WHO: Nearly 200 Cases of Monkeypox in More Than 20 Countries

The World Health Organization says nearly 200 cases of monkeypox have been reported in more than 20 countries not usually known to have outbreaks of the unusual disease but described the epidemic as “containable” and proposed creating a stockpile to equitably share the limited vaccines and drugs available worldwide.

During a public briefing on Friday, the U.N. health agency said there are still many unanswered questions about what triggered the unprecedented outbreak of monkeypox outside of Africa, but there is no evidence that any genetic changes in the virus are responsible.

“The first sequencing of the virus shows that the strain is not different from the strains we can find in endemic countries and (this outbreak) is probably due more to a change in human behavior,” said Dr. Sylvie Briand, WHO’s director of pandemic and epidemic diseases.

Earlier this week, a top adviser to WHO said the outbreak in Europe, U.S., Israel, Australia and beyond was likely linked to sex at two recent raves in Spain and Belgium. That marks a significant departure from the disease’s typical pattern of spread in central and western Africa, where people are mainly infected by animals like wild rodents and primates, and outbreaks haven’t spilled across borders.

Although WHO said nearly 200 monkeypox cases have been reported, that seemed a likely undercount. On Friday, Spanish authorities said the number of cases there had risen to 98, including one woman, whose infection is “directly related” to a chain of transmission that had been previously limited to men, according to officials in the region of Madrid.

U.K. officials added 16 more cases to their monkeypox tally, making Britain’s total 106. And Portugal said its caseload jumped to 74 cases on Friday.

Doctors in Britain, Spain, Portugal, Canada, the U.S. and elsewhere have noted that the majority of infections to date have been in gay and bisexual men, or men who have sex with men. The disease is no more likely to affect people because of their sexual orientation and scientists warn the virus could infect others if transmission isn’t curbed.

WHO’s Briand said that based on how past outbreaks of the disease in Africa have evolved, the current situation appeared “containable.”

Still, she said WHO expected to see more cases reported in the future, noting “we don’t know if we are just seeing the peak of the iceberg (or) if there are many more cases that are undetected in communities,” she said.

As countries including Britain, Germany, Canada and the U.S. begin evaluating how smallpox vaccines might be used to curb the outbreak, WHO said its expert group was assessing the evidence and would provide guidance soon.

Dr. Rosamund Lewis, head of WHO’s smallpox department, said that “there is no need for mass vaccination,” explaining that monkeypox does not spread easily and typically requires skin-to-skin contact for transmission. No vaccines have been specifically developed against monkeypox, but WHO estimates that smallpox vaccines are about 85% effective.

She said countries with vaccine supplies could consider them for those at high risk of the disease, like close contacts of patients or health workers, but that monkeypox could mostly be controlled by isolating contacts and continued epidemiological investigations.

Given the limited global supply of smallpox vaccines, WHO’s emergencies chief Dr. Mike Ryan said the agency would be working with its member countries to potentially develop a centrally controlled stockpile, similar to the ones it has helped manage to distribute during outbreaks of yellow fever, meningitis, and cholera in countries that can’t afford them.

“We’re talking about providing vaccines for a targeted vaccination campaign, for targeted therapeutics,” Ryan said. “So, the volumes don’t necessarily need to be big, but every country may need access to a small amount of vaccine.”

Most monkeypox patients experience only fever, body aches, chills and fatigue. People with more serious illness may develop a rash and lesions on the face and hands that can spread to other parts of the body.

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Nobel Laureate Denounces Rape as Weapon of War

When asked if he is afraid for his life, Dr. Denis Mukwege responded candidly: “I am human.” Due to the nature of his work, the renowned gynecological surgeon has received death threats for years.

But the Congolese Nobel Peace Prize laureate said he draws his strength from the women he treats. Patients who come to him to heal after going through unimaginable horrors.

“The women I’m treating are so powerful,” Mukwege said in an interview with VOA’s Straight Talk Africa TV program. “What I’m doing is just a small sense if I compare what they [rape survivors have been through] in the situation of conflict where everyone wants to use them.”

He is now honoring the women he says inspired him, including his mother, in a new book titled “The Power of Women: A Doctor’s Journey of Hope and Healing.” In it, he reexamines the agency of women in spaces and platforms where decisions are made and at times despite some patriarchal societies that often fail women, he said, women continue to give back and nurture for a greater good.

