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Rosie Scribble

Africa Trip

Pampers, UNICEF and my blogging trip to Africa

Some time ago I mentioned a trip to Cameroon, so perhaps this post should be called: What I really did this summer.

Perhaps it should end with a reference to the fact that you never really know what lies around the corner and what opportunities will suddenly present themselves.

For me, I did not think I would ever find myself sitting in a hospital in one the most remote parts of West Africa, being photographed with a group of women and their babies.

Because opportunities like this simply don’t happen.

Do they?

Rosie Scribble Pampers UNICEF Cameroon

This August, while IJ holidayed with her grandparents in the Lake District, I travelled 3000 miles to Cameroon — a trip which proved to be emotional, inspiring, moving and thought-provoking.

I went to Cameroon, as a blogger, with the Pampers and UNICEF teams to witness the progress of their “1 pack = 1 life-saving vaccine” campaign which is helping to eliminate maternal and newborn tetanus (MNT).

My role was to see the work of the campaign firsthand, to meet the women and children it was helping, experience the conditions the villagers live in and report it all back. So over the next ten days I will be posting my experiences of a trip which was emotional at times, yet on the whole positive and without doubt the best thing I have ever done.

Cameroon Africa

The campaign background

Pampers and UNICEF joined forces in 2006 to help raise funding for vaccines to protect women and their babies against MNT. Now in its fifth year, the partnership has expanded across the globe reaching 21 countries in two continents and is helping to protect 100 million women and their babies.

The Pampers and UNICEF campaign runs from October to December. For every Pampers product purchased with the “1 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.

Pampers UNICEF 001

Tetanus is a disease which can be eliminated in our lifetime and a goal that is within reach, with our help.

It was a privilege to travel to Cameroon, to see the campaign in action and to be so warmly welcomed by the communities we visited. I gained a rare insight into the lives of the villagers and the exceptional work of UNICEF.

Preparing for the trip I did not think it was possible to visit a developing country, spend time with some of the poorest people in the world, and not be altered by the experience.

And I was right.

Tomorrow my journey begins, at London Heathrow, with a 3am start, excitement, apprehension and slightly too much luggage.
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London Heathrow, Destination: Yaounde, Cameroon

My field trip to Cameroon with the Pampers and UNICEF team began with a 3am alarm call and a short taxi ride to Heathrow Terminal 4 where, feeling excited and a little apprehensive, I met the rest of the group. I would be spending my week in Africa with Jemma Walton, features editor for Mother and Baby magazine, Nicola Westoby, a midwife from the Royal College of Midwives, Alex Lee and Liz Jones from UNICEF UK, Catherine McGough, Pampers PR manager and Bronwyn Fieldgate from Fleishman-Hillard. We will be joining the UNICEF Cameroon team on our arrival.

Despite the early hour, I was wide awake having decided not to sleep and risk sleeping through my alarm. Looking around the group at the check-in desk, it quickly became obvious that my idea of packing light differed slightly from everyone else’s as I seemed to be carrying a great deal more luggage. It is likely that I am one of the few people who have travelled to rural Africa with mini hair-straighteners and a travel hairdryer.

As there was the possibility of my luggage getting lost en route, I had also decided to pack all my ‘essentials’ in my hand luggage, together with every single anti-mosquito repellent I could get my hands on.

I was a little over-excited to see my visa from the Cameroon Embassy stamped in my passport and realise that the trip was really happening. I had never travelled to a developing country before or done anything as significant as this and it was hard to believe that despite the vaccinations and the weeks of preparation, I really was travelling to Africa.

The purpose of my field trip to Cameroon was; to see in action the success of the Pampers and UNICEF partnership, which aims to help eliminate maternal and newborn tetanus (MNT), to experience firsthand the conditions faced by women and babies in developing countries, gain an understanding of why tetanus vaccines are essential and see the work that still needs to be done to make sure every woman and her baby is protected against the disease. I had come armed with the facts:

  • To date, Pampers have donated funding for 300 million vaccines, which is helping to protect 100 million women and babies from maternal and newborn tetanus
  • Since 2006,  Pampers have helped protect mums and their babies in 21 countries across two continents
  • More than 80 years after the tetanus vaccine first became available, MNT still threatens the lives of 170 million women and their newborn babies in 40 countries around the world
  • In 2010, it has been calculated that approximately 59,000 newborns die annually from newborn tetanus, and thousands of women from maternal tetanus *
  • Every nine minutes, one baby dies needlessly from MNT *

I had no idea what to expect. I had never witnessed hardship and abject poverty to the extremes I was about to encounter. It felt important to embrace every single aspect of the trip, to document my thoughts and experiences and return in a position to be able to help. Spending my last couple of hours on British soil, the weight of responsibility suddenly felt huge and I wondered if I was up to the task in hand.

