By Starphel Sithole
Two years after devastating floods from Cyclone Freddy destroyed most of the infrastructure at Nkhulambe Health Centre in Phalombe District, signs of recovery are finally visible. A new maternity wing is now under construction, bringing renewed hope to communities that have struggled to access safe and dignified health services since the disaster.
When the cyclone struck in March 2023, about 75 percent of the facility was washed away by floodwaters and mud. Health services were forced to relocate to temporary tents at Nkhulambe Primary School, where recipients of care endured long queues, limited space, and lack of privacy.
Among the most affected services were HIV care and maternal health services, where privacy and proper infrastructure are critical.
But today, the sound of construction at the site of the health centre signals a turning point for the community.
Community Voices Spark Change
The rebuilding effort follows persistent monitoring and advocacy conducted under Community-Led Monitoring (CLM) initiative implemented by the Network of Journalists Living with HIV (JONEHA). Through community data collection, analysis and engagement with health authorities, the project documented challenges recipients of care faced and helped bring the situation to the attention of decision-makers.
Senior Medical Assistant at the facility, Dixy Khando, said the new maternity wing funded by Phalombe District Council will significantly improve maternal health services.
“For a long time we were operating from tents, which was very difficult for both health workers and recipients of care. Expectant women sometimes had to deliver in temporary shelters with very little space and privacy,” said Khando.
“The construction of this maternity wing is a big relief to the community. It means mothers will soon deliver in a safer and more dignifying environment.”
The role of Community-Led Monitoring
Community-Led Monitoring under JONEHA played a crucial role in documenting the realities at the facility soon after the disaster. Data collectors gathered feedback from recipients of care and health workers, highlighting issues such as lack of privacy for HIV services, limited space in tents, and challenges in providing maternal care.
According to Byton Matome, a CLM data collector representing JONEHA in the area, the advocacy generated through the monitoring process helped amplify community concerns.
“When we started collecting data, many recipients of care told us they feared coming to the facility because the tents did not offer privacy, especially for ART services,” Matope explained.
“We shared these findings with health authorities and partners. Seeing construction begin now shows that when community voices are heard; it can lead to real change.”
Restoring Privacy and Confidence in Health Services
For people living with HIV, privacy is essential for continued access to treatment. The temporary setup after the cyclone often forced recipients of care to wait outside the tents, raising fears of stigma and possible disclosure of their HIV status leading to treatment interruptions and spread of HIV
The rebuilding process is expected to address many of these challenges by restoring proper service spaces.
Khando said the facility’s long-term goal is to fully reconstruct the health centre so that all services including HIV treatment, outpatient care, and maternal health—can be delivered in appropriate buildings.
“Our vision is to rebuild the entire facility so that recipients of care can access services with dignity and confidentiality,” he said.
A Symbol of Resilience
While much still needs to be done, the new maternity wing represents an important milestone in the recovery of Nkhulambe Health Centre.
For community members who endured months of accessing health services in temporary tents, the construction symbolizes resilience, partnership, and the power of community engagement.
For JONEHA and the CLM initiative, the development demonstrates how community-generated evidence can influence decisions and improve health services.
“As communities, we felt heard,” said Matope. “This maternity wing is proof that when communities speak through evidence, change is possible.”
As rebuilding continues, the people of Nkhulambe look forward to a future where health services are not only available but delivered with dignity, privacy, and confidentiality.