Ukraine, Ethiopia rape survivors

Mukwege’s work is particularly relevant today as sexual violence is being used as a weapon of war in conflicts around the globe. He used two examples to illustrate the urgency of the issue: Ukraine and Ethiopia.

Before Russia’s invasion of Ukraine in February, his foundation had established contact with women in Donbas who were raped in 2014 when Russia annexed the Crimean Peninsula from Ukraine. There have been more than 700 reports of rape by Russian forces in Ukraine since the February invasion, the Ukrainian parliament’s human rights ombudsman said May 9. In northern Ethiopia, both government and Tigrayan forces have been accused of sexual violence. Nisha Varia, formerly the advocacy director of Human Rights Watch’s women’s rights division, told VOA that rape in Tigray is being used as a weapon and is accompanied by ethnic slurs and other degradation.

Mukwege said when rape is used during conflicts, it is “used to humiliate, to just make the so-called enemy to feel powerless, to be in a situation that is completely humiliating and you can’t really fight against it. It’s a weapon, but it’s a strategy of war,” he said.

But he said he is heartened by an international outcry about the violence against women in Ukraine. He would like to see the same outcry against atrocities in other parts of the world.

“The international community should react in each conflict because the suffering is universal and the reaction against the suffering or to take care of the suffering people should be also universal,” he said, adding that “the case of Ukraine shows us that if there is a will, we have the capacity to stop atrocities.”

Mukwege said a universal sentiment connects most women who have been raped, whether he speaks to victims in Africa, Asia, the Middle East and elsewhere. He said perpetrators leave a sense of fear and that you hear victims saying, “they’ll kill me,” he said. “Most of the women have the impression that they don’t exist at all after being raped.”

Mukwege, who met with senior U.S. officials and first lady Jill Biden during his visit to Washington, is also calling for more efforts to prosecute perpetrators so women can receive justice.

 

“I think that justice is very important. It’s not revenge,” he said. “Justice is not only pressure against the perpetrators, but justice is needed for victims because in the process of healing, victims need really to be recognized as a victim. They need really to get someone with this power, this authority, to say you are not guilty. It’s not your fault.”

Justice and resilience

Death threats against Mukwege at times come from unknown sources and he has been forced to live at Panzi Hospital in Bukavu, Democratic Republic of the Congo, or the DRC, where he treats rape survivors. “I can’t leave the hospital without an escort. I have the police who are taking care of me,” he said. “To get this kind of life living in the hospital with your patients and my family and so on. This is a terrible thing.”

Since 1999, Mukwege and his team have treated more than 50,000 survivors of sexual violence at the hospital he founded. The hospital also treats the psychological trauma of women caught up in the ongoing violence between militia groups in the eastern DRC.

Mukwege said those resilient women are the best hope for some of the world’s war-torn regions. After they have healed, they demand change.

“When women stand up after being treated, they didn’t stand for themselves, they are standing for themselves and for their children, for their family. For me, this is really wonderful. Society can’t protect them, but when they get healing and stand up, they stand up and raise their voice for all the community.”

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Japan to Resume Tourism in June; Only Packaged Tours for Now

Japan will open its borders to foreign tourists in June for the first time since imposing tight pandemic travel restrictions about two years ago, but only for package tours for now, the prime minister said Thursday.

Beginning June 10, Japan will allow the entry of people on tours with fixed schedules and guides, Prime Minister Fumio Kishida said.

Tourists from areas with low COVID-19 infection rates who have received three vaccine doses will be exempt from testing and quarantine after entry.

Japan this week is hosting small experimental package tours from four countries, Australia, Singapore, Thailand and the United States. That experiment, which involves only 50 people who received special visas, not tourist visas, is to end May 31.

“Free and active exchange of people is the foundation of economy and society, as well as that of Asia’s development,” Kishida told his speech at a Tokyo hotel Thursday.

Japan, while watching the infection situation, will gradually accept more tourists in stages to the level of arrivals before the pandemic, he added.

After facing criticism that its strict border controls were xenophobic, Japan began easing its restrictions earlier this year and currently allows entry of up to 10,000 people a day, including Japanese citizens, foreign students and some business travelers.

