In most rural areas of Mangochi, a child born with cerebral palsy (CP) is still seen as a curse. For some extreme cases, the child is hidden indoors, denied school attendance opportunities and friends and, more often than not, the mother is blamed for the child’s condition.
The result is a cycle of isolation that is breaking marriages and breaking the lives of innocent women, who might have had no control over the condition of their babies.
Recent research paints a stark picture.
According to a 2024 study published from the Malawi Cerebral Palsy Register, CP prevalence in rural Malawi is estimated at 1.7 per 1,000 children.
The study, which screened 911 children and registered 538, found that 90.5 percent had severe motor impairment, with bilateral spastic CP being the most common type at 46.3 percent.
Globally, prevalence ranges from 1.5 to 4 per 1,000 but, in low-resource settings like Malawi, rates can rise to 10 per 1,000 according to the study.
Preventable causes drive the condition in Malawi. Perinatal asphyxia brain damage due to lack of oxygen during birth accounts for 40.5 percent of cases, followed by cerebral malaria at 12.3 percent.
Prolonged or obstructed labour was reported in 42.7 percent of cases.
However, behind each statistic is a mother left to carry the burden alone.
In Mtanga Village, 28-year-old Shakira Malamba sits on a plastic chair with her 10-year-old daughter beside her on a wheelchair, unable to sit without support.
She explained that her husband left her a few months after the child was born.
“He told me that I could not give birth to a normal child again and that there was no reason for the marriage to continue. He left me alone. Every day, I have to find piecework to feed us and still carry my daughter on my back,” Malamba narrates, tears filling her eyes.
In some cases, Malamba said she left the girl alone in closed doors and went for casual work to find food to feed the household, which had two other children.
At 10, her daughter has never been to primary school, or even nursery school. There is no special needs teacher in any of the schools around Jalasi.
“I fear that my child will never achieve her dreams. She wants to learn like other children, but the schools do not want her.
“In the schools I have gone to, they told me that if I wanted the child to be enrolled, I had to be available every day to offer support when the child is at school. And I cannot do that because I also have to work to earn a living,” she says.
A few villages away, in Msomba Village, 22-year-old Saudiya Majidu faces a different nightmare. To go to the market or the garden, she must leave her child locked alone in the house.
“Neighbours and even some relatives are not willing to associate with my child. They say we are cursed. I have no one to leave her with, so I leave her alone and I am always worried,” Majidu says.
The stories are not isolated.
Out of 20 women spoken to in Namwera, 16 were single mothers. Their husbands ended their marriages immediately after the birth of a child with CP, convinced that the mother or her family had brought a curse.
Health experts say this stigma is fuelled by lack of information and lack of services.
Malawi Cerebral Palsy Register Team Lead Thembi Katangwe Chirwa says most CP cases in the country are preventable, yet support systems remain critically weak.
“42 percent of CP cases in Malawi happen due to brain damage that occurs during delivery. Another major cause is cerebral malaria. These are preventable if we have good maternal and newborn care [facilities],” Chirwa says.
She adds that even after the child is born with CP, the system fails them.
“Only 10 percent of children with CP have assistive walking devices suitable for them. This means 90 percent are left immobile, locked in houses. We must make education inclusive, improve access to health care for CP children and provide support to all children regardless of disability,” she says.
She says the Malawi Cerebral Palsy Register is working in four districts of Mulanje, Mangochi, Blantyre and Zomba. The idea is to identify and offer adequate support to children with CP.
“So far, we have managed to provide 160 assistive walking devices in Mulanje and we will also provide some in Mangochi, Zomba and Blantyre. The idea is, we want to reach all the children if resources permit,” she says.
At Mangochi District Hospital, Health Research Coordinator Hope Kumwenda admits that CP is becoming a growing but silent crisis.
“CP is becoming a challenge for Mangochi due to late detection of cases. Children are brought to us when complications have already worsened. We need improved training for health workers and awareness among parents on how to quickly detect CP for early referral,” Kumwenda says.
For now, Malamba can count herself lucky to have received a wheelchair for her daughter, but a lot of mothers with CP children are still waiting to get a wheelchair so that their children can walk; they are waiting for a special needs teacher so that their child can go to school; they are waiting for a husband who will return, and for a community that will stop seeing their child as a curse and start seeing a child.