It is a traumatic period for many people in Malawi, especially those battered by the Cyclone Freddy.

Many have lost their lives, homes and livelihoods, which is psychologically demanding and physically draining.

How does the nation deal with this disaster?

Malawi is facing a unprecedented natural disaster more devastating than ever before.

There is no safe water supply for many and many people have no food, shelter, electricity and nowhere to go.

The country is on a high alert not only from the loss and damage, but also the infectious diseases that will follow.

By the third day of continuous rains, the flash floods and mudslides had washed away everything in their way, including sewage, into flooded homes and streams where people draw water for daily use.

Cyclones have happened in many countries and Malawi can learn from them to launch a successful response to Freddy’s effects.

The lessons include strategies to prevent a public health disaster, especially cholera and other diarrhoeal outbreaks fuelled by extreme flooding and mudslides.

Malawi needs mass casualty plans and deployment of essential personnel and resources to meet affected populations’ local healthcare needs.

The central command centre should coordinate the response activities, including the deployment of teams to provide emergency clinical care, technical support, health education and investigation of potential disease outbreaks.

There is also a need for teams to provide mental health support and relief workers to assist displaced persons.

It is important to identify risks factors in the affected communities, including sanitation, environmental, and community mental health gaps that require urgent measures to mitigate a further disaster.

Initiate health education programmes on personal hygiene, water and food safety, waste management, toilet construction, injury prevention and mental health.

While many are still in shock, proper guidance from the Ministry of Health, Department of Disaster Management and relevant partners is crucial to meet the survivors’ health and sanitation needs.

Lack of health and sanitation facilities will put not only endanger the affected population’s lives, but also everyone around them.

There is need to assess all the water points for the affected communities to establish if they are contaminated by toxic substances and germs, including bacteria that caused cholera.

Clear tips and instructions on how to manage drinking water sources will help avert diarrhoeal diseases.

The World Health Organisation provides a rapid assessment tool that can be used to collect information about hospitals’ capacity to handle the cases and anticipated gaps, including damaged buildings and communication, electricity, water and sewage systems; adequacy and condition of healthcare workers, medical supplies and morgue facilities.

Away from the infectious diseases’ angle, managing such a disaster requires coordination from various stakeholders in health, transport, communication, nongovernmental organisations and humanitarian support, among others.

Surveying affected communities’ needs can help identify relevant stakeholders to support the response.

There is a need to initiate public health surveillance in all the affected districts as information collected from affected individuals and case reports could be useful in preparing for future disasters.

Some illnesses reported after cyclones and water-related disasters include acute diarrhoea, wound infections, febrile illnesses and respiratory conditions. Health healthcare workers should be on the lookout for increased cases and monitor hotspots.

The country seriously has to think about preparedness because what we do before disaster strikes determines the cost we pay for loss and damage.

There were early warnings that a cyclone was approaching and we needed to do everything possible to reduce its impact.

Preparedness means calculating the risk, those at risk and how to manage the risks to prevent or reduce the damage. It also involves plan B.

We need to be proactive, not reactive, because there is a better and systematic response if one is well-prepared.

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