Japan will double the cap to 20,000 a day from June 1, which will also include package tour participants, said Makoto Shimoaraiso, a Cabinet official in charge of pandemic measures.

The scale of the package tours and other details will be finalized after officials evaluate the results of the current experimental tours, he said.

It will take some time before foreign visitors can come to Japan for individual tourism, Shimoaraiso said.

Japan this week also eased requests for mask wearing. While masks are still requested on public transportation, hospitals and other public facilities, people can take off masks outdoors where others are not around or talking. Despite the easing, most Japanese so far are seen sticking to wearing masks in public.

Japan’s tourism industry, hit hard by the border controls, is eager for foreign tourism to resume. COVID-19 infections have slowed in Japan since earlier this year and the government is gradually expanding social and economic activity.

Kishida said during a visit to London earlier this month that he planned to ease the border controls as early as June in line with the policies of other Group of Seven industrialized countries, but gave no further details.

Foreign tourist arrivals fell more than 90% in 2020 from a record 31.9 million the year before, almost wiping out the pre-pandemic inbound tourism market of more than 4 trillion yen ($31 billion). 

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Nigerian Albinos Demand Authorities Restore Free Cancer Treatment 

Nigerian Cynthia Ukachi, who has albinism, first noticed the changes on her skin in 2018. When she went to the hospital, she was told it was an early stage of skin cancer, and that it had started because of exposure to the sun.

Thanks to a government support scheme that offered free skin cancer care for albinos, she had surgery to remove the affected areas and was treated.

However, Ukachi says the malignant skin cells returned months ago, long after the government ended its free treatment plan.

“I have three on my neck, I have two at my back and I just have this on my forehead here,” she said. “It looks very small but it’s very painful and it can bleed.”

Without the government support, about 4 million albinos in Nigeria could be at risk of skin cancer, according to aid groups.

Too expensive for her

Ukachi says she cannot afford the treatment. Every affected skin area can cost up to $350 to treat.

“Noticing this issue again, I already knew what it was, but I couldn’t go back to the hospital, knowing I’ll be asked to pay, and the money is what I do not have,” she said. “If the government wants me to live, if the government wants persons with albinism to live, they should reinstate the free cancer treatment.”

Nigerian authorities started the program in 2007, and the Albinism Association of Nigeria says around 5,500 patients including Ukachi benefited from it before it was discontinued for lack of funding.

Jake Epelle, a skin cancer survivor and AAN’s president, said, “Even the current administration started the skeletal implementation at the beginning of their tenure but then reneged. The reason is simply the poverty of funds and the fact that they cannot continue to offer this treatment. The effect is that persons with albinism are dying in droves.”

Medical experts say albinos in sub-Saharan Africa are a thousand times more likely than the general population to develop skin cancer because of the partial or complete absence of melanin, a pigment responsible for eye, hair and skin color.

In Nigeria, myths and discrimination associated with the condition make it far more difficult for albinos to get jobs and afford skin cancer treatment.

Authorities respond

This month, during a national awareness day to remember people living with albinism, AAN renewed its call for the government to reinstate the free skin cancer treatment.

Nigerian authorities responded. James David Lalu, executive secretary of the National Commission for Persons with Disabilities, said, “We had discussions with the permanent secretary of the federal ministry for health for us to be able to revisit this. We’re going to provide some funding support to do that. Additionally, by next year we’re going to provide proper budgetary allocation that will support this cancer treatment for our people.”

AAN cautions there is no time to lose as free treatment is the only lifeline for people around the country like Ukachi, who fears she will run out of time.

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Five Ways Climate Change Is Making Poor People Poorer

Heat waves like the ones roasting South Asia this year don’t just sap people’s strength. They drain people’s finances in ways that are not always obvious.

It’s one of the ways climate change is weighing on the economy and making poor people poorer.

“These effects are global, they are pronounced, and they are persistent,” said Teevrat Garg, an economist at the University of California-San Diego’s School of Global Policy and Strategy.

South Asia is especially vulnerable to the impacts of climate change-driven heat waves. But temperature extremes are becoming more common worldwide as the planet warms.

  1. Too hot to work

March and April were the hottest or near-hottest months on record across South Asia.

Climate change made this heat wave about 100 times more likely, according to the U.K. Met Office.

