Three years ago, Zibuyile Ntuli’s life turned upside down. In April 2022 she lost her home and six of her immediate family in one fell swoop when KwaZulu-Natal experienced some of the worst flooding on record. Close to 500 people lost their lives, over 4000 homes were destroyed, and 40 000 people were left homeless.
Only one body from Ntuli’s family was recovered and buried. The rest remain unaccounted for.
“The pain is unbearable,” she tells Health-e News. “I almost collapsed when police told me earlier this year that they were officially closing the case, meaning they would stop searching for the missing.”
Among those missing is her 11-year-old daughter, Luyanda.
“I asked myself, does this mean I’ll never bury my child? I couldn’t accept it. I refused to sign the documents agreeing to close the case. I cried endlessly,” Ntuli recalls tearfully.
Recognising her distress, the detective handling Ntuli’s case referred her back to a social worker for counselling at the Open Door Crisis Care Centre, a non-profit organisation based in Pinetown.
Ntuli had received counselling from the organisation for eight months, but the police officer believed she needed additional support. The counselling stopped in June this year, but her healing is far from complete. She continues to suffer from recurring nightmares and lives with the daily reminder of her loss.
Clinical psychologist Anele Siswana provided mental health support to survivors of the June 2025 floods in the Eastern Cape. He explains how the floods have deeply disrupted people’s sense of safety and belonging.
“Many survivors speak of profound loss – not only of loved ones, homes, and livelihoods, but also of a predictable world,” says Siswana. “This often triggers anxiety, hyper-vigilance, grief, and existential questioning. For many, there are invisible wounds, such as the trauma of witnessing destruction while feeling powerless to protect oneself or one’s family.”
Many mental health challenges arise after floods, affecting people’s lifestyles and overall well-being.
“I have seen survivors of floods and disasters present with sleeplessness, flashbacks, and guilt for surviving when others did not, along with heightened irritability,” he says.
No adequate counselling
Ntuli is among the very few who were fortunate enough to receive counselling. Many people who survive extreme weather events don’t get any mental health support.
“This is primarily because psychosocial support in South Africa’s disaster response efforts is often limited, with emergency relief focusing mainly on housing, food, and safety,” explains Dr Bonginkosi Mafuze, a psychiatrist.
Nozipho Cele* (45) from Lamontville, south of Durban, is still reeling from the floods that caused widespread destruction in the city in February this year.
“What I experienced, I wouldn’t wish on my worst enemy, because no one deserves to go through that. I lost everything I had worked so hard for. It’s frustrating to see everything you’ve built vanish before your eyes, and you have no power to save it,” she tells Health-e News.
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Whenever it rains, she panics, remembering the loss of her five-room house that she had just moved into.
“I received a house from the KZN Department of Human Settlements, but it had no furniture. The school transport promised for our children only lasted for two months. Thereafter we were told there was no money to pay for it. Our children were left stranded, and some couldn’t go to school,” says Cele.
Her son, who is in grade 11, is struggling to keep up. He failed the second and third terms. Cele believes that this is related to their housing situation and the stress of losing his three friends during the flooding.
Neither Cele nor her son has received mental health support.
Gendered survival
According to Siswana, natural disasters affect women, men, and children differently.
“Women often bear both visible and invisible burdens, caring for children and the elderly with limited resources, all of which can lead to exhaustion and feelings of hopelessness,” he explains.
Children, on the other hand, are highly sensitive to their environments during these times; they may mirror adult anxiety or otherwise retreat into their inner worlds.
“In contrast, men often internalise distress due to cultural expectations around masculinity, causing them to delay seeking help, leading to anger outbursts or physical complaints,” says Siswana.
“Often, depression develops as the reality of long-term displacement and financial strain sets in. Additionally, there is a quiet, unspoken loneliness, particularly among men, who may feel pressure to appear strong while emotionally crumbling inside,” he says.
Africa Zondi (69) from Othongathi in northern KZN lost his home to a tornado in June 2024 and has lived with the fear that disaster will strike again since.
“I can’t sleep properly; I constantly have nightmares and live with trauma, but I hide it with drinking alcohol excessively,” he says. “We all know that as the head of the family and a father, I have to be strong. But I don’t want to lie; I’m hurting inside. I’m worried about how I will fix my house.”
The tornado blew away part of the Zondi family home, damaging the roof and collapsing some walls, creating a dangerous living situation. Now Zondi and his wife live in an outside building constructed by Gift of the Givers.
Isaac Hlophe (65) understands the feeling that “as a man”, one needs to be tough and not show emotions. In the floods of April 2022, Hlophe lost part of his six-room house, including a section of the church built in his yard.
“I lost almost everything that day – furniture, building materials that were still packed outside, scaffolding. Even part of my yard was destroyed. I asked God why this was happening to me and our community. I questioned why He didn’t protect our houses that we have worked so hard to build,” he recalls.
“My mental state was not okay; I felt like I was losing myself. But as a father and a church leader, I had to remain strong for my family and the members of my church.”
Thirty-five homes in the area were destroyed. Hlophe says none of his community received professional counselling from a social worker or psychologist. Instead, he became a pillar for the community, as many people sought help and wanted to talk to him.
Planning for mental health
Extreme weather events such as floods and droughts are predicted to become more frequent and more severe. This means that people’s mental well-being can no longer be an afterthought.
“Mental health is often neglected or underfunded,” says Mafuze.
“NGOs, faith-based groups, and certain government departments, such as social development, provide valuable services. But the coverage is inconsistent. We need a stronger, more coordinated national response to address these issues.” – Health-e News.
*not her real name
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Sandile Mbili, Phili Mjoli and Anele Siswana are part of the Africa Health Communications Fellowship (AHCF), a programme by Fray College of Communication that encourages journalists and health experts to collaborate to enhance health reporting and public health messaging.
