Covid-19 Malawi

March 25, 2020
We hope this email finds yourself and your loved ones safe.

MESSAGE FROM CEO Dr Tamsin Lillie

Over the last few weeks we have all started to develop a new normal.  The only certainty for the next few months is that everything is going to be uncertain.  Many of the core team at Medic to Medic are on the frontline in public health and staffing our GP surgeries and hospitals.  We're so proud of them and how they are helping our communities within the midst of this pandemic.  

I had been planning a Malawi trip to set up the Medic to Medic office and train our local administrator so that we can delegate core tasks to the in country team and increase our capacity building within Malawi.  For obvious reasons this has been postponed and I am awaiting my GMC license to join my colleagues during the next few weeks of uncertainty.  As an overseas clinician I relinquished my GMC license a few years ago.

Naturally we are all concerned about our students and graduates in Malawi.  Some of the world's best health systems have been beyond stretched by this pandemic.  This begs the question how some of the world's most fragile health systems will defend themselves against Covid-19, where basic principles of disease prevention are not possible.  When you don't have money to buy food, how will you afford to buy soap? When malaria, TB and overcrowding are common place, how can you avoid people with a fever and cough?  When a large number of the population have underlying health conditions and already threatened immunity due to HIV, how will their bodies defend themselves?  In addition to this, these countries and their governments have the least capacity to respond and whilst the developed world turn their attentions to their own pandemic response, they are in less of a position to provide assistance.

Malawi has not yet had a confirmed case of Covid-19 in the country.  We sincerely hope that Malawi will be the answer to the question "What country was the only country in the world to never have a confirmed case of covid-19 during the 2020 pandemic?"  Sadly we know that this is very unlikely to be the case for much longer.  Bordering Tanzania, Zambia and Mozambique all have confirmed cases.  The importance of human resources in health are now more than ever before being recognised as essential workers against death and disease.  They are SO important and even more so within sub-saharan Africa where there are simply not enough during the best of times, let alone the worst of times.  

I saw this on a friend's social media page and thought it worth sharing: "If Public Health called tomorrow and told you that you had tested positive for COVID-19 and asked you to list all the places you had been and all the people you had been in contact with for the last 10 days - would you be proud of yourself, or embarrassed by your actions? #STAYHOME"

Should you be contacting Medic to Medic over the next little while, we may not be as efficient at responding as normal due to our core team being involved in the delivery of health services in the UK.  We will try to keep you updated from the Malawi perspective but in the meantime, stay safe, stay well, stay at home and be kind.



CORONA VIRUS PANDEMIC; A MALAWIAN DOCTOR 
Reported by Dr Zaziwe Fatsani Gundah (Medic to Medic Graduate), Senior Medical Officer, Blantyre DHO

Dr Fatsani Gundah is on the Malawi Covid-19 taskforce and is a Medic to Medic graduate.  He has written us a short blog to tell us what is happening in Malawi and how the country is preparing for it:

"Since reported from December 2019, Corona virus outbreak has swept the entire earth from east to west and Africa has not been spared. In Malawi, the ministry of health has put up various measures to prevent international transmission of the corona virus into the country.

Recently, the president of Malawi, Arthur Peter Mutharika, has declared the state of national disaster. The public gathering of more than 100 people is prohibited, schools closed, and passengers coming in from the affected countries are ordered to go for self-quarantine for a period of fourteen days if asymptomatic and those with symptoms are mandated to be isolated in our Quarantine Centers that we have in Blantyre and Lilongwe. We have additional isolation camps in Mchinji, Mzuzu and Karonga.

For the past two months, I have been involved in screening of the passengers at Chileka airport. When the passengers alight from the planes, they wash hands with soap before entering the Arrivals section. Immediately they are subjected to infrared temperature check and they fill a form that requires them to declare the countries they have visited. On the form they are also asked if they had fever, cough, shortness of breath in the last 14 days. Furthermore, they declare their residency, nationality and they fill their contacts on the form. Lastly, they are given a slip with phone number for the district health office to call should they start having the symptoms within the 14 days whilst on self-quarantine. The forms filled, provide the DHO office with enough information to follow up the passengers on self-quarantine enforce them to follow the self-quarantine procedures including the wearing of appropriate mask.

When the passengers develop symptoms, they are taken to the quarantine camps for proper assessment and blood and throat swabs are taken for testing for corona and other relevant lab tests. Upon completion of the 14 day self-quarantine, the passengers are discharged and are allowed to carry on with their normal lives. In Malawi, we are using both the Rapid Tests for screening as well as the DNA PCR for confirmation.

Lately, the work is overwhelming as the corona virus infection is spreading and new cases are being confirmed in the surrounding countries such as south Africa which is a 3 hour flight. There is a need to recruit and train more health personnel, procedure Personal Protective Equipment for health workers and also prepare and equip the quarantine centers for possible admission of would be patients.

The Corona Virus also known as Covid-19 has killed a lot of people in a great number of countries in a very short period time. Personal hygiene is encouraged in the homes and public places. Malawi has not registered any cases to date and the ministry the ministry of health is doing everything possible in making sure that we prevent the virus from coming into the country."


HOW WE ARE SUPPORTING OUR STUDENTS

We have created a WhatsApp group for ALL our students across the 5 universities where we work in Malawi (Mzuzu, COM, Ekwendeni, SJOG, KCN) to come together to discuss rumours and share information about what's happening with Covid-19 in Malawi.  Part of this group is Dr Fatsani Gundah, who can update our students on Malawi's position and share information.  

Most of the universities are closing for a few weeks and whilst our students are in their home communities, they can have a positive role acting as an educator about the pandemic and help deliver key public health messages to those who may not have access to them.  We also know that rumours, misinformation and fear is common place, so this forum will be a way of students being able to check information with Dr Fatsani.

We have shared the Australasian College of Emergency Medicine Covid-19 guideline for emergency departments with limited resources and hope this may be useful to some of the graduates in preparing their workplaces or giving ideas on how things can be organised.



HOW YOU CAN CONTINUE TO HELP MEDIC TO MEDIC DURING THESE CHALLENGING TIMES

We know that this is an unsettling time for all of us and we do not know the longer term impact that this will have on the charity sector.  We know that some of our donors will face economic hardship and we're very aware that charitable donations put pressure on already difficult times. It is our sincere hope that we will be able to continue supporting our students as normal but we know that during the next academic year, we may need to make changes to the way that we support our students with what funding we have available.  We have weathered many challenges in the past through donor support.  Thank you for continuing to support us and our students and graduates in Malawi.

Practical ways that you can help us:

  • Having a sort out during self isolation?  Come across your old mobile phones?  Keep them and trade them in at envirofone or music magpie (when it is safe to do so) and donate the proceeds to Medic to Medic.  Have a group of books that you no longer need?  Ziffit them!  Download the app, send off your books, games and DVDs and donate the proceeds to Medic to Medic!
  • Shopping Online?  Remember to use easy fundraising and select Medic to Medic as the charity that you support.  The shop will make a donation to us at no extra cost to you! ###liinfo@medictomedic.org.uk) for a scrub top!  £12 each or £10 if buying more than 1.
  • Set up a recycling scheme - collect all your empty toothpaste tubes and soap dispensers from liquid soap with your neighbours.  Share the word through your WhatsApp group or email trees.  We collect these and send them in to Terracycle for recycling.  Raising valuable funds for us and they are things that we are using now more than ever.  (There are other recycling programmes to collect for, email us for more info).


Wishing you and your families well over the coming weeks.

From all the Medic to Medic team.