In the remote dust of Liwale, the distance between a mother’s home and a life-saving surgery isn't just measured in kilometers; it is measured in the minutes that slip away on a long, treacherous road. For a pregnant woman in the periphery of Tanzania, what she doesn't know can be fatal; a hidden complication or an undiagnosed twin pregnancy is a silent ticking clock. My name is Sarah, a doctor from Switzerland, and I am here with Médecins Sans Frontières (MSF) because we believe that a woman’s survival should never depend on her ability to afford a bus fare or survive a five-hour journey to the city. We are bringing the eyes of the hospital to the heart of the village, ensuring that the first time a mother learns of a complication isn't when it's already too late.
In Liwale, our primary goal is straightforward yet vital: to reduce maternal mortality. The key to doing that is prevention. Many women here live in the "periphery"- isolated areas far from the district hospital. For them, a routine check-up isn't a quick drive; it’s a long, expensive, and often risky journey over difficult roads. Many choose to stay home, unaware of potential complications until it is too late. To solve this, we don’t wait for them to come to us. We bring the ultrasound to them, for you cannot prevent what you cannot see.
By bringing portable ultrasound machines to local health facilities, we can identify high-risk cases early. We can tell a mother if she needs to plan for a birth at a larger hospital capable of performing a C-section, potentially saving two lives before the first contraction even begins.
Just the other day, I was performing a routine scan on a woman who had traveled from a nearby village. As I moved the probe across her belly, I saw the familiar flicker of a beating heart and the curve of a spine.
"The head is positioned high," I explained through our medical interpreter. "We have time for the baby to move, but we should check again before birth."
Then, a sudden thump against the probe. We laughed; the baby was active. But as I continued the standard measurements to estimate weight and age, my screen showed something unexpected. I paused, moved the probe again, and there it was: a second head.
"Twins," I said, looking up in surprise. "We are having twins!"
The mother’s face lit up. She hadn't known for sure, but she told us she had been dreaming of twins for weeks. In that moment, the clinical room transformed. We showed her the tiny faces, the eyes, the noses, and the delicate flutter of two separate heartbeats.
It is exactly these cases, multiple pregnancies, that carry higher risks and require specialized care. Because we were there, she now knows she must deliver in a hospital equipped for emergencies. Because we brought the ultrasound to her village, we could identify that risk early and create a plan to keep her and her babies safe.
For as long as I can remember, I wanted to be part of Médecins Sans Frontières (MSF). When I was six years old, watching the news in Switzerland, I saw people helping in the world’s most remote places and knew that was my path. I studied medicine specifically for this purpose, to give back because I was lucky enough to be born into a life of comfort and education.
But after arriving in Tanzania for my first mission, I’ve realized something important: it isn't just about what we give. It is about what we receive.
The bond we form with these women, the shared giggles when a baby kicks, and the relief in a mother's eyes when she hears a healthy heartbeat; these moments are incredibly rewarding. It is a profound exchange of humanity that enriches my life far more than any textbook ever could.
At MSF, our ability to act quickly and reach the most remote areas depends entirely on the independence of our funding. We rely on people like you to ensure that a woman’s geography doesn’t determine her survival.
Every ultrasound we perform and every high-risk pregnancy we identify is made possible by your donations. Thank you for helping us stay in the field, for helping us remain independent, and for ensuring that mothers in Liwale can dream of a future for their children and see that dream come true.
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