The heat has been brutal for farmers, construction workers and anyone who has to work outside. That’s about half the workforce in South Asia.

“Wage laborers like us work despite the heat,” Indian construction worker Kushilal Mandal told Agence France-Presse in April. “We won’t be able to eat if we don’t work.”

At these temperatures, heatstroke and even death are real risks.

Many work sites shut down early. But that means lost wages.

The U.N. International Labor Organization says that in 2030, hours lost to heat worldwide will be the equivalent of losing at least 80 million full-time jobs.

  1. Lower earnings for outdoor work

It doesn’t take a full work stoppage to hurt workers’ wages. People just can’t do as much when it’s hot.

In a study Garg co-authored, workers in Indonesia in a hot, sunny environment were 8% less productive than those in a shady environment that was about 3 degrees cooler. Doubling wages did not increase productivity.

“It’s not about workers feeling icky or lazy or just like, ‘I don’t want to work because it’s hot,’ ” Garg said. “It’s that heat is representing binding constraints on workers’ ability to do their job.”

  1. Factory slowdowns

Heat affects workers even if they are not exerting themselves. High temperatures slow down factory workers, too.

“We think of manufacturing as a thing that occurs inside. But inside doesn’t mean protected from heat. It doesn’t mean air conditioning,” said World Bank economist Patrick Behrer.

Studies as far back as 1915 show factory workers paid by the piece earn less at higher temperatures. Even call center workers get less done in hot conditions.

“It’s harder for you to pay attention. It’s harder for you to focus. You get tired more easily,” Behrer said. “All of those things feed through to reductions in productivity.”

  1. Workplace injuries

More than wages can be at risk.

“Because you’re paying less attention to what you’re doing or you’re more tired, you’re much more likely to injure yourself,” Behrer said.

On very hot days, workers are about 10% more likely to be injured on the job than on a cool day, Behrer and colleagues found in a study.

That could mean lost wages for the day, or it could be more serious. “If you get hurt on the job, that can be a permanent change in your life,” Behrer said.

  1. Poverty traps

Poorer areas are more vulnerable to the impacts of rising temperatures than wealthier areas, researchers have found. Workers tend to be in industries that are more exposed to heat. And poor people often can’t afford air conditioning. These inequalities are expected to worsen with global warming.

High temperatures also lower crop yields, which lower household incomes in largely agrarian economies such as those of South Asia.

The effects can be passed on to children in these rural households. Garg and colleagues found that students score lower on math and reading tests the year after a hot year, perhaps because their families had less money to spend on education, or even on food or health.

 

Adaptation

Societies can adapt to hotter temperatures. Factories, for example, can buy air conditioning.

But that’s money they won’t spend on better equipment or hiring more workers, Garg noted.

“Adaptation is not free. It’s expensive. It’s costly,” he said. “And in general we find that the poorer you are, the more expensive it is.”

Social safety net programs can help. Garg and colleagues, for example, conducted a study focused on a safety net program in India that supplemented income in rural areas. Since heat waves did not affect farm households’ budgets as much, the effect of heat on students’ test scores was smaller.

With heat waves becoming more common, demand for safety-net programs is growing.

“Countries are already paying for climate change,” Garg said, “because the demand on social protection is rapidly increasing as we get more and more hot days.”

“When we think about climate investments, [typically] we’re thinking about seawalls and green energy. And all of that’s quite important. But … safety net [programs] are going to play a huge role for low- and middle-income populations,” he said.

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Pfizer to Offer Low-Cost Medicines, Vaccines to Poor Nations 

Pfizer said Wednesday that it will provide nearly two dozen products, including its top-selling COVID-19 vaccine and treatment, at not-for-profit prices in some of the world’s poorest countries.

The drugmaker announced the program at the World Economic Forum’s annual gathering in Davos, Switzerland, and said it was aimed at improving health equity in 45 lower-income countries. Most of the countries are in Africa, but the list also includes Haiti, Syria, Cambodia and North Korea.

The products, which are widely available in the U.S. and the European Union, include 23 medicines and vaccines that treat infectious diseases, some cancers and rare and inflammatory conditions. Company spokeswoman Pam Eisele said only a small number of the medicines and vaccines are currently available in the 45 countries.

