Emergency on the Island


Neema has traveled so far. By motorbike, car, and ferry across Africa’s largest lake — all while bleeding and in labor, and yet she kept going.


For the last few hours, Neema Gerevas has been in labor. On a plastic chair pulled into the shade, she tries to ignore the pain. She wants to stay at home for as long as possible before going to the health center to deliver the baby.

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Neema is staying because she has work to do. On her remote island in Tanzania, surrounded by Lake Victoria, families rely on fishing and farming to feed their children. Some days it’s not enough.

Neema peels root vegetables. Scraps fall past her belly, collecting at her feet. It’s around 8 AM when she sees the blood soaking her skirt. It’s time to go, and she must go quickly. She knows who to call.

Watching for Danger Signs

42-year-old Mganga Ndalo is a fisherman, farmer, and father of six young children. He cares a lot about the future of Kome Island. Two years ago, he got a chance to prove it.

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Mganga walks from home to home, using his Pathfinder training to share knowledge with women like Neema. He connects them to reproductive health services and skilled doctors. He teaches them to watch out for danger signs.

When he hears about Neema’s bleeding, he tells her not to wait. Go to the health center. Go now.

The Journey Begins

Neema’s husband, Patrick, sprints toward the road. He flags down a motorbike and helps his wife climb on the back. Bleeding and in labor, Neema barrels along the red dirt road toward the island’s small health center.

It is 10 AM when she arrives — and Mganga is waiting.

“There’s a lot of blood,” Neema says.

He tries to calm her, while a nurse assesses Neema’s condition. Within minutes, it’s clear this is serious. They have to get her off the island and to the big district hospital. But how?

There are no ambulances on Kome Island. And distance can be a death sentence. First, there’s a ferry across Lake Victoria. Then there’s a long drive — over three hours on rough, unpaved road.

Mganga fishes a small card from his pocket. On the back, he locates the toll-free number — 0800 755 755 — and dials. Help is on the way.

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Going Where the Need Is Greatest

In 2013, Pathfinder helped launch a groundbreaking emergency transport system that uses digital technology to save women’s lives.

It’s part of our Mobilizing Maternal Health project funded by USAID, Vodafone Foundation, Swiss Re, and other private donors.

The government of Tanzania is committed to saving the lives of women like Neema by connecting remote communities to the health care they urgently need. Pathfinder goes where their ambulances cannot.

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Here’s How It Works

“Where are you calling from?”

“Has she had her baby yet?”

Inside the big district hospital, a man on a mobile phone asks a series of questions. Behind him, roadmaps plaster the walls. This is the dispatch center, and Sadath Lija is a dispatcher. He answers calls that come in to the project’s toll-free number.

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“My job is to arrange transport. If I don’t do it in time,” he says, “we could lose women.”

Sadath knows women like Neema have few options for reaching the hospital. So he uses technology to find the most efficient way of getting her there.

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He enters information into a digital app developed by the project. The app helps him assess a woman’s condition, find a taxi ready to pick her up, and calculate the fastest route to the hospital. It’s a game-changer.

For Neema, it can mean the difference between life or death.

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A New Day

“His name is Freddy,” Neema says, smiling as she wraps her infant son tight. It’s been about four months since a taxi picked her up and carried her — by ferry and road — all the way to the hospital.

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Patrick sits close to his wife. “If the emergency transportation wasn’t there, I am afraid we would have lost our baby…I could have lost my wife.”

Neema agrees. “Now we share the information with our friends. I tell them — if you are pregnant and have a problem, call that number. Get help.”

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Each year in Tanzania, an estimated 8,200 women die from complications in pregnancy and childbirth. That’s about 22 women each day. Pathfinder is working to change this. And you can help. Learn more about our work in Tanzania.

Every girl deserves the same choice.

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