BY KASSIM MWALIMU ADINASI: Mageta and Ndere Islands in Siaya County are paradises of fishing and close-knit community life.
Mageta and Ndere Islands, observed from the mainland in Bondo Sub-county, present an idyllic picture of tranquility.
Mageta stands majestically, surrounded by clean blue waters and cooled by refreshing breezes, while Ndere Island resembles a manicured garden with striking rock outcrops, promising a perfect retreat for tourists and nature lovers.
Yet, this superficial beauty masks a grim reality for pregnant women residing there.
Amidst the cool breeze and natural splendor, these islands are places of profound danger where the journey to motherhood is fraught with risk, and life often hangs on a treacherous balance.
When the moment of delivery arrives, a silent but deadly countdown begins, often pitting the fragile thread of a mother’s life against the mighty, unpredictable waters of Lake Victoria.
The fundamental issue is simple: inadequate local healthcare facilities combined with a treacherous emergency referral system.
The existing health centres on the islands are sparsely equipped, lacking the essential equipment and specialised human resources needed to manage obstetric complications like severe bleeding or pre-eclampsia.
For these critical emergencies, the only hope is the referral hospital on the mainland, the Bondo Sub-County Referral Hospital, a lifeline that is tragically distant and unreliable.
The journey is a maritime nightmare. It depends entirely on the availability of an engine boat and the temperament of the lake. Calm waters can mean a nervous but swift journey; rough waves mean a life-or-death gamble.
The Fear of the Night and the Waves
For the islanders, this reality is not an abstract statistic but a lived trauma.
Auma Adhiambo, 32, a mother of four from Mageta Island, recounts the harrowing experience of her neighbour.
“My neighbour, she had her first baby two years ago. The delivery started well at the dispensary, but then the baby’s position changed, and they said they had to refer her immediately,” Auma shared, her voice etched with remembered fear.
“It was late, around 11 PM, and the wind was strong. The local boat we found had a small engine, and the waves were eating the side of the boat. It took us over three hours to reach the mainland, and then we had to get a motorbike to Bondo. By the time we reached, the baby was gone. The mother was saved, but the life inside her… it was taken by the lake’s delay. We fear the night and the waves more than anything,” she recalls the ordeal which, vividly, traumatised her.
This fear drives many women to take risks. Jared Okello, a village elder on Ndere Island, points out the impossible choice many families face.
“We are told to go to the hospital, to use a skilled attendant. But what good is the skilled attendant if their hands are tied? If they have no blood for transfusion, no theater, and no reliable transport?” he asks, gesturing towards the churning grey water.
“Some of our daughters choose to stay home with the traditional birth attendants. Not because they don’t want the facility, but because they believe that if they must die, they would rather die on land than in the middle of the lake, alone in the dark. It is a terrible choice for a mother to have to make.”
The financial burden is another crushing factor. When an emergency strikes, families scramble to hire a private boat, often at exorbitant, opportunistic prices.
Okello adds: “A public boat costs little, but an emergency boat at night can cost us up to Sh10,000 or Sh12,000, money most of us do not have ready. Sometimes, the delay is simply because we are negotiating for the money.”
Community Solution
The islanders, living at the sharp end of this crisis, have clear, urgent proposals for change.
They understand the nature of the “Three Delays” in maternal care: delay in deciding to seek care, delay in reaching a facility, and delay in receiving adequate care.
First they advocate for a reliable water ambulance service, which they demand from the county government of Siaya led by governor James Orengo.
“The county government has to stop giving us promises about an ambulance boat,” says Auma adding that, “We need a dedicated, fast, well-maintained boat, with a trained nurse on board and a powerful engine that can withstand the lake’s anger. It must be fueled, manned, and available 24 hours a day, seven days a week, and it should be free for emergencies.”
Secondly, the islanders demand immediate upgrading Local Health Centres which are found within Mageta and Ndere Islands.
Jared Okello stressed the need for more than just a dispensary.
“The facilities here on Mageta and Ndere must be upgraded to offer more than just basic antenatal care. We need a proper maternity wing, with a constant supply of essential drugs, an equipped delivery room, and at least two permanent, well-paid clinical officers or nurses who can handle basic complications and stabilize a patient for referral,” he stresses believing it is the panacea of the challenges and would help bypass the first crucial minutes where lives are often lost.
The islanders also advocate for the empowering of the Community Health Volunteers (CHVs), they want the county administration to focus on investing in the people on the ground.
“Our Community Health Volunteers are our eyes and ears,” Okello explains. “They need better training in identifying pregnancy danger signs early, a reliable communication tool like a two-way radio to contact the mainland, and a small stipend so they are motivated to track every pregnant woman. Early warning can save a life before the complication becomes a tragedy.”
The people of Mageta and Ndere islands are surrounded by the bounty of Lake Victoria, but when it comes to safe childbirth, they are stranded.
Their plea is for the government and its partners to bridge the watery divide with concrete action, ensuring that for their women, motherhood is a joy celebrated on land, not a life-threatening voyage across the waves.
