

Unlike some people in her village, she has not suffered any damage to her house or the loss of any member of her family. But she says it is a tragedy of her life that for the first time as a farmer, the 51-year-old will harvest almost nothing from her field after months of toil, leaving her to face a year-long struggle for food.

Asked whether she has a way out, Mponya stares blankly and then says, “I don’t know what to do.”

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Belief in Witchcraft Costing Lives of Elderly Women in Malawi — Global Issues

Attacks on the elderly are increasing in Malawi, often under the pretext that witchcraft is at play. Survivor Christian Mphande lived to tell her story, but there is a worrying increase in elder abuse. Credit: Charles Mpaka/IPS
  • by Charles Mpaka (blantyre)
  • Inter Press Service

BLANTYRE, Mar 17 (IPS) – In December last year, a video clip went viral of two elderly women surrounded by a charged-up crowd and engulfed in a cloud of dust as they filled up a grave in a village in the Mzimba district in northern Malawi.

As the two elderly sisters laboured in the task, which men in Malawi traditionally handle, someone in the mob kicked one of the women, Christian Mphande, and sent her flying into the open grave.

What was their crime?

A young woman related to the two had died, and people in the village accused Mphande, 77, of killing the young woman through witchcraft.

To punish her, Mphande was forced to bury the dead, helped by the sister. She was assaulted, her belongings, such as livestock, confiscated, and she was banished from the village.

It was yet another incident in the spiralling cases of harassment of older persons in Malawi.

Mphande is alive – now living away from home but within the district, probably to forever grapple with nightmares of her experience and live with the physical evidence of a gap in her gums after she lost some teeth in the assault by the mob.

But several elderly have lost their lives in Malawi at the hands of mobs. Five older women were killed between January and February 2023, according to the Malawi Network of Older Persons Organisations (MANEPO), a coalition of human rights organisations in the country.

In 2022, 15 elderly women were killed and 88 harassed for various reasons, largely on accusations of witchcraft—a rise from 13 killed and 58 harassed in 2021.

MANEPO’s Country Director, Andrew Kavala, describes the abuses of elderly women as a scourge visiting the nation.

“As a society, we have failed our elderly. We have unjustified anger towards them. Whether driven by frustration due to survival failures, we are venting our anger on innocent people. This is a tragedy,” Kavala laments in an interview with IPS.

Top of the factors behind this terror is what he describes as “baseless belief in witchcraft and magic,” which, he says, some people blame for their personal misfortunes.

Colonial Witchcraft Act

Malawi has in force the Witchcraft Act, which came into existence in 1911 under British colonial rule.

According to the Malawi Law Commission, the legislation was enacted with the aim of eradicating what the colonialists considered as dangerous some practices such as trial by ordeal, the use of charms and witchcraft itself.

In effect, the Act assumes that witchcraft does not exist. That being the case, it is, therefore, an offence for anyone to allege that someone practices witchcraft.

It is also an offence for anyone to claim that he or she practices witchcraft.

In 2006, the government set up a Special Law Commission on Witchcraft Act to review the 1911 witchcraft law. It was in response to calls that the law is alien to the common belief in witchcraft among Malawians.

In a report, the Special Law Commission indeed found a common and strong belief in the existence of witchcraft.

“There is witchcraft or, at least, a belief in witchcraft among Malawians,” the report said, concluding, “It is not correct to argue that there is no witchcraft in Malawi for the sole reason that the practice is premised upon mere belief.”

“Consequently, the commission concludes that the existence of witchcraft should not be regarded as a doubtful but conclusive (thing),” said the Commission’s chairperson, Judge Robert Chinangwa, at a presentation of its report in 2021.

But human rights organisations trashed the recommendations of the Commission for the review of the law. In a joint statement, the organisations said by definition, a witch or wizard is someone who secretly uses supernatural powers for wicked purposes.

Assuming that the law is amended to criminalise the practice of witchcraft, there would be the difficult issue of evidence, they argued.

“It is a good law practice that for one to be convicted of a criminal offence, the prosecution must have proven its case beyond a reasonable doubt.

“However, witchcraft involves the use of supernatural powers. Therefore, proving the allegations would be very difficult in a court of law,” they said in a joint statement.

The Majority Believe in Witchcraft

There has been no conclusion since. That is, Malawi’s fight against abuse of the elderly on witchcraft-related accusations finds itself stuck on the rough edges between strong belief in witchcraft on the one hand and, on the other, that there would be no proof for its existence in a court of law if reviewed.

This belief in witchcraft is compromising Malawi Police Service’s efforts to clamp down on the abuses against the elderly, according to national police spokesperson Peter Kalaya.

