Gender shaped health harms after Cyclone Freddy, with women reporting worse reproductive care disruptions and violence

Interviews in southern Malawi found uneven disaster health impacts, and aid that often arrived late or without gender-sensitive planning.

This qualitative study found that Cyclone Freddy’s health impacts in Malawi were sharply gendered. Women reported disrupted reproductive and maternal health care, menstrual hygiene barriers, and exposure to gender-based violence, alongside delayed mental health support. Men emphasized livelihood loss and related psychological distress tied to provider roles.

Quick summary

What the study found: Women and girls described major gaps in reproductive care, menstrual hygiene, protection, and mental health support; men more often centered housing and livelihood loss and the strain of expected provider roles.
Why it matters: “Gender-neutral” disaster responses can miss predictable needs, worsening preventable harms and distress during displacement and recovery.
What to be careful about: This was a cross-sectional qualitative study based on interviews; it maps experiences and perceived gaps, not population-wide rates or causal effects.

What was found

In Living through Cyclone Freddy: “Gendered Health Impacts and Coping Responses in Malawi”, survivors and responders described a response that often failed to anticipate gendered needs. The journal article drew on interviews conducted in 2024 in an urban and a rural district.

Women described displacement as both physical danger and family separation, then an added load of caregiving for injured relatives. Men also described injury and fear, but more often highlighted the loss of homes, tools, and economic identity.

What it means

Health risk did not land evenly because people did not enter the disaster with equal roles, safety, or access to resources. Women reported loss of reproductive health services, including maternal care, family planning, and safe delivery support.

Women and girls also reported severe disruption to menstrual hygiene management. This included shortages of pads and underwear, lack of privacy, and difficulty washing and drying cloth substitutes.

Gender-based violence was reported, including sexual exploitation and coercion linked to scarcity and power imbalances in camps. Transactional sex was described as a survival strategy in the context of systemic aid failures, not free choice.

Where it fits

The themes reflect a well-established pattern in disaster psychology: stressors are both acute (injury, displacement) and chronic (resource loss, unsafe environments), and they compound over time. When services are delayed, people rely on informal supports that may be inconsistent.

Mental health effects described in the study included ongoing fear and anxiety, and persistent distress in children during rainy seasons. One account described hallucinations after the cyclone; hallucinations are perceptions that feel real but occur without an external stimulus.

How to use it

For responders, the practical takeaway is to plan for gender-specific health and protection needs from day one. This includes maternal health pathways, staffing that improves access to reproductive care, and clear protection mechanisms in camps.

Water, sanitation, and hygiene should be treated as a safety intervention, not just an infrastructure task. Separate, private sanitation facilities and reliable water access reduce health risks and can lower exposure to harassment and violence.

For mental health, early structured psychosocial support matters. Psychosocial support combines practical assistance with emotional support, often delivered through trained helpers, referral systems, and predictable access points.

Limits & what we still don’t know

The study was qualitative and cross-sectional, capturing experiences and perceptions at one period after the cyclone. It cannot tell us how common each experience was across all affected communities, or whether specific interventions directly reduced harm.

Some aid efforts were described as gender-responsive, including dignity kits and women-only sanitation blocks, but implementation was inconsistent. The excerpts do not specify which components worked best, for whom, and under what constraints.

Closing takeaway

Cyclone Freddy’s aftermath shows how gender roles shape exposure, needs, and recovery pathways. When humanitarian systems treat disasters as gender-neutral, predictable gaps open in reproductive care, sanitation privacy, protection, and mental health support. Preparedness that builds these needs into core planning is a direct health intervention, not an optional add-on.

Data in this article is provided by PLOS.

Tagged Africa, Atmospheric science, Behavioral and social aspects of health, Environmental health, Epidemiology, Geographical locations, Health care, Hygiene, Malawi, Maternal health, Medical risk factors, Mental health and psychiatry, Meteorology, Natural disasters, Public and occupational health, Sanitation, Tornadoes, Wind, Women's health