New York-based Pfizer will charge only manufacturing costs and “minimal” distribution expenses, Eisele said. It will comply with any sanctions and all other applicable laws.

The drugmaker also plans to provide help with public education, training for health care providers and drug supply management.

“What we discovered through the pandemic was that supply was not enough to resolve the issues that these countries are having,” Pfizer Chairman and CEO Albert Bourla said Wednesday during a talk at Davos.

He noted that billions of doses of the company’s COVID-19 vaccine, Comirnaty, have been offered for free to low-income countries, mainly through the U.S. government, but those doses can’t be used right now.

Earlier this month, the head of the World Health Organization called on Pfizer to make its COVID-19 treatment more widely available in poorer countries.

Comirnaty brought in nearly $37 billion in sales last year, and analysts expect the company’s COVID-19 treatment Paxlovid to add almost $24 billion this year, according to the data firm FactSet.

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Six Ways Climate Change Is Making Poor People Poorer 

Heat waves like the ones roasting South Asia this year don’t just sap people’s strength. They drain people’s finances in ways that are not always obvious.

It’s one of the ways climate change is weighing on the economy and making poor people poorer.

“These effects are global, they are pronounced, and they are persistent,” said Teevrat Garg, an economist at the University of California-San Diego’s School of Global Policy and Strategy.

South Asia is especially vulnerable to the impacts of climate change-driven heat waves. But temperature extremes are becoming more common worldwide as the planet warms.

  1. Too hot to work

March and April were the hottest or near-hottest months on record across South Asia.

Climate change made this heat wave about 100 times more likely, according to the U.K. Met Office.

The heat has been brutal for farmers, construction workers and anyone who has to work outside. That’s about half the workforce in South Asia.

“Wage laborers like us work despite the heat,” Indian construction worker Kushilal Mandal told Agence France-Presse in April. “We won’t be able to eat if we don’t work.”

At these temperatures, heatstroke and even death are real risks.

Many work sites shut down early. But that means lost wages.

The U.N. International Labor Organization says that in 2030, hours lost to heat worldwide will be the equivalent of losing at least 80 million full-time jobs.

  1. Lower earnings for outdoor work

It doesn’t take a full work stoppage to hurt workers’ wages. People just can’t do as much when it’s hot.

In a study Garg co-authored, workers in Indonesia in a hot, sunny environment were 8% less productive than those in a shady environment that was about 3 degrees cooler. Doubling wages did not increase productivity.

“It’s not about workers feeling icky or lazy or just like, ‘I don’t want to work because it’s hot,’ ” Garg said. “It’s that heat is representing binding constraints on workers’ ability to do their job.”

  1. Factory slowdowns

Heat affects workers even if they are not exerting themselves. High temperatures slow down factory workers, too.

“We think of manufacturing as a thing that occurs inside. But inside doesn’t mean protected from heat. It doesn’t mean air conditioning,” said World Bank economist Patrick Behrer.

Studies as far back as 1915 show factory workers paid by the piece earn less at higher temperatures. Even call center workers get less done in hot conditions.

“It’s harder for you to pay attention. It’s harder for you to focus. You get tired more easily,” Behrer said. “All of those things feed through to reductions in productivity.”

  1. Workplace injuries

More than wages can be at risk.

“Because you’re paying less attention to what you’re doing or you’re more tired, you’re much more likely to injure yourself,” Behrer said.

On very hot days, workers are about 10% more likely to be injured on the job than on a cool day, Behrer and colleagues found in a study.

That could mean lost wages for the day, or it could be more serious. “If you get hurt on the job, that can be a permanent change in your life,” Behrer said.

  1. Poverty traps

Poorer areas are more vulnerable to the impacts of rising temperatures than wealthier areas, researchers have found. Workers tend to be in industries that are more exposed to heat. And poor people often can’t afford air conditioning. These inequalities are expected to worsen with global warming.

High temperatures also lower crop yields, which lower household incomes in largely agrarian economies such as those of South Asia.

The effects can be passed on to children in these rural households. Garg and colleagues found that students score lower on math and reading tests the year after a hot year, perhaps because their families had less money to spend on education, or even on food or health.

 

Adaptation

Societies can adapt to hotter temperatures. Factories, for example, can buy air conditioning.