“Our main challenge is that we work hard to enforce this law in a society where the majority believes witchcraft exists. As such, there is great resistance ,” Kalaya tells IPS.

The police’s situation is worsened by the fact that, in most cases, incidents of abuse of older women occur in rural locations remote from the nearest police stations. According to Kalaya, this sometimes negatively affects police response to provide a swift rescue of victims and arrest perpetrators.

He further indicates how the police sometimes evade the treachery of the witchcraft law.

“Most of the abuses older persons face fall within the general crime of mob justice such as being beaten, killed, their houses and property being burnt and being subjected to verbal insults,” he explains.

Wycliffe Masoo, Director of Disability and Elderly Rights at the Malawi Human Rights Commission (MHRC), a public body, says witchcraft belief in itself is not to blame; it is what happens as a result of that belief that is of concern.

“The question that remains is that if witchcraft exists, is it being practised by older persons only?” Masoo wonders.

He says while police have at times been swift in arresting and investigating suspects for abusing the elderly, the wheels of prosecution take too long sometimes and give the abuses an edge.

Legislation Already in Place

According to Masoo, whether Malawi sticks with the Witchcraft Act or reviews it and contends with the tricky challenge of proving witchcraft in a court of law, the country already has some legislation in place which, if properly used, would ably curb issues of mob justice on older persons.

For example, the Constitution prohibits discrimination of persons and guarantees “equal and effective protection against discrimination” on whatever grounds.

It guarantees human dignity, stating that “no person shall be subject to torture of any kind or to cruel, inhuman or degrading treatment or punishment.”

What Malawi needs, according to MHRC, Manepo and the police, is to expedite the enactment of the Older Persons Bill into law and invest in a formidable, coordinated mass awareness that brings along traditional, religious and judicial leadership for all Malawians to understand the rights of older persons.

“This will wholesomely protect older women,” Masoo says.

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Research Uncovers Cheaper Diagnostic Tools For Chronic Hepatitis B in Africa — Global Issues

Patients in Africa often cannot access treatment as per the WHO hepatitis B guidelines. Now researchers have found a way to improve the diagnosis and care of people living with hepatitis B. Credit: Charles Mpaka/IPS
  • by Charles Mpaka (blantyre)
  • Inter Press Service

BLANTYRE, Mar 02 (IPS) – Researchers have found that cheaper and more accessible blood testing methods can improve the care of patients with chronic hepatitis B in Africa.

In a study published in Nature Communications, the researchers recommend revising the current World Health Organization (WHO) guidelines on managing the condition.

“Our data are important for informing clinical practice in and should be considered in the next revision of the WHO hepatitis B guidelines,” say the researchers who make up the Hepatitis B in Africa Collaborative Network (HEPSANET).

Lead author of the study, Asgeir Johannessen, tells IPS that clinicians working in Africa have “repeatedly reported that very few patients in Africa” are eligible for treatment using the current WHO guidelines published in 2015.

“The lack of data from Africa is a major challenge, and we wanted to use African data from African patients to inform African treatment guidelines,” says Johannessen, a specialist in internal medicine and infectious diseases at the Institute of Clinical Medicine, University of Oslo in Norway.

According to the study, Africa represents one of the high-burden regions for chronic hepatitis B virus. Of the estimated 316 million people that live with chronic hepatitis B virus infection worldwide, 82 million are in Africa.

The research further says that antiviral therapy effectively reduces the risk of complications resulting from hepatitis B virus infection.

But with current WHO-recommended guidelines, early diagnosis and treatment are impacted because often only picked up when there is advanced liver damage.

The challenge in clinical practice in Africa has been to identify patients at risk of progressive liver disease who should start antiviral therapy in good time.

“In resource-limited settings, however, these fibrosis assessment tools are rarely available, and antiviral treatment is therefore often delayed until the patients have developed symptoms of advanced chronic liver disease,” the research paper says.

So, the researchers set out to deal with this question: “Can we diagnose advanced liver fibrosis in the Africa region, using routinely available and low-cost blood tests for patients with hepatitis B?” says Alexander Stockdale, a member of the team and senior clinical lecturer at the University of Liverpool and Malawi Liverpool Wellcome Programme.

In the study, the 23 researchers reviewed data for 3,548 chronic hepatitis B patients living in eight sub-Saharan African countries, namely Burkina Faso, Ethiopia, The Gambia, Malawi, Nigeria, Senegal, South Africa, and Zambia.

They evaluated the existing WHO treatment guidelines and a simple liver damage biomarker developed in West Africa.

