Cyclone Freddy hit the southern region of Malawi on 12 March 2023, with heavy rains and strong winds causing damage to infrastructure such as roads, buildings and electricity lines. The districts of Blantyre, Chikwawa, Chiradzulu, Mulanje, Mwanza, Neno, Nsanje, Thyolo, Phalombe and Zomba have been most affected by the devastation and Malawi’s president has declared a state of disaster.

“The situation is very dire. There are many casualties, either wounded, missing or dead, and the numbers will only increase in the coming days,” says Guilherme Botelho, Médecins Sans Frontières (MSF) emergency project coordinator in Blantyre. 

“The Queen Elizabeth Central Hospital in Blantyre is overwhelmed with the influx of casualties coming from different areas, so we have put together a team of nurses and clinical officers to provide medical and logistic support. We are also donating medical supplies and will assess if food needs to be provided to patients,” says Botelho. 

According to official numbers, Blantyre district has recorded the highest number of deaths in the country since the cyclone hit. Queen Elizabeth Central Hospital alone has reported 220 casualties, of which 42 adults and 43 children were pronounced dead on arrival.

“We have redirected some of our staff from our regular project for cervical cancer to assist our emergency team at the Queen Elizabeth Central Hospital,” says Marion Pechayre, MSF head of mission in Malawi.

“We have also suspended outreach activities to protect our staff from any risks linked to flash floods and landslides during movements or building collapsing,” says Pechayre.

The threat of a resurgence of cholera also remains a serious concern as Malawi recently suffered the biggest outbreak the country has seen in its history after tropical storm Ana hit last year. 

“We have moved the cholera treatment centres close by to the hospital to ensure the safety of the patients,” says Botelho. “The rain hasn’t stopped yet and there is a lot of damage, which really worries us on many levels. 

“Indeed, another rise in cholera cases is one of our concerns in the aftermath of this storm, especially since the vaccine coverage in Blantyre is very poor.” 

MSF emergency teams will continue to assess the situation and needs of people and health facilities in the most affected southern districts of Malawi in the coming days to provide support, including treatment and access to clean water and sanitation.