IN the cold grey light of a 5am dawn, the women pull their colourful chitenge sarongs tight around them to ward off the day’s early chill. Charcoal burns in a small pit in the floor, offering a small degree of comfort.

With daybreak, it is apparent that comfort is not something found easily here at Chikweo health facility. The shelter I am sitting in provides scant protection against the elements: though the night was stormy morning promises another baking hot day in Malawi.

The woman I am talking quietly with is called Khisse. She’s here at Chikweo with her pregnant niece. Expectant mothers must come to such facilities a month or so before their due date to get medical care in a bid to cut Malawi’s maternal and neonatal mortality rate. A family member accompanies them – Khisse in this case. She is her niece’s guardian.

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It will be her niece’s third child. All three will have been born here, as she was. She knows all too well the circumstances in which she’s about to give birth – in a small, two-bed maternity room without running water.

Water here doesn’t come from a tap: water is kept in buckets on the floor, drawn each morning by the guardians from a borehole a 10-minute walk away.

There can be as many as 10 births a day here. Often, as one woman has given birth, another needs the bed. There is a constant rotation between bed and floor, before the new mums head next door to the post-natal room where they remain for 48 hours before returning home.

There is only one toilet – a cramped pit latrine on the other side of the yard. It’s here new mums are taken to wash after giving birth.

The latrine is next to the guardian’s shelter, which is adjacent to the facility’s medical waste incinerator and placenta pit.

There are days, Khisse says, that even when they have food, they often do not eat because of the intensity of the odours. It’s a stark insight into the difficult circumstances women encounter here.

The importance of having access to fresh, clean, running water here cannot be underestimated. For women to give birth without it seems an affront – absurd on many levels – for both the mothers and for the nurses and clinicians.

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The women here face a difficult decision: a choice between leaving their villages to spend a month in a facility with no water but where there is medical support, or give birth at home where they might be many kilometres from care.

“Staying here is the lesser of two evils,” says Khisse. “We are choosing between risking life and risking unpleasant living conditions. If we stay at home, the risk is that the labour could start and there would be no way that we could make it from the house to get here – and that could lead to loss of life.”

Work will begin next year to ensure change is on the way for this facility – and others like it that serve rural and remote communities across the Zomba and Machinga regions. I am in Malawi with WaterAid to see how water and sanitation projects benefit from funds raised in Scotland by employees of Scottish Water.

The international charity is about to embark on an ambitious plan to work with the communities and health facilities to improve access to clean water, instal decent toilets and boost hygiene management.

Scottish Water is organising fundraising activities, like the Munro Challenge 2020, throughout the year to raise money that will make a real difference to families in Malawi.

The difference it makes is literally life-changing and life-saving. The Deliver Life to Mothers, Girls and Children project is funded by the Scottish Government International Development fund, and matched by Scottish Water employee fundraising. It will help bring clean water to communities to enable women to give birth in safer conditions, and with more dignity..

At Kawinga health centre, 80km away, villagers are anticipating a momentous occasion next month. Work is under way to connect the site to a water supply.

It’s not straightforward, as lead clinician there for nine years, Francis Nthonga, explains. It must be pumped uphill to collection tanks before it can be supplied to the facility. Pipes are being laid to connect the nearby borehole supply to the tanks.

They’ve tried drilling for water here before – but struck bedrock, not water.

When the water arrives in any village, there are celebrations. Bright, colourful, beautifully melodic, vibrant celebrations. They’ll be all the brighter and even more melodic when the cry of a safely delivered new-born baby is heard.

Andrew Walker is head of communication at Scottish Water.