Malawi was recently devastated by the largest floods in living memory. Three weeks later people are still struggling to get on with their lives and preparing as best they can for a difficult future ahead, like the arrival of a new baby.

Berita didn't run when the floods hit. She didn't run because there was nowhere to go: Makhanga, a cluster of villages with a population of 5,000, rests on what can barely be called a hill, but is nonetheless on slightly higher ground than the vast plains of south Malawi. But Berita also didn't run because she was eight months pregnant.

The water came during the night. At 3am Berita woke up: there was water in her house, licking the blanket on which she slept. Slowly, slowly, it crept up. Ankle deep, knee deep... until midnight when it reached her home's window sill. It ate up the corn fields that feed the village. It contaminated the wells that sustain the families. It blanketed the local clinic with thick, oozy mud which clung to drugs, to instruments, to everything.

There was nowhere to go but up; there was nothing up but trees. Mathias, Berita's husband, hauled his heavy wife and their five children up onto the branches, still drenched from the heavy rains. They stayed there for four days. The baby kept kicking.

And then it was time. Early on Thursday morning, 22 January, 13 days after the floods came and went and stole all of her possessions, Berita felt the baby was ready, even if she was not. “We went to the clinic, but it was closed. There was no one there to help. I was told to wait, that a helicopter was coming, that it could take me to another clinic,” she recalls. By that time, Makhanga village had become an island cut off from the rest of the country, apart from a slow trickle of aid dropped from the air.

“When we landed we were told there was a woman in advanced labour, but nobody to deliver the baby. So it was up to me,” says Clive Kasalu, a Malawi nurse and midwife working for Médecins Sans Frontières (MSF). Clive had an emergency delivery kit and 14 years experience under his belt, so he felt confident. But still, “we had to improvise a bit,” he says. Only parts of the clinic had been cleaned up during the three days that MSF had a team at work in Makhanga. Clive enlisted an assistant to “run up and down to get us water ” while focusing on the suffering mother.

Within an hour, Berita was engulfed by birthing pains, sweating and clinging to the bare bed while her husband Mathias, the village's headman, waited outside, worrying – it's taboo here for fathers to attend a birth. And then, at noon, Makhanga had one more villager - a healthily screaming, hungry, 2.9kg baby girl.

Three weeks after the floods hit, Makhanga remains an island of trapped inhabitants. While MSF is regularly bringing medical relief by helicopter, helping villagers get on with their lives, the consequences of the worst floods in Malawi that any elder can remember will be felt for months. “I am glad to have my new baby,” says Berita. “But we don't have enough food, we don't have clean water, we don't have any clothing.” Her brick and mud house – built a year ago – is still standing, but bears the scars from the great flood. It's crowded too, because relatives who lost their homes have found refuge there: there are now 13 people living in a one-bedroom house. Her family's field, recently planted, was wiped clean of all hope for the coming months’ crops.

Life trudges on.

The now one-week-old baby girl has yet to receive a name.