They established that the conventional hepatitis B care standards are unsuitable for patient management in Africa. They found that the diagnosis level as set by the WHO “is inappropriately high in sub-Saharan Africa,” which is often constrained by a lack of resources.

The problem, the researchers say, is that the existing WHO guidelines are not adapted for the African population.

The study that informed these guidelines was performed among active chronic hepatitis C patients in the USA, much older than Africa’s hepatitis B virus population and on a very different patient population compared to African chronic hepatitis B patients.

“Our data are important for informing clinical practice in SSA and should be considered in the next revision of the WHO hepatitis B guidelines,” says Johannessen.

He says they have shared their findings with the WHO and the Centre for Disease Control (CDC) in Africa.

“We believe our findings will inspire the first ever African hepatitis B treatment guidelines, and even the WHO is now changing their guidelines because of our work,” he tells IPS.

“Africa is now the epicenter of the hepatitis B epidemic. In fact, 2 of 3 new infections occur on the African continent. To combat the hepatitis B pandemic in Africa, we need African data to inform practice,” Johannessen says.

Initially, the researchers thought their main challenge would be to get people to share data.

“But in fact, everyone we reached out to were eager to participate. It is obvious that this is a topic that feels like a priority to colleagues working throughout Africa,” he says.

The study is the largest, most comprehensive, and geographically representative analysis ever conducted in Africa.

“We, therefore, believe our results are generalizable,” the researchers conclude.

However, they admit some limitations of their study. For example, the method used to assess liver damage has been associated with technical limitations, including unsuccessful measurements reported in patients with certain health conditions such as obesity. The researchers did not ascertain the rates of failure of these tests.

“This may affect the overall applicability of our findings to the entire population with HBV,” they say.

But Adamson Muula, Professor and Head of Community and Environmental Health at the Kamuzu University of Health Sciences (KUHES) in Malawi, says in terms of the methodology used in this study, the systematic review of data was relevant in answering the question at hand.

“In the hierarchy of evidence, systematic reviews and meta-analyses are high up with respect to the rigor of the findings,” says Muula, who was not part of the research.

He noted, however, that there are downsides to this approach, including the fact that in the interpretation of the findings, there is an implicit sense that Africa is one place. Muula argues that African health systems can be different even within the same country.

Within a country, you can find a health system comparable with developed countries; others are more closely aligned to developing countries. The studies applied more to those with less sophisticated health systems.

Regardless, the study is vital, he acknowledges.

Hepatitis B diagnosis on the continent has been a luxury. In Malawi, for example, where 5 percent of the adults are estimated to be infected, virtually no screening or diagnostic system exists.

Individual patients may interact with the health system, but more so when things are already out of hand when irreversible liver damage has already happened.

“Efforts to reduce the time at which diagnosis can happen are therefore commendable. This study adds guidance as to when such earlier diagnosis may be attained.

“However, research is one thing, health systems strengthening another. Studies like this one add to the impetus and arm the policymakers to make the right decisions,” he says.

But he urges communities to take charge of these findings instead of leaving action in the hands of “sometimes incapacitated policymakers’ hands.”

“The question should be, what is the community saying about findings such as these? If we wait for policymakers to decide when they are going to invest in hepatitis B interventions, we will wait for the rest of our lifetimes.

“Time has come for community groups to work with the duty-bearers to the extent that hepatitis B is not a neglected tropical disease anymore,” he says.

The WHO’s goal is to have hepatitis eliminated by 2030.

IPS UN Bureau Report


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Malawi Suffers Worst Cholera Outbreak in Decades — Global Issues

Cholera ward in a health centre in Blantyre. Malawi has experienced a massive rise in cholera in the past year. Credit: Charles Mpaka/IPS
  • by Charles Mpaka (blantyre)
  • Inter Press Service

BLANTYRE, Jan 09 (IPS) – On March 3, 2022, Malawi declared a cholera outbreak after a district hospital in the southern region reported a case. This was the first case in the 2021 to 2022 cholera season.

That single case was a warning for what would become Malawi’s worst cholera outbreak in decades.

For nearly a year now, cholera has gripped the country, with cases reported in all 29 districts and rising.

In an unprecedented occurrence, the cases rose sharply even through the summer months when cholera is least expected and the country least prepared for it.

As of January 4, 2023, up to 640 people were killed, and 19,000 cases were registered, government data shows. The case fatality rate stands at 3.4 percent, higher than the recommended rate of less than one percent.

Maziko Matemba, Executive Director for Health and Rights Education Programme (HREP), a local civil society organisation, says the situation is alarming and keeps the country in a “spiral of health crisis”.

