At 10am on a Saturday the normally busy Mbenje Health Centre is flooded. Chairs for waiting patients sit in water. The facility, in the Nsanje district, at the southernmost tip of Malawi’s southern region, bordering Mozambique, has been inundated regularly this rainy season.
“The floods are bad news for me. I have to walk over an hour to the next facility to collect my Antiretroviral (ARV) drugs refill,” says Elizabeth Sosono, who has received treatment from this facility since 2016. The current floods are caused by cyclone Jude which has hit Malawi’s southern region, closing schools and other services.
In the last decade, Malawi has suffered severe effects of climate change including cyclones Idai, Gombe and Freddy, originating from the Indian Ocean, to the east of Malawi and Mozambique, according to the Malawi Meteorological Services department.
When Mbenje health centre closes, Sosono says, it takes a minimum of two weeks for operations to resume, “This puts my life at risk. I’m supposed to take ARVs for life.”
The flooding devastation extends to the houses of the facility’s employees.
Edward Malinki, the health centre’s head, has witnessed four flooding episodes, resulting in four closures since the beginning of the last rainy season, which runs from November to March.
The health facility serves a more than 32,000 people, and offers outpatient, antenatal, maternity, under five, nutrition and family planning services.
“We have to suspend all these services to protect the patients from further infections as sanitation is highly compromised,” Malinki says.
Africa’s vulnerability
The health system’s vulnerability to climate change effects is not unique to Malawi. World Health Organisation (WHO) acknowledges that climate change is increasingly affecting many facilities globally.
Middle- and low-income countries need to assess climate change issues and vulnerabilities on health care facilities, according to WHO guidance.
Malawi and other African countries are facing severe effects of climate change due to their geographical location, more prone to extreme weather events. Malawi is listed as one of the five countries most affected by climate change in the 2021 Global Climate Risk Index, but produces less than 0.01% of the world’s emissions.
Malawi’s chief forestry officer, Babra Ntapara, notes that Africa’s limited economic resources, inadequate infrastructure, and high dependence on rain-fed agriculture exacerbate the continent’s vulnerability to climate change impacts.
Ntapara observes that climate change effects leading to flooding at places like Mbenje health centre compromises access to healthcare, especially for vulnerable populations like pregnant women, children, and the elderly.
“This can lead to higher morbidity and mortality rates, exacerbating existing health challenges, disruption of healthcare services, and the increase in water-borne diseases, malnutrition, and mental health issues,” she says.
In Kenya, climate change has led to an increase in vector diseases which puts additional pressure on healthcare facilities, leading to disease burdens that never existed due to the prolonged drought that led to scarcity of essential resources such as water.
“We are experiencing strange vector dynamics we never saw before, where mosquito and tick-borne diseases are expanding and increasing in areas where they did not exist,” observes Joseph Kamau, Head of One Health Centre, Kenya Institute of Primate Research, State Department of Public Health within the Ministry of Health.
Malaria, leishmaniasis, Rift Valley fever, and tick and rodent-borne diseases are the most common, leading to premature morbidity and mortality rates in Africa, according to National Centre for Biotechnology Information.
“African health systems need to accept that they will continue to experience climate change effects and therefore should increase funding allocation towards health care infrastructure to remain resilient,” Kamau says, noting that strengthening health care systems through increased funding would have more benefits, “The poorer you are, the more vulnerable you are to climate change effects.”
