Carrying Life: Malawi photo series reveals the burden of pregnancy and childbirth without clean water

28 February 2023
Emilida Laison, 35, sitting in the kitchen area of the guardian shelter at Kangolwa health centre.
Image: WaterAid/ Laura El-Tantawy

Download photosWaterAid and the Wimbledon Foundation launch Carrying Life: Motherhood and Water in Malawi, a striking outdoor multimedia exhibition by award-winning British-Egyptian photographer, Laura El-Tantawy, open to the public until 14 April at More London near Tower Bridge.

The 22-piece collection of photography and moving imagery shines a light on the stories of mothers and babies in Malawi’s Ntchisi district, who were previously impacted by dirty water, poor sanitation and a lack of hygiene in health centres.  

Captured in El-Tantawy's distinctive and emotive style, these powerful photos highlight the hopes and fears of women waiting at their local ‘guardian shelter’ to give birth. Expectant mothers, and their family member or ‘guardian’, wait at these shelters in the hospital premises, before going into labour and moving to the wards. However, until WaterAid’s intervention, with support from the Wimbledon Foundation, many of these facilities lacked the clean water, decent toilets and good hygiene to give birth safely.

19-year-old Enala Etifala's reflection in a container of water. Enala lives near Kangolwa health centre and gave birth a year ago, before the centre had clean water.
19-year-old Enala Etifala's reflection in a container of water. Enala lives near Kangolwa health centre and gave birth a year ago, before the centre had clean water.
Image: WaterAid/ Laura El-Tantawy

Enala, 19, lives near Kangolwa health centre and gave birth a year ago, before the centre had clean water. She describes her experience:

“My guardian had to get water from a stream so that I could bathe and clean myself after the birth. The water was dirty and not good. I could see things settling to the bottom of the bucket...I had to use the same water to drink from. We didn’t have a choice."   

Delia has given birth 14 times, but sadly eight of her children have died, some in childhood. She describes waking up every day worrying about water. Her worry is understandable as tragically, the 56-year-old lost her 7-month-old grandson to diarrhoea.

“Water is something I wake up every day worrying about. I have so many worries, it is like I have nowhere to run to.”  

For Eliza, a young mother, who gave birth at Ntchisi district hospital before taps and toilets were installed described her experience as “the longest four days”. Now conditions have improved, she says:

“I’ve seen the new toilets – they are good! I was visiting someone at the guardian shelter, and I thought “wow, things have really improved here”. Before I couldn’t stand the sight of the toilets, women didn’t have the dignity they deserved, now it’s a really big improvement.”

These stories are among the collection of images and moving portraits displayed across lightboxes and digital screens, giving a unique glimpse into the lives of the women in their final stages of pregnancy, childbirth, and the journey into motherhood and beyond. Through this new work, El-Tantawy not only offers an intimate insight into the lived experiences of mothers across the generations but also explores the extraordinary bond between women giving birth in such unsafe circumstances.   

Photographer Laura El-Tantawy said:

“I witnessed the women in communities around Ntchisi trying to cope without water during some of the most intense moments of their lives, as they were about to give birth. But living in communities without access to clean water is a constant stress for them.

“In Carrying Life, I wanted to explore through images the emotional toll it takes on women to wake up daily and worry about where to get water; to feel the burden that your life and your family’s life is dependent on a bucket of water and its source.

“I was struck by the strength of the women I met. They lived with the reality of a lack of clean water, yet they never complained about it. My hope is that my photographs will help people understand the anxieties experienced by communities living without these basics, and also portray their dignity in the face of these struggles.”  

Paige Murphy, Head of the Wimbledon Foundation, said:

“The Wimbledon Foundation is proud to support WaterAid and this remarkable photo exhibition. It is shocking that a quarter of health centres around the world do not have clean water on site and four out of five in the poorest countries lack decent toilets.

“Carrying Life highlights the realities of giving birth without the essentials that many of us take for granted. By supporting WaterAid’s work to bring clean water, decent toilets and good hygiene to all health centres around the world, we hope to save lives and give women and babies a better chance of a healthy future.”

Laura Summerton, Photography Manager at WaterAid, said:

“Every two seconds a woman around the world gives birth in a health centre without clean water, decent toilets and good hygiene – that’s a massive 16.6 million each year facing the risk of needless infections. No woman should have to endure this injustice.

“By bringing Laura El-Tantawy’s formidable photos to the public’s attention, this issue can gain the attention it deserves. The result is a deeply moving yet empowering collection that serves not only as a rallying cry for action but also as a celebration of the bond between women across the generations as they navigate this important life stage.”