At that point our journey from Heathrow to Cameroon via Paris-Charles de Gaulle seemed straightforward. None of us could have envisaged as we sat in the departure lounge waiting to board our plane that it would be anything but.

* Based on CHERG/ WHO estimates for annual MNT deaths, 2008 as published in Lancet on 12.05.10

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A straightforward journey that was anything but

Prior to our trip, the Pampers and UNICEF team heading off to Cameroon had met only once for a briefing meeting about our field trip. As we began our journey to Africa, we quickly discovered that the best way of getting to know a group of people you have only just met is to experience a stressful situation together and live to tell the tale. That was the situation we found ourselves in minutes after taking off from Paris-Charles de Gaulle airport, travelling at 400 mph, at around 20,000 feet.

We were still gaining height when the alarms sounded signalling a problem with the aircraft. Minutes later the pilot made an announcement, only part of which I could understand, but it contained, without doubt, the word ‘fire’.  It is really not a word you want to hear under such circumstances. As I looked out of the window I could see what appeared to be smoke billowing out of the left wing and I was engulfed with the overwhelming disappointment that, after all the excitement, we would never make it to Cameroon.

For what felt like an eternity, but can only have been about three minutes, I was acutely aware of our distance from the ground and my urgent need to be anywhere in the world apart from on board a plane. We were then informed, a little reassuringly, that it was not smoke we were seeing but fuel. The pilot was dumping his fuel to make an emergency landing back in Paris.

He landed the plane minutes later to a round of applause and we were greeted on the tarmac by a team of fire engines. Never in my life had I been more relieved to step off an aeroplane. I made a mental note of the plane’s serial number and made the decision never to get back on that particular plane. In fact, for about half an hour I wasn’t certain I was prepared to get back on any plane.

The ten-hour delay in Paris which followed gave me a chance to relax and calmed my nerves. The rest of the group did not seem overly anxious so I took my cue from them and decided to continue, more determined than ever that I would make it to Cameroon.

The delay provided the perfect opportunity to catch up on some sleep and to get to know the rest of the team a little better. By the time we arrived in Yaoundé, Cameroon, over 24 hours after that early morning alarm call, it felt like we had completed an epic journey.

Yet that was only the beginning.

Sometimes we are more capable than we realise. Sometimes we need a challenge to help ourselves discover that. This was my challenge. Over the next few days I would witness levels of poverty I could never have imagined, view delivery suites that would horrify me, see emergency food supplies for malnourished children that would move me to tears, and meet the villagers who have benefitted from the Pampers and UNICEF MNT campaign and those who still need our support.

Rosie Scribble in Cameroon Africa

I would document every detail of the trip and would home return feeling positive, energised and determined to do my bit to help raise awareness and support the Pampers and UNICEF campaign.

And it would change my life.

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A first glimpse of Africa

Waking up in a hotel room in West Africa to find myself entangled in a mosquito net was a slightly surreal experience. We had arrived in Yaoundé at 4am to a city in darkness, so finding my bearings was difficult and I was looking forward to seeing Cameroon in daylight for the very first time.

Our day began with a meeting at the UNICEF Cameroon office where we were warmly welcomed by the team, some of whom would be spending the next few days with us as we travelled around the area. From my brief glimpse at the surrounding scenery, the rich red African soil, the constant beeping of car horns, the bright yellow taxis and a city buzzing with people, it was like nothing I had experienced before and I was keen to see more.

Yaounde Cameroon Africa

The UNICEF Cameroon team briefed us about their country and gave us some essential security information along with facts about the Eastern region where we would be spending the majority of our time.

All our journeys would be made in a convoy of 4×4 UNICEF vehicles fitted with radio communications and we could only travel between the hours of 6 am and 6p m to areas given prior security clearance by the UN. Any signs of political instability in areas of Cameroon bordering Chad and the Central African Republic would necessitate an armed escort. This is the reality of travelling to certain parts of Africa.