“We started the year 2022 hoping to recover from the devastation of Covid-19. Then Tropical Storm Ana knocked us back in January. In March, cholera hit, and it hasn’t left for ten months, worsening as time passes. We have not had this kind of cholera outbreak for a long time,” Matemba tells IPS.

And there are growing fears that the disease could spread further now that the rainy season when it usually breaks out in Malawi, has begun.

Tropical Storm Ana has played a significant part in this outbreak, experts say. The rainstorm affected 16 districts, including Machinga, where the first cholera case was reported in March, and Nsanje, a flood-prone district and one of the first areas to report cholera cases in this outbreak.

A final situation report on the impact of the storm by the Department of Disaster Management Affairs found that over 53,000 latrines collapsed, while 337 boreholes, 206 water taps and eight gravity-fed water schemes were damaged in those 16 districts.

The department said this resulted in low sanitation coverage, limited access to safe water and poor hygienic practices, with some sites and communities reporting open defecation and contamination of the few available water sources.

The report said the situation increased the risk of cholera and other communicable diseases.

“As such, safe water supply, sanitation and hygiene services are immediately needed to address water, sanitation and hygiene issues. Furthermore, there is a need for rehabilitation of toilets to avoid infectious and waterborne diseases,” it said.

But Malawi has not fully recovered from this disaster since, Matemba says.

“So lack of recovery on water and sanitation infrastructure destroyed during that time have created good conditions for cholera to thrive. That comes into an existing frame of a weak prevention system. We usually take prevention rather casually,” he says.

Save Kumwenda, an environmental health expert, says alongside the water, sanitation and hygiene issues, there is also evidence of temperature and precipitation being influential in cholera outbreaks – with temperature driving epidemics and rainfall acting as a dispersal mechanism.

“Then there are also socio-economic conditions which are key drivers for outbreaks, as these increase pathogen exposure,” says Kumwenda, an associate professor at the Malawi University of Business and Applied Sciences (MUBAS).

He says the situation could worsen as the rainy season spreads the bacteria through contamination of water bodies and food.

The outbreak has hit the hardest Malawi’s two major cities of Lilongwe, the capital city, and Blantyre, the commercial city.

For instance, in the 7 days between December 29, 2022, and January 4, 2023, the country recorded 2,773 cases and 137 deaths. Out of these, Blantyre and Lilongwe contributed 47 percent of the new cases and 53 percent of the new deaths.

Kumwenda says this is the case because the two cities, struggling with solid waste management and aged sewer systems, have large peri-urban areas where residents depend on wells, boreholes and river water which is highly contaminated by faecal matter from toilets, broken septic tanks, broken sewer pipes and open defaecation.

He says most houses in these areas do not have adequate toilets, and many depend on sharing.

In addition, most of these households cannot afford to pay for water from waterboards for both drinking and domestic use. They, therefore, prioritise safe water for drinking only and unsafe water for other uses, which leads to contamination of foods and utensils and also contamination of the available safe water.

“The other reason for the high numbers of cholera cases in these cities is the high number of people who rely on piece works, and these rely on foods sold in markets where hygiene and sanitation conditions are compromised,” he says.

In response, the government has delayed by two weeks the opening of schools in the two cities and surrounding areas. Malawi opened the 2022 academic year on January 3.

Minister of Health Khumbize Kandodo Chiponda says in a statement that opening schools in the two cities would affect containment efforts for the outbreak, considering that cholera is passed from one person to another through contaminated food, water and inadequate sanitation facilities, a feature that exists in school settings.

“The converging of learners, especially in the nursery, primary and secondary schools, increases the chances of uncontrolled spread of the vibrio bacteria that causes cholera disease,” she says.

During the two weeks delay, the government will be conducting a thorough assessment and improving the water and sanitation situation in the schools in both cities.

For a national response, among other measures, the government says it will be opening more treatment centres in the cholera hotspots, employing more staff in the treatment centres, intensifying hygiene promotion and undertaking water quality assessments in targeted areas.

In November last year, Malawi rolled out the oral cholera vaccination reactive campaign targeting 2.9 million people aged one year and above.

Kumwenda says Malawi needed to act quickly to stop the outbreak before the onset of the rainy season as there was clear evidence of the impending emergency due to the rising of the cases through the hot months.

But for long-term control of the disease, Malawi needs to invest in research in order to come up with interventions based on evidence.

“This will ensure that we always invest in interventions which yield maximum benefits. We need to understand the main drivers of the epidemic and also identify reservoirs of the bacteria causing cholera. The knowledge of the reservoirs will help us to easily prevent the re-occurrence of the outbreak,” says Kumwenda, president of the Malawi Environmental Health Association, a group of environmental health experts.

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