Malawi has been hit by its worst-ever cholera epidemic, killing more than 1,000 people so far this year. The Ministry of Health says that people are more vulnerable than usual due to malnutrition and food shortages. Hundreds of people died of hunger earlier this year and food aid is urgently needed for an estimated three million people - more than one quarter of the population - aid agencies warn. Aids is also rife in Malawi, meaning many people are less able to fight off both diseases such as cholera and hunger.  The high number of deaths was a "major anomaly", Habib Somanje, controller of preventive health services told the French news agency, AFP.

Poor sanitation

In normal years, around 0.2% of the adult population gets cholera, but in 2002, this has risen to 1% and 33,000 were infected. Last year, just 2,000 cholera cases were recorded. Poor sanitation exacerbates the spread of cholera. Only 65.6% of Malawians have access to clean water, while only 81.4% of households have a toilet or latrine, according to official figures quoted by AFP. More than half of rural inhabitants obtain drinking water from unsafe sources, while 50% of illnesses in the country are water-borne diseases reports a study by the United Nations Children's Agency, UNICEF.  Up to 20% of adult Malawians are HIV positive. This has reduced average life expectancy from more than 60 years, to less than 40.