The statistics presented to us about infant and maternal mortality rates in Cameroon made depressing reading. Since 2002 however, with the support of partners and UNICEF, the Cameroon Government has been working towards a long-term plan for the elimination of maternal and newborn tetanus campaigns through the implementation of vaccination campaigns targeting women aged 15-49 years in 102 high risk health districts out of the 174 in the country, to try and reduce the number of deaths from the disease and help lower the country’s infant and maternal mortality rates.

Huge progress has been made since 2002 and during our trip, it was evident that support from the Pampers and UNICEF partnership was proving effective in helping the country work towards the goal of eliminating the disease*.

  • Life expectancy at birth is 51 years
  • The under-five mortality rate (probability of dying between birth and five years of age) is 144 per 1000 live births, compared with 6 per 1000 live births in the UK
  • The infant mortality rate (probability of dying between birth and one year of age) is 74 per 1000 live births, compared with 5 per 1000 live births in the UK
  • The maternal mortality rate is 669 per 100,000 live births, compared with 8 per 100,000 live births in the UK
  • 77% of newborns are now protected again tetanus
  • Pampers has donated over $1 million to help support the elimination of MNT in Cameroon and contributed over half the funding received for the MNT elimination programme in Cameroon since 2008

From Yaoundé we took a four-hour drive to Bertoua in the Eastern region and I was able to see Africa properly for the first time. I was struck by the obvious poverty as the larger buildings of the urban centre made way for mile upon mile of very basic mud huts.

Basic mud hut Cameroon Africa

Groups of children could be seen playing outside in the soil. Many others could be seen selling their wares at the roadside or walking the long distances from the surrounding farms to their homes with essential food supplies for their families.

Children playing Cameroon Africa

I had witnessed nothing like it before. The most basic mud huts had no running water, no electricity, poor sanitation and no refrigeration and were typically home to very large families, the majority of whom were children. This is a young country. We would see very few people aged over 50 during our trip. Yet these children are living in conditions which would be considered completely unacceptable in the developed world. In Cameroon alone, 33% of the population live below the International Poverty Line of $1.25 a day *.

Cameroon Africa

It is a sobering experience and a world away from life with my daughter in the UK. The following day I would get the rare opportunity to travel to some of the remotest parts of Cameroon, to meet the villagers who live in conditions like these, to sit in their homes and find out firsthand what life is really like for them. I would see the conditions in which women give birth and why being vaccinated against tetanus really is a matter of life and death.

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The grim reality of childbirth in the developing world
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.

Health centre Cameroon Africa

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.

Health centre Cameroon Africa

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.
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Where risky home births are the only option
From the district hospital in Bertoua, I travelled with the Pampers and UNICEF team to Lembe village a short distance away and home to 240 villagers, the majority of whom were children.

Young girl Cameroon Africa

It was a village I found to be particularly desolate and bleak and many of the children looked quite despondent. Yet many of the villagers came out to greet us and sang an upbeat song about UNICEF and tetanus. Alex, one of our UNICEF representatives from the UK, was presented with a bouquet of flowers.

Welcomed into Lembe village Cameroon

The fact that we were made so welcome in Lembe village, and in all the villages we visited during our time in Cameroon, was due to the very strong links UNICEF has established with these communities. As a result the villagers were happy to welcome us into their homes and talk openly to us about their lives.

Mud hut Cameroon Africa

The first person we interviewed was Mr Desire Andono, a community mobiliser. Without television or other forms of mass media, the villagers relied on mobilisers like Mr Desire to educate or ‘sensitise’ them about health issues such as tetanus. An important part of any mass maternal and newborn tetanus elimination campaign is explaining to women the importance of being vaccinated as well as providing practical information about where they can receive their tetanus vaccines.

Mr Desire spoke with great enthusiasm about his presenting role at the local radio station and his weekly programme ‘Let’s talk about health.’ He was very keen to own a dictaphone so he could record locals for his show. As he explained this I was suddenly very aware of the dictaphone I had in my hand, something I had picked off the shelf shortly before the trip on the off-chance I might need it. I had given little consideration to the cost. How different the situation is in Cameroon. For Mr Desire it would cost him two months’ wages, yet he had a far greater need for it than me.

