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It's only 9 a.m. and Zainunda Wilson is already tired from shovelling sand since daybreak into a five-tonne truck on the shores of Lake Malawi.

The 37-year-old sand miner has no time to admire her surroundings - a tourist hot spot centred on the vast body of water known as the Lake of Stars for the brilliance of its nighttime reflections.

Maxwell Nsona stood in the dried-out bed of the Nthumba River in Malawi's southern Chikwawa district and recalled how this wide ribbon of footprint-studded sand turned into a raging torrent during heavy rains a decade ago.

The fear is that this could happen again as a country brought to its knees by southern Africa's worst drought in decades braces for a rainy season that meteorologists say could bring widespread flooding and landslides.

Domestic worker Annita Symon fears for her children's health after seeing several friends fall seriously ill due to a cholera outbreak that has killed more than 1,600 people in Malawi over the last year.

Like many low-income families, she and her two children are forced to get their drinking water supplies from contaminated rivers that are spreading the disease in a country where about one in three households lacks access to safe drinking water.

MWANZA, Malawi - Waiting in line to register his three children with the government for the first time, Malawian motorcycle taxi driver Nyadani Michael recalled the everyday problems caused by their lack of official identity papers.

"When you enrol them in school, they ask for a birth certificate or some age proof," said Michael, 30, as he queued up outside a classroom in the border town of Mwanza where the forms had to be submitted, holding the hand of his six-year-old daughter.