19 February 2025 by Limpho Sello

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Twenty-five-year-old Nthabiseng Mabesela takes slow, measured steps, cradling a small brown box in her arms.

She delicately holds it close to her chest, as if letting go might shatter everything inside. With every step, the weight in her heart grows heavier.

Just a day earlier, on January 16, 2023, Mabesela had walked into the Likhetlane Filter Clinic in Leribe for a routine antenatal check-up.  At eight months pregnant, she already knew she was expecting a baby girl.

But soon after she entered the examination room, clinicians began preparing her for an urgent transfer to Motebang Hospital in Lesotho.

It was there that she delivered a stillborn. Doctors later told her that hemorrhage was the cause—yet throughout her pregnancy, she had never been diagnosed with the condition.

“I returned home with a coffin to bury my daughter,” Mabesela said in an exclusive interview with Uncensored News.

As she recounted her experience, the anguish in her voice revealed the “unbearable pain” she felt carrying a box that held her daughter’s remains.

“No mother should have to bury their child,” Mabesela explained.

The preliminary results of the 2023-2024 Lesotho Demographic Health Survey estimate that for every 100,000 mothers who give birth, 566 do not survive due to childbirth or pregnancy-related complications.

This reflects a significantly high maternal mortality rate in Lesotho, with the World Health Organization indicating that severe bleeding (hemorrhage), hypertensive disorders during pregnancy, and complications from unsafe abortions are major contributors to maternal deaths in the country.

The impact extends beyond mothers, with the United Nations Children’s Fund (UNICEF) data estimating that approximately six newborns die each day before reaching their first month of life. Of these, three are stillbirths—like Mabesela’s daughter.

Lucky the second time?

Mabesela, who resides in Ha Nyenye, Maputsoe in Leribe district, admits that after giving birth to a stillborn, the thought of having another child, in her own words, felt like stepping into an uncertain future.

Despite her fears, a year after the tragedy, she found herself pregnant again in 2024. Six months into her pregnancy, on September 15, 2024, Mabesela began experiencing severe contractions.

She immediately called for help under the m-mama free transport provision for mothers in Lesotho.

“The vehicle provided by m-mama took me to the clinic. But upon arrival, the nurses in the emergency department mistook my contractions for vaginal discharge and told me to go back home, saying there was nothing serious,” Mabesela said. 

She added: “On our way back, I told the driver to return to the clinic because the pain was worsening every minute.”  

Upon her second arrival at the clinic, just hours apart, she gave birth prematurely to a baby boy, now five months old. 

M-mama is an affordable emergency transport service that connects mothers and newborns to life-saving healthcare in rural areas of both Tanzania and Lesotho. Through this service, expectant mothers like Mabesela can call for help and be transported free of charge to a nearby health facility, ensuring the safety of both mother and child.

Lee Wells, Director of m-mama for the Vodafone Foundation, highlighted that this model is much cheaper than using fully equipped ambulance services, thanks to dedicated volunteer drivers like the one who transported Mabesela to a safe place where she could deliver her son.

“Having enough ambulances for this mountainous country was always going to be too expensive in the short term. The terrible reality was that we were losing precious lives as a result,” he said. 

“But today, the entire national m-mama emergency transport service costs the government less than what it takes to buy and run one ambulance each year.  This is all thanks to the dedicated volunteer drivers, horse riders, and boat owners who step in during emergencies to help their neighbors, mothers, sisters, and babies.” 

Meanwhile, Mabesela admitted that without m-mama, possibilities of her giving birth to a live child were very limited.  

“This child is my light after the dark,” she said, holding her son close.

She added: “His birth brought mixed emotions because he weighed only 1.16kg. I was happy he was alive but still afraid I might lose him too. But with God’s grace, we are here now. He has restored my happiness and helped me heal from my loss.” 

Mabesela expressed deep gratitude for m-mama and the patience of her driver. 

“If it weren’t for m-mama, my story might have ended differently. I could have lost my child had I not received help on time, or if the driver had refused to turn back after the nurses misdiagnosed me. 

From Vodacom Lesotho to Ministry of Health

The m-mama program has now been handed over to the Ministry of Health in Lesotho. During the handover ceremony in Mohale’s Hoek on January 31, 2025, Minister of Health Selibe Mochoboroane reassured the public that the program’s administration would remain as flexible as it had been under Vodacom Lesotho.

He highlighted that from 2018 to 2025, the program had run smoothly, and in the past year under government administration, no major challenges had arisen.

Speaking at the same event, Lee Wells, Director of m-mama for the Vodafone Foundation, highlighted that in 2024, the service had been fully funded and operated by the government of Lesotho.

He indicated that Vodafone Foundation had invested $4.5 million to set up m-mama and had gifted all the technology to the government with no ongoing fees or charges, making it an affordable solution. 

However, Wells said more could be done to improve efficiency. 

“In Tanzania, m-mama also coordinates ambulance services. This has reduced the cost per trip by 30 percent and increased ambulance efficiency from one call in ten to seven calls in ten.” 

On her part, the m-mama Programmes Manager in the Ministry of Health, Mapeete Moshoeshoe, said the program has bridged the gap in emergency transport for mothers and babies. 

“Since its inception, m-mama has handled 8,834 maternal emergencies and 643 neonatal emergencies, bringing the total to 9,477 cases,” she said. 

Moshoeshoe added: “The highest numbers were recorded in Leribe, Botha-Bothe, and Berea because these were the pilot districts in 2018. That is why they appear at the top in the table below.”

However, Moshoeshoe noted that while they have records of assisted cases, a comparative statistical analysis of maternal health before and after m-mama is not yet available. 

Who accounts for dying mothers and babies?

Meanwhile, Mochoboroane called on all stakeholders—including village health workers, community councillors, chiefs, doctors, and nurses—to take collective responsibility in reducing maternal and neonatal deaths.

“Although the 2024 Lesotho Demographic Health Survey preliminary results show a decline in maternal and neonatal deaths, the decrease is not significant enough,” he said. 

“We need to push for a highly significant decline in these deaths because no mother should die during labor, and no baby should die at birth. Bringing a child into this world is a precious gift from God, and no child should be lost during that moment.”

Mochoboroane made a strong appeal to health workers, emphasising accountability. 

“We may not be losing as many lives between homes and health facilities, but we are still losing lives in our health facilities, in the hands of health workers. 

“My appeal is that every health worker must account for their work—where they have excelled and where they have failed. Even in cases of negligence, there must be accountability.”

He indicated that on his side, he reports to Her Majesty Queen Masenate whenever a mother or child dies in this country.

“This means it can no longer be business as usual. A loss of life—whether a mother or child—must be accounted for. If we fail to do so, we will continue to appear negligent,” Mochoboroane said. 

Despite the challenges surrounding the accountability of maternal and neonatal deaths in Lesotho’s health facilities, Lee Wells of Vodacom Lesotho pointed out that “Lesotho was the first country in Africa to establish a national emergency transport system for mothers and babies.”

“You have set an example. M-mama Tanzania is now national, and m-mama Kenya and m-mama Malawi are set to launch later this year. Congratulations, Honourable Minister, on Lesotho being the first.”