Living through a disaster like a flood led to mental health issues in about a quarter of people, found a recent study across four African countries. But the psychological fallout is often not recognised as a health problem. Here’s what data from a study in four African countries show – and why it’s important for decision-makers, write Bhekisisa’s Linda Pretorius and Karen Harkema.
In 2024, roughly four in every 10 disasters were because of water overflowing land that is normally dry.
But keeping your head above water when a flood hits is about more than just staying safe in the moment; it’s also about not drowning in feelings of despair, fear or impending dread afterwards.
Studies show that living through a flood can leave psychological scars that last for years, especially if people are poor or have little social support.
Yet the mental health effects of natural disasters such as floods are mostly unknown in Africa, despite half of the continent’s 54 countries having had extreme rainfall in 2024.
Climate models show that extreme rainfall will likely hit more often as the earth’s air keeps on warming. (In 2025, the global air temperature was about 1.4°C higher than what it was 150 years ago, before we people started burning lots of fossil fuels.) Combine this threat with poor infrastructure like roads, housing, sanitation and healthcare, and limited ability to rebuild when disaster does hit, it’s like a perfect storm brewing – with people’s mental well-being as the collateral damage.
This is why a new study looked into how floods affect people’s mental well-being in four countries in Africa – Burkina Faso, Kenya, Mozambique and South Africa.
The results are striking: across the four study sites combined, floods led to mental health issues in about a quarter of people who took part in the study. In other words: if the flood had not happened, 25% fewer people would have had mental health problems.
What do the results mean for countries where public health systems are already under pressure and communities have little means to bounce back after a disaster, especially when extreme weather is no longer a rare event?
A snapshot of a continent
The research team worked in four countries across West, East and Southern Africa to study the link between flooding and mental well-being. “We also looked at both shared patterns and differences, said AHRI (Africa Health Research Institute) epidemiologist Prof Collins Iwuji, the project’s lead researcher. “Although our findings do not represent Africa as a whole, they broaden the evidence on flooding and mental health across these regions.”
The study included 5 336 participants, with a sample of between about 1 000 and 1 600 in each country, with at least as many people having experienced a flood as those who didn’t.
It sites spanned urban and rural areas and included a spread of household sizes and employment and education levels, giving a good mix of socio-economic conditions.
High waters, low feelings
Across the sample as a whole, signs of mental health problems were more common among people who had lived through a flood than among those who had not.
When looking at data from all four countries combined, one in 12 people who had been in a flood showed signs of serious anxiety, and one in eight had symptoms pointing to depression. One in five flood survivors’ mental state looked like that of someone with post-traumatic stress disorder, a condition in which you feel like you repeatedly relive a terrifying event in some way, often with severe anxiety to boot.
The same trend held in South Africa, but the proportion of flood survivors experiencing mental health problems was more than twice as high.
The findings show that extreme weather events like a flood add another layer of stress to people’s lives when they already live in poverty or without good social support. “When a disaster hits, people suffer because it adds to the hardship they’re facing every day,” said Vasco Cumbe, a psychiatry expert on the research team and based in the Sofala province where the Mozambican part of the study was done.
But people’s distress compounds, he added. In communities like the ones included in the study, a next storm often hits before people can fully recover from the previous one. When the ability to build back livelihoods and infrastructure like houses, roads and clinics is already poor, an additional shock can push people closer to developing mental health problems that mess with everyday life.
In the aftermath of a flood, people usually get help with basic needs like food, water and clothes, he said, but mental health issues are often not considered. Not paying attention to the effect of weather disasters on people’s mental state is “a gap”, not only in response but also in preparedness, he noted.
Fewer floods, better mental health
If people had not been exposed to a flood, 25% fewer people would have had mental health issues, the study shows. In South Africa, that portion was closer to a third.
Today, mental health disorders are the leading cause of disability, analyses show, even more so than heart disease or cancer. “People in this age group are just coming into their productive years,” said Iwuji, “so if mental health problems start at a young age and continue for the rest of their lives, you can imagine the economic impact that would have on the society.”
Yet the psychological fallout of a weather disaster is often overlooked in planning for emergency response, Cumbe said. “People think it’s not important to raise mental health issues [as a concern]. We shelter people, we give food, we give water. But we also need to pay attention to the psychological side.”
If we don’t, we run the risk of pushing yet another generation into poverty, instead of lifting them out of dire circumstances, Iwuji said. “Climate change is a threat multiplier.”
Bhekisisa – Without floods, a quarter fewer Africans in this study would have mental health problems
See more from MedicalBrief archives:
Human health already under climate change pressure
KZN floods: 318 autopsies, 80 healthcare facilities damaged, fears of disease
Environmental factors worsen neurologic health – US review of 30 years’ research
Fate of thousands unknown as rescuers struggle to reach Mozambique flood victims