But that’s money they won’t spend on better equipment or hiring more workers, Garg noted.

“Adaptation is not free. It’s expensive. It’s costly,” he said. “And in general we find that the poorer you are, the more expensive it is.”

Social safety net programs can help. Garg and colleagues, for example, conducted a study focused on a safety net program in India that supplemented income in rural areas. Since heat waves did not affect farm households’ budgets as much, the effect of heat on students’ test scores was smaller.

With heat waves becoming more common, demand for safety-net programs is growing.

“Countries are already paying for climate change,” Garg said, “because the demand on social protection is rapidly increasing as we get more and more hot days.”

“When we think about climate investments, [typically] we’re thinking about seawalls and green energy. And all of that’s quite important. But … safety net [programs] are going to play a huge role for low- and middle-income populations,” he said.

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Climate-Driven Heat Waves Increasing Inequality

March and April were the hottest or near-hottest months on record across South Asia. And climate change made this heat wave 100 times more likely, the U.K. Met Office says. Heat waves like these don’t just sap people’s strength; they drain people’s finances in not always obvious ways —just another example of how climate change is weighing on the economy and making poor people poorer. VOA’s Steve Baragona has more.

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Tedros Re-Elected as Head of World Health Organization

The World Health Organization’s (WHO) members re-elected Tedros Adhanom Ghebreyesus as director general by a strong majority for another five years, the president of the World Health Assembly said on Tuesday.

The vote by secret ballot, announced by Ahmed Robleh Abdilleh from Djibouti at a major annual meeting, was seen as a formality since Tedros was the only candidate running.

Ministers and delegates took turns to shake hands and hug Tedros, a former health minister from Ethiopia, who has steered the U.N. agency through a turbulent period dominated by the COVID-19 pandemic. The president had to use a gavel several times to interrupt the applause.

German Health Minister Karl Lauterbach tweeted on Tuesday: “Just re-elected as Director General of #WHO: @DrTedros. 155/160 votes, spectacular result. Congratulations, fully deserved.”

Germany recently overtook the United States as the U.N. health agency’s top donor.

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Malawi Rolls Out Cholera Vaccine to Contain Outbreak

Malawi has rolled out a vaccination campaign to help stop an outbreak of cholera.  Authorities report more than 350 cases and 17 deaths from cholera across eight districts of southern Malawi.

Malawi’s Ministry of Health declared the cholera outbreak in early March after the first case was confirmed in the Machinga district in southern Malawi.

The disease has so far spread to eight districts including Nsanje, Chikwawa and Blantyre.

In its latest report on Monday, the ministry said the country had recorded 367 cholera cases in all with 17 deaths and 19 hospital admissions.

Dr. Gertrude Chapotera represented the World Health Organization at the launch of the vaccination campaign Monday in Blantyre.

She said the campaign is running with support from various global partners, including the Gavi Vaccine Alliance and the Global Task for Cholera Control.

“We are supporting the Ministry of Health with up to 3.9 million doses that will be administered in two rounds,” she said. “So this actually is the beginning of the first round with the campaign starting from today the 23rd of May running up Friday this week the 27th of May.”

Cholera is an acute diarrheal infection caused by ingesting food or water contaminated with bacteria. The disease affects both children and adults and, if untreated, can kill within hours.

Dr. Gift Kawalazila is director of Health and Social Services in Blantyre.  He says the district has so far seen nearly 100 cases of cholera, with five deaths but only three hospital admissions as of Monday.

“This means that cholera is a disease that can easily be reversed and we have treatment options with us,” said Kawalazila. “So, the general message to the general population is that they should quickly present themselves to our health workers in our different health facilities whenever they notice the signs and symptoms of cholera which is profuse diarrhea and vomiting in some cases.”

Health authorities say many people are turning up for vaccination, with some districts running short of the doses.

Alinafe Longwe is among those who received the cholera vaccine in Blantyre.  Longwe says she did not get the COVID-19 vaccine, citing fears of blood clotting and other health issues.  

“But with this one, I haven’t heard any issues, so I am okay with it and I have received it and I am fine,” said Longwe.

Meanwhile, the Ministry of Health says it has intensified public education preventing cholera infections. These include the use of clean water for domestic purposes and observing personal hygiene.

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