WATCH: Madonna attends opening of hospital in Malawi
US pop superstar Madonna on Tuesday took her four adopted Malawian children back to their home country for the opening of a paediatric hospital wing that her charity has built.
Standing alongside President Peter Mutharika, she unveiled a plaque to mark the completion of the 50-bed facility in Malawi's second city of Blantyre.
The Mercy James Institute of Paediatric Surgery and Intensive Care -- named after one of her children -- has taken two years to build and includes three specialist operating theatres.
It is the first health unit for children in the southern African nation, and will double the capacity for paediatric care at the Queen Elizabeth hospital.
Earlier this year Madonna, 58, adopted twin girls from an orphanage in Malawi, where she has been a regular visitor for several years.
Twins Estere and Stella, four years old, joined her other Malawian children, Mercy James and David Banda, both aged 11.
"I am a freedom fighter and a feminist with a rebel heart... so I would not accept the word 'no'," a smiling Madonna told a crowd of well-wishers as she described the challenges of adopting the children.
"I never gave up or backed down. I fought for Mercy and won," she said, adding the hospital was built because "children should never die of terrible diseases we can easily cure."
Madonna, who set up her "Raising Malawi" charity in 2006, joined in with local dancers to celebrate the opening after a one-hour tour of the hospital, which was decorated with national flags and bunting.
The wards have been designed with murals including images of Nelson Mandela and archbishop Desmond Tutu, while US actor Leonardo DiCaprio was listed on a wall as a major benefactor.
Mutharika cut a blue ceremonial ribbon, and held it up to the cheering crowd.
Mercy James gave a short speech saying it was "a great honour that the centre will save many lives," while David Banda joined a performance by an orphans' acrobatic dance group.
- 'A chance of survival' -
Madonna has not always been welcomed with open arms in Malawi, one of the world's poorest countries, where some activists accuse her of using her wealth to short-cut the adoption process.
In 2013, she was stripped of her official VIP status by then president Joyce Banda's government, which accused her of being "uncouth" and expecting gratitude for her adoptions.
President Mutharika has since moved to repair the relationship.
On Tuesday he praised Madonna for building "the first and best child care centre" in Malawi and described her as a "symbol of motherly spirit."
The singer, who divorced film director Guy Ritchie in 2008, now has six children after adopting her twins.
Court documents detailed how the twins were taken in by an orphanage supported by Madonna's charity.
Their mother died soon after childbirth, their father left to marry another woman, and their grandmother struggled to look after several children.
"Malawi needs such kind-hearted people to prosper," Malita Ndau, a 20-year-old woman selling doughnuts in Blantyre, told AFP.
"Malawian children will now have a chance of survival because of this hospital."
But some Malawians said the hospital highlighted the country's failures.
Malawi should "be ashamed for begging from her to build this facility because we have failed to tame corruption," said Mumbo Phiri, who sells second-hand clothes.
The new hospital wing opened to patients last week and has already performed its first surgery.