Enala Etifala, 19, lives near Kangolwa health centre and gave birth a year ago, before the centre had clean water.
Enala Etifala, 19, lives near Kangolwa health centre and gave birth a year ago, before the centre had clean water.
Image: WaterAid/ Laura El-Tantawy

Carrying Life is the first photo collaboration between international charity WaterAid and its partner, the Wimbledon Foundation, which has been supporting WaterAid’s work since 2017. Launched ahead of International Women’s Day, the exhibition aims to celebrate the dignity and strength of women in Ntchisi district, Malawi, whilst also drawing attention to the stark realities that nearly one in four healthcare facilities in Malawi are without clean water on site, leaving mothers and babies at risk of deadly infections. 

WaterAid has now provided these essentials in ten clinics in Ntchisi, four of which were provided with funding from the Wimbledon Foundation, official charity of the All England Lawn Tennis Club and The Championships, supporting the installation of taps and toilets. This means that women can now give birth free from the worry of infection caused by a lack of clean water, decent toilets and good hygiene.

Carrying Life: Motherhood and Water in Malawi is free to the public and will be open daily at Riverside, More London, from 3 March to 14 April 2023.

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Notes to Editors:


WaterAid is working to make clean water, decent toilets and good hygiene normal for everyone, everywhere within a generation. The international not-for-profit organisation works in 28 countries to change the lives of the poorest and most marginalised people. Since 1981, WaterAid has reached 28 million people with clean water and nearly 29 million people with decent toilets.

For more information, visit our website, follow us on Twitter @WaterAidUK, @WaterAid or @WaterAidPress, or find us on Facebook, LinkedIn or Instagram.

  • 771 million people in the world – one in ten – do not have clean water close to home.
  • Almost 1.7 billion people in the world – more than one in five – do not have a decent toilet of their own.
  • Over 300,000 children under five die every year from diarrhoeal diseases caused by poor water and sanitation. That's more than 800 children a day, or one child every two minutes.
  • Investing in safely managed water, sanitation and hygiene services provides up to 21 times more value than it costs.

[1] WHO/UNICEF (2021) Progress on household drinking water, sanitation and hygiene 2000-2020. Joint Monitoring Programme. Geneva: World Health Organisation.

[2] WHO/UNICEF (2021) Progress on household drinking water, sanitation and hygiene 2000-2020. Joint Monitoring Programme. Geneva: World Health Organisation.

[3] WaterAid calculations based on: Prüss-Ustün A, et al. (2019). Burden of Disease from Inadequate Water, Sanitation and Hygiene for Selected Adverse Health Outcomes: An Updated Analysis with a Focus on Low- and Middle-Income Countries. International Journal of Hygiene and Environmental Health. vol 222, no 5, pp 765-777. AND The Institute for Health Metrics and Evaluation (2020) Global Burden of Disease Study 2019. Seattle, WA: University of Washington.

[4] WaterAid. (2021) Mission-critical: Invest in water, sanitation and hygiene for a healthy and green economic recovery.

The Wimbledon Foundation

The Wimbledon Foundation is the official charity of The All England Lawn Tennis Club and The Championships and has partnered with WaterAid since 2017. The Foundation’s current grant donates £1.2 million to WaterAid between 2020 and 2023 and supports WaterAid’s work in Malawi, Myanmar, Ethiopia and Madagascar. The Wimbledon Foundation has part-funded the Carrying Life exhibition and has also funded the water, sanitation and hygiene (WASH) facilities and training at the healthcare facilities mentioned in the exhibition. For more information, go to, or follow us @WimbledonFdn.

Laura El-Tantawy

Laura El-Tantawy is a British-Egyptian documentary photographer, artful bookmaker and educator. She currently lives between London, UK and Cairo, Egypt. Growing up between East and West inspires her work, which contemplates notions of home & belonging, with a particular focus on social & environmental issues pertinent to her background. Her photography is recognised for its characteristically painterly & lyrical eye on reality.

El-Tantawy is the recipient of various international awards and recognitions, including the Deutsche Börse Photography Foundation Prize, the W. Eugene Smith Memorial Fund award for humanistic photography, Prix Virginia, PH Museum, the Royal Photographic Society’s 100 Photographic Heroines. Her work has been published in The New Yorker, Afar, Le Monde, Wall Street Journal, National Geographic, Time, New York Times, Huck & Foam among others.

Since 2020, she has been an ambassador for Canon, collaborating with the global camera giant on initiatives across visual education and empowerment.

2022 JMP report on WASH in healthcare facilities “It is estimated that almost one in four births globally take place in LDCs (Least Developed Countries), and that each year 16.6 million women in these countries give birth in health care facilities with inadequate water, sanitation and hygiene.”