SMS saves pregnant woman

At midnight Valentine Uwingabire's back began to hurt. Her husband ran to tell Germaine Uwera, a community health worker in their village in the fertile foothills of Rwanda's Volcanoes National Park.

Equipped with a mobile phone from the local health centre, Uwera sent an urgent SMS text message and within a quarter of an hour, an ambulance had whisked Valentine to hospital. Minutes later Uwingabire's third child was born.

"We called our child Manirakoze, which means 'Thank God'," she told reporters, sitting outside her mud and bamboo house pitched in the shadow of Karisimbi volcano, home to some of the world's few remaining highland mountain gorillas.

Had it not been for Rwanda's new Rapid SMS service, Valentine would have been carried in agony, down the hill to the nearest town on an improvised stretcher.

As is the case in much of Africa, fixed-line telephone networks are virtually non-existent outside of the capital and major cities.

Health24 is also deeply involved in research around the possibilities of cellphones in medical care, and has developed a mobile application, Afridoctor, where users can access free medical information from their mobile phones.

Rapid SMS service

The Rapid SMS scheme - a joint initiative between three UN organisations - is being tested in the Musanze District where 432 health workers have received mobile phones.

Health workers register pregnant women in their village via free SMS text messages and send regular updates to a central server in the capital, Kigali. They are monitored during the pregnancy, and those at high risk brought in for check-ups.

Rwanda, Africa's most densely populated nation, is ranked among the world's worst for maternal mortality, according to UN data, and it is an important target for the global body's goal to reduce maternal deaths by 75%globally by 2015.

No maternal deaths

John Kalach, director of the nearest hospital in Ruhengeri, says since Rapid SMS launched in August 2009, his hospital has had no maternal deaths, compared to 10 the previous year.

"We used to get ladies coming here with serious complications just because they delayed the decision because the journey was very long," he says.

Kalach says authorities can use the data to work out which diseases affect women during pregnancy, the causes of death for children below five years, the volume and type of drugs required, and to monitor population growth rates.

Maternal health workers

Friday Nwaigwe, UNICEF's country head of child health and nutrition, says the next step is to give mobile phones to 17,500 maternal health workers across the country and eventually to all 50,000 community health workers.

"In Rwanda we have 750 out of every 100,000 pregnant women die every year. It's a very big problem," Nwaigwe says.

Still, in a nation where only 6% of its 10 million-strong population has access to electricity, a country-wide expansion of the scheme may run into problems.

Germaine says to charge her phone she has to walk 20 minutes to the nearest charging booth, and Kalach says some remote areas of the hilly country do not yet have network coverage.

But surrounded by trees heaving with chandeliers of green bananas and fields bursting with beans, Uwera and Uwingabire agree a simple text message has had a big impact on their lives.

"We used to use a traditional ambulance made of mats, like a stretcher made of papyrus and sticks. It takes one hour by walking - or five minutes in a car," Germaine says, cradling baby Manirakoze and proudly brandishing her mobile telephone. - (Herewald Holland/Reuters Health, May 2010)

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