Our hotel in Bertoua, in the Eastern region of Cameroon, was surprisingly comfortable given the rural location and the obvious poverty in the surrounding area. I was adapting to sleeping under a mosquito net, although the sound of mosquitoes hovering around the lake outside had me applying repellent in a slightly heavy-handed fashion.
Our first stop was the district hospital in the village of Nguelemendouka. There we viewed the facilities, including the storage room where the tetanus vaccines were kept in fridges to keep them at their required temperature. The District Medical Officer, Dr Wassep, discussed his work at the hospital and explained to us how outreach services took vaccines to villagers in the surrounding areas.
The last maternal and newborn tetanus campaign in the region, in February 2010, had proved successful with 81.5% of women of childbearing age now protected against a disease he explained was virtually impossible to treat. He last saw a case in 2008 – a three-week-old baby – but was unable to save him.
The hospital was very sparse, chronically under-resourced and we only saw a handful of patients during our visit. The remote location made travelling to the hospital by dirt track extremely difficult, and healthcare in Cameroon is not free, so patient numbers are determined by the ability to pay.
It was the delivery suite I found most disturbing: a hot, cramped room with no privacy, a sink with no running water and a metal bed with aggressive-looking metal stirrups. Women gave birth with no pain relief. If they wanted an anti-inflammatory post-delivery they had to pay. Those needing a C-section were given ketamin and nothing else. Again, this had to be paid for.
Giving birth at the district hospital cost US$6 – the equivalent of approximately £3.80 – and women had to bring their own equipment, including a razor blade, alcohol, blankets and a thread to tie the umbilical cord. For many women this is simply too expensive, so they are left with no choice but to give birth at home with no qualified professional on hand. It is unsurprising that the maternal death rate in Cameroon is 699 per 100,000 live births.
The unhygienic conditions in which so many women give birth and the high risk of infection highlight the importance of women and babies being vaccinated against tetanus. As many women have as many as ten children during their lifetime, the need is greater still.
As I left the hospital alarmed at what I had seen, I could think of no worse place to give birth. It also occurred to me that had I given birth to my daughter in an environment with no oxygen and resuscitation facilities, it is unlikely she would have survived.
The Pampers and UNICEF campaign runs from October to December. For every pack of Pampers products purchased with the “I pack = 1 life-saving vaccine” logo, Pampers will donate the cost of one tetanus vaccine to UNICEF. Additionally, by visiting the Pampers Village website and clicking on the Big Kiss button, a 'virtual kiss' will be sent to Pampers and UNICEF. For every 'virtual kiss' sent. Pampers will make an additional donation to UNICEF.