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Malawi: Children At Risk of Cholera in Aftermath of Cyclone Freddy


Nairobi/Johannesburg/New York — Millions of children are at risk in the face of a potential increase in cholera cases in Malawi and Mozambique in the aftermath of Tropical Cyclone Freddy, which has ravaged both countries for the second time in less than a month.

Devastation and flooding caused by the cyclone have added to the serious vulnerabilities of children and families in the countries, further weakened by inadequate water, hygiene, health and sanitation systems.

“In the face of crisis and chaos, it is children who are the most vulnerable,” said UNICEF Regional Director for Eastern and Southern Africa, Mohamed M. Malick Fall. “Cyclone Freddy has taken a devastating toll. Many families in Malawi and Mozambique have had their lives swept away, leaving them with very little and putting children and the most vulnerable in particular at immense risk. UNICEF is working around the clock with authorities and partners to meet the immediate needs of children and their families.”

Across Malawi and Mozambique, flooding and damage caused by the cyclone have led to death, devastation of infrastructure and social services and displacement, while hampering access to health and other basic services, which will almost certainly exacerbate the cholera outbreaks the two countries are experiencing. Even prior to the cyclone, Malawi and Mozambique were among the countries most seriously affected by the cholera outbreak that has, this year alone, resulted in more than 68,000 cases across 11 countries in the eastern and southern Africa region.

Mozambique has been facing a cholera outbreak since September 2022, with confirmed cases in 35 districts across seven provinces, and with more likely also affected. As of 18 March 2023, nearly 10,000 cases had been reported, more than tripling case reports since early February. Mozambique is at the same time responding to multiple competing humanitarian crises, with 2 million people in need of humanitarian aid in the country’s northern region, and nationwide polio vaccination efforts ongoing. Freddy made landfall twice in Mozambique, first in late February, in central Mozambique’s Inhambane province, and again on 12 March, further north in Zambezia province.

Moving inland, the cyclone then hit southern Malawi severely, causing devastating damage to roads, infrastructure, homes, businesses, and health centres, including cholera treatment units and schools in affected areas. Cholera has already claimed more than 1,660 lives. Combine this with the ongoing annual lean season – when millions of Malawians are expected to be food insecure – and children are suffering most as a result of this crisis. As the planet warms, Malawi is likely to be hit by worse climate-induced hazards such as stronger storms and droughts. Today an estimated 4.8 million children are in humanitarian need. By the end of March, almost a quarter of a million children under five years of age are expected to be acutely malnourished, with over 62,000 expected to be severely malnourished. As a severely malnourished child is 11 times more likely to die from cholera than a well-nourished child, a bout of cholera may amount to a death sentence for thousands of children in Malawi.

In both Malawi and Mozambique, UNICEF is focused on the mobilization of essential basic supplies, ensuring access to food and safe water; hygiene promotion and supplies; tents; medical supplies, emergency latrines; education and other key services; and psychosocial support and protection from potential abuse. In collaboration with drone operators, UNICEF is supporting aerial mapping in six districts of Malawi to assess the extent of damage and flooding in areas that are difficult to access and also for search and rescue efforts.

UNICEF is urgently calling for funding of US$155 million to respond to the impacts of flooding and cholera on children and families in the region, and to provide lifesaving supplies, services, and technical support in water, sanitation, and hygiene; health and HIV; education; nutrition; child protection; and social protection with social behaviour change interventions integrated across all sectors.