Arranging the ride before labour starts

Start with a boda rider who lives in your village rather than one at the trading centre stage, because the one who lives near you can be reached on foot when a phone fails. Ask somebody who has done this before. Riders who have carried a woman in labour know to go slower over the ruts and know where the gate is at the facility.

Then name a second person, and tell them they are the second person. It is not an insult to the first one. The reason is arithmetic: at any given hour, a single rider is quite often unavailable, and half of those hours are at night.

In many villages the third option is somebody with a vehicle: a shopkeeper with a pickup, a teacher with a car, the LC1 chairperson. You do not need a formal agreement. You need them to have heard, once, before the night, that they might be asked.

Four things: the fare, the fare at night, where you are going, and that he will come when called even if he is at home asleep.

Say the numbers out loud with a witness present, ideally your village health team member or a neighbour. Not because anybody expects dishonesty, but because a price agreed in a calm week is a different price from one agreed while a woman is groaning in the doorway, and the witness is what makes the earlier price stick.

Also agree who else rides. On a boda, the mother needs somebody behind or in front of her for support, so agree whether he will take two passengers, and what that adds to the fare.

Not in the household tin. Money kept with daily money gets spent on the week the food runs out, and no one decides to do that, it simply happens.

Good places: with your savings group as an agreed emergency withdrawal, with a trusted relative who does not live in your house, or on mobile money kept separate from any trading float. Whatever you choose, tell one other person where it is, because you may not be in a state to explain it on the night.

Keep part of it as notes. At two in the morning the agent's shutter is down, and a rider woken from sleep wants cash in his hand, not a promise of a transfer at sunrise.

The fare rises, and expect that rather than arguing about it at the door. A rider getting up at 1am and riding a dark road is being asked for something different from a daytime trip.

Phones are the second problem. In villages where charging happens at a shop with a solar panel, half the phones in the village spend the night somewhere other than the house they belong to. This is why the numbers go into two phones and why one household member keeps a charged phone at home in the last month.

The third problem is the gate. Some facilities keep the main gate closed at night and the person on duty is around the back. Ask at an antenatal visit how you get in after dark, so that arriving is not followed by twenty minutes of shouting.

A murram road that carries a boda comfortably in the dry months becomes something else after a night of rain. Ruts fill, the surface turns to grease and a stretch that is normally ten minutes becomes forty, or becomes impassable on two wheels.

Ask your rider, in the seventh month, which parts of the route go bad and what he does then. The answer is often an alternative route that is longer but firmer, or a first leg on foot or on a bicycle to the point where the murram improves.

Where a river or a swamp crossing is involved, find out now what happens to it in the wet season and who else in the village has crossed it recently at night. This is the single detail most likely to break a plan in Kamuli and in parts of Napak.

Households plan the trip to the health centre and stop there. But a real proportion of mothers are sent onward, either during pregnancy because of what an antenatal check found, or on the day because what is needed is an operation or a transfusion.

Ask at an antenatal visit which facility you would be referred to, and how far it is. Then ask the practical question: if that referral happens at night, who takes us, and is it the same rider or somebody with a vehicle.

Ask also whether an ambulance can be requested from your facility and how. Do not assume it, and do not build the plan on it. Treat an ambulance as a good outcome, not the plan.

Once, yes, and preferably as part of an antenatal visit so the trip is not wasted. Ride the actual route with the actual rider, note how long it takes, and see the gate you will arrive at.

A practice run turns up the small things that ruin a night: a bridge under repair, a stretch where the phone has no network, a junction the rider assumed you knew. It also means the rider has been to the facility before, which is worth more than it sounds.

Send a person, not a phone call. Somebody on foot to the first rider's home, somebody else to the second. Two errands at once, not one after the other.

Go to the LC1 chairperson, and say the words woman in labour. In most villages that sentence produces help that a general request for a lift does not.

Tell your village health team member as early as possible, not once everything else has failed. They know who in the parish has a vehicle, they may be able to phone the facility so somebody is expecting you, and following up on exactly this is part of their job.