We then met Madame Meling Jacqueline, aged 20, who was nine months pregnant and due to give birth any day. As she spoke to us in her home about her wish to give birth in the district hospital, where conditions had shocked me that morning, I wondered what sort of birth lay ahead for her and whether she and her child would survive. She was waiting to receive the US$6 she needed to give birth in hospital from her sister. If the money did not arrive, she would have no option but to give birth at home with the assistance of a Traditional Birth Attendant (TBA). TBAs have experience of delivering babies but very basic training, if any at all, and limited resources.

When we were introduced to the village TBA, Madame Biwole Biscotine, later that afternoon, I was shocked to see that her ‘delivery kit’ consisted of just a plastic apron and a plastic mat. Women gave birth in her kitchen and were required to bring their own kit, including gloves. If they were not able to bring their own gloves then she would deliver the baby with her bare hands.

Despite her limited training, Madame Biscotine did have a comprehensive understanding of maternal and newborn tetanus. She understood that it could be contracted during childbirth as a result of unhygienic birthing practices, such as cutting the umbilical cord with unsterile instruments or treating it with contaminated dressings, and also how it could be prevented with vaccinations and hygienic birthing practices.

So despite the remote locations, the lack of education, and the poverty, the message about tetanus was getting through to these communities. The maternal and newborn tetanus elimination campaign in Cameroon, that money from Pampers and UNICEF was helping to fund, was proving successful and I left the village feeling a little more hopeful for the generations of villagers and their children living there.
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Facing the reality of tetanus in the developing world
Tetanus is not something I had given a great deal of thought to before my field trip to Cameroon. The last recorded case in the UK was over 80 years ago and children are now routinely vaccinated against the disease. Yet in Africa, and many parts of the developing world, maternal and newborn tetanus is still a reality.

From Lembe village we made the twenty minute drive to Akussa village, home to Madame Ngans Sophie and Mr Nkodo Tongo Isodore. They were the grandparents of the baby treated for newborn tetanus by the District Medical Officer we had spoken to that morning. He died in 2008, aged just three weeks, before there was even a chance to give him a name.

Grandparents Akussa Village Cameroon

Despite the heat and their obvious poverty, Mr Isodore had dressed for our visit in a suit and tie and immaculately polished shoes. It was moving to see the effort he had gone to on our behalf and the importance he clearly placed on our visit. As his wife sat quietly in the corner of their very basic home, Mr Isodore told us the story of his grandson, born to one of his daughters, Madame Christelle when she was just 14.

His daughters had been told that any new boyfriend must be introduced to the family so they could get to know him. However his fourteen-year-old had not done this, and on discovering she was pregnant had fled the family home, concealing the pregnancy from her parents.

She returned home months later, unsure of exactly how many months pregnant she was. The father of her unborn child was told to take responsibility for her, but instead he disappeared and was never seen again.

During that time the girl received her first tetanus vaccine. However, the outreach motorbike delivering the second crucial vaccine broke down. So when she gave birth to a baby boy at home shortly afterwards, she was not fully protected against the disease. Her mother cut the umbilical cord using a razor blade dipped in alcohol to sterilise it and tied the cord with thread used to plait hair that had been bought from the local market. The thread was not clean.

For three days the consequences of the unclean thread were not obvious, but then the baby became stiff, changed colour and refused to breastfeed – all classic signs of newborn tetanus. The girl’s father borrowed money and took them both to the local health centre where they were sent home with medicines to inject.

By the evening the baby’s condition had deteriorated. Mother and baby both went to the district hospital where they remained for seven days. After that time, and showing no signs of improvement, they were sent home. The baby boy died the same day.

Tetanus is known as the silent killer. It is still a reality in the developing world. Pampers and UNICEF have been working in partnership since 2006 to help work towards eliminating the disease and raise money for tetanus vaccines to protect the millions of women who are still at risk from the disease. It is a goal which can be achieved in our lifetime, with our help. For every pack of Pampers products purchased with the “1 pack = 1 life-saving vaccine” logo, Pampers will donate the cost of one tetanus vaccine to UNICEF.

Pampers UNICEF 001

Preventing unnecessary deaths, like this one, really is as simple as that.
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The day everything changed
I was aware that this field trip would impact on me, cause me to reassess my life, look at the world differently and appreciate what I have. I knew it would change me. Yet nothing could have prepared me for the day I found myself discussing childhood malnutrition in a nutrition