Whenever rain clouds gather over her village, Ntombenhle Ndlovu finds herself checking the weather forecast again and again, bracing for what might come next. When the rain finally starts, she steps outside to feel the first droplets on her skin, measuring their intensity before she can breathe a little easier.
“It has become a natural instinct. If I don’t do this, I get very anxious until the rain stops.”
The mother of two and community activist from Embo, a village south-east of Durban, was not always afraid of the rain. For most of her life, rainfall meant relief from heat and the revival of her garden.
This changed four years ago, in April of 2022, when catastrophic floods tore through parts of KwaZulu-Natal, destroying homes, displacing thousands of families and claiming 443 lives, with several people still unaccounted for.
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More than 500mm of rain fell in just two days, and scientists later confirmed that the deadliest flood in South Africa’s history was not just a natural disaster. Climate change played a major role in intensifying the storm.
Climate change
The World Health Organisation (WHO) says climate change – described as the long-term changes in temperatures driven largely by human activities such as burning fossil fuels that create a layer that traps heat in the atmosphere and disrupts weather patterns – is expected to cause an additional 250 000 deaths per year between 2030 and 2050 from heat-related illnesses alone.
Developing countries with weak health systems and poor infrastructure, including South Africa, are likely to be hardest hit if urgent action is not taken.
In the latest floods to hit the country, 19 people in Mpumalanga and Limpopo have died since December as heavy rains continue to batter the two provinces, as well as neighbouring Mozambique where almost 100 people have died.
The head of the National Disaster Management Centre, Bongani Sithole, confirmed that 14 deaths were recorded in Mpumalanga and five in Limpopo. In an advisory the South African National Parks (SANParks) said some roads and gates in Kruger National Park had been closed.
The mental load of climate change
New research suggests that the unease Ndlovu and her family feel about changing weather is not unique to their household. It’s a widespread experience, affecting communities across the world as weather patterns become more unpredictable. A scoping review in the January issue of Social Science & Medicine journal shows that climate change events such as floods, heatwaves and droughts are increasingly linked to stress, anxiety and depression.
While both women and men experienced mental health effects, their experiences differed.
Women were at a greater risk of mental health challenges due to caregiving roles, and family responsibilities, such as collecting food and water. Men, on the other hand, experienced economic stress. The social expectations to provide for families intensified feelings of failure and distress, increasing suicide risk.
Another study shows that climate change worsens gender inequalities, putting female-headed households and young girls at greater risk of displacement. This increases exposure to gender-based violence, poor living conditions, disrupted access to reproductive health services, and higher rates of unplanned pregnancies.
Ndlovu can relate to the challenges faced by the women in the study.
When the April 2022 floods struck, she had just returned home with her two-month-old premature baby.
After days of heavy rainfall, images and messages began flooding her phone, showing mudslides, homes swept away, damaged bridges and stranded neighbours. With one hand holding her baby and the other on her phone, she quickly sprang into action.
“The scene was devastating, and that’s when I realised my problems were small compared to others. A neighbour came to my gate and told me they had found a terribly injured man down the ravine, and had taken him to her house,” she recalls. “When I went into the room where the man was, he was groaning and looked exhausted. He had been washed down the ravine from his bed and smashed into a tree. I was horrified.”
Climate-related distress
Ndlovu’s account is part of a digital story recorded for the WEMA (Weather Events and Mental Health Analysis) project, which examines the often-overlooked mental health impacts of climate change in Africa.
The community-led research, currently being done by various research institutions in Burkina Faso, Kenya, Mozambique and South Africa, brings together science, policy and digital storytelling to shed light on the lived experiences of those at the frontlines of climate-related distress.
It is based on real-life experiences of trauma, stress, anxiety and resilience among communities facing climate disasters.
Consistently facing high levels of stress can trigger an overproduction of stress hormones such as cortisol, which disrupts bodily processes such as increasing the heart rate and raising blood pressure, which are risk factors for hypertension, heart attacks, and strokes.
But Collins Iwuji, faculty member at the Africa Health Research Institute (AHRI) and principal investigator of the WEMA project, warns that beyond physical health, climate-related stressors expose women to heightened risks of intimate partner violence, deepened poverty, and disrupt education, “factors that can limit future opportunities and perpetuate a cycle of inequality”.
Iwuji, who is also a Professor of Global Health and HIV Medicine at the University of Sussex, says women’s growing vulnerability to climate impacts – including a higher risk of interrupting HIV treatment during droughts – shows that countries such as South Africa need to adopt a stronger, gender-responsive approach to climate policy. He emphasises that women, particularly those living in rural areas, must be included in climate planning and given access to land, credit, safe spaces and mental health support.
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“Because women in rural areas tend to rely more on natural resources such as subsistence farming, they are especially vulnerable to droughts and floods. They also have fewer financial buffers than those in cities. Girls are often pulled out of school to fetch water and help at home, disrupting their education and locking families into cycles of poverty,” says Iwuji.
“That is why it’s so important to have policies that provide women with livelihood support, and have leadership programmes that enable them to support one another during times of crisis. Not only does this empower and protect them from violence, but the whole community becomes resilient to climate-related shocks. When women are empowered, communities are empowered.”
For Ndlovu, the impact of April 2022 did not end when the floodwaters receded, a reminder of how climate disasters can leave invisible scars.
“As a community activist, being able to help my own community during a time of need was therapeutic and gave me a sense of calm,” she says. “But I worry about the long-term impact on the children. Their clinginess and need for comfort whenever it rains show that they are still carrying trauma. The storm may be over, but its effects are still with us.” – Health-e News