In Chikwawa, the rainy season now arrives on the back of rising floodwaters. Rivers burst their banks, muddy water pours into homes and fields, and families scramble to higher ground as livelihoods are washed away in a matter of hours.
What were once occasional disasters have become a seasonal reality in the Lower Shire, turning survival into a yearly struggle against the advancing tide.
As floodwaters recede, they leave behind a quieter and more dangerous legacy stagnant pools of water scattered across fields, footpaths, and homesteads.
Some of these pools dry up within days. Others remain for weeks or permanently. For children, they become irresistible spaces to cool off after school, learn how to swim, or momentarily escape the heat and hardship surrounding them.
“I like playing in the pools after school,” says eight-year-old Chimwemwe. “It is fun and makes me happy, even if it is dirty.”
What looks like an innocent place for children to cool off is, in reality, a hidden danger. Researchers say these small pools are perfect homes for parasites that cause bilharzia and other life-threatening diseases. “These pools are breeding grounds for vectors that transmit malaria and bilharzia, posing a serious health threat to communities, especially children who frequently play in them,” said one of the researchers.
Bilharzia, also known as schistosomiasis, is a parasitic disease caused by worms that live in freshwater snails. People become infected when they come into contact with contaminated water where the snails release the parasite into the water.
The growing threat comes at a time when countries around the world are working to eliminate bilharzia as a public health problem by 2030. The global target, outlined in the World Health Organization’s 2021 2030 roadmap for neglected tropical diseases, prioritizes protecting children through mass drug administration, improved access to clean water, better sanitation, and snail control measures.
However, with only a few years remaining to meet the target, Malawi is facing serious setbacks.
Researchers from the Shire-VEC Project an initiative linked to the government’s Shire Valley Transformation Programme have found alarmingly high infection rates among school-going children in Chikwawa.
The study, implemented by the Malawi-Liverpool-Wellcome Research Programme in collaboration with other stakeholders, focuses on identifying snail breeding sites, understanding environmental conditions that support transmission, and studying human activities that increase exposure.
Eggrey Aisha Kambewa, one of the study’s lead researchers from the Malawi-Liverpool-Wellcome Research Programme, says many children are infected with both urogenital and intestinal bilharzia. At Mangulenje Primary School, infection rates have reached about 80 percent a situation she describes as deeply worrying.
“This is something that needs urgent attention,” said Kambewa. “According to national guidelines, Chikwawa is classified as a low-prevalence district, but these findings show high infection levels, indicating that the disease is firmly established in the area.”
Kambewa attributes the spread of the disease to changing rainfall patterns and the increasing frequency of cyclones in the Lower Shire and other parts of the country. She explains that flooding alters ecosystems by sweeping disease-carrying vectors from one area to another, creating new breeding sites closer to communities and significantly increasing the risk of infection.
Similar findings were reported in another study known as HUGS, conducted in Mangochi and Nsanje by the Malawi-Liverpool-Wellcome Research Programme. The study found that about 70 percent of people, including children living near water bodies such as lakes, rivers, and pools, were infected with bilharzia.
Speaking during the presentation of the findings in Lilongwe, Deputy Director at the Malawi-Liverpool-Wellcome Research Programme, Professor Janelisa Musaya, warned that the disease has developed hybrid genetic traits that affect the human reproductive system. She said the infection can cause symptoms similar to cancer and sexually transmitted infections in both young people and adults.
“The disappointing part is that children are also highly affected by the disease,” Musaya said.
Reacting to the findings, health expert Benjamin Chinoko said he was deeply alarmed, describing the situation as clear evidence of the destructive link between poverty, weak infrastructure, and climate change.
Chinoko stressed that bilharzia is not only a health issue but also a serious threat to children’s development, education, and long-term economic prospects.
He explained that the impact on children is particularly severe because their bodies are still developing and they are often repeatedly re-infected. Children commonly suffer from chronic abdominal pain, diarrhea, anemia caused by blood loss in urine or stool, malnutrition, and persistent fatigue. These conditions lead to poor school attendance and reduced cognitive performance.
“A generation growing up chronically infected will place a heavy burden on the health system for decades to come,” Chinoko warned.
To address the growing crisis, Chinoko has called on authorities to take immediate and coordinated action. He recommends scaling up mass drug administration programmes, particularly school-based campaigns to ensure children are reached efficiently. He also emphasizes the need for sustained investment in water, sanitation, and hygiene by constructing protected water sources and improved sanitation facilities to break the cycle of infection.
Environmental expert Robert Deuka Kacheche says the crisis illustrates how environmental changes linked to climate change are directly affecting human health.
According to Kacheche, bilharzia must now be treated as both an environmental and public health problem. He has urged authorities to adopt an integrated response that includes improving water management, drainage systems, and flood control measures alongside regular screening and treatment.
He also stressed the urgent need to provide communities in Chikwawa and Nsanje with safe water alternatives.
“Communities should be supported with safe water options so that children do not rely on stagnant water for bathing,” Kacheche said.
Child rights expert Amosi Chibwana has also called for widespread civic education on the dangers of bilharzia. He said parents and guardians must take full responsibility for protecting children from unsafe water bodies, noting that the Child Care and Protection Act places a legal obligation on caregivers to ensure the safety and well-being of children.
In the end, the bilharzia crisis in the Lower Shire exposes a deeper, interconnected challenge facing Malawi: climate change is no longer an abstract environmental issue, but a direct driver of disease, inequality, and lost human potential.
Floods that create stagnant pools may seem temporary, but their health consequences are long-lasting, especially for children whose bodies and futures are still forming.
In places like Chikwawa, climate change is no longer measured only in collapsed houses or ruined crops, but in weakened bodies, interrupted schooling, and futures slowly eroded by preventable disease.
Until safe water, strong health systems, and climate resilient infrastructure reach these communities, the muddy pools that follow each flood will continue to mirror a deeper national failure: the inability to protect the country’s youngest from a crisis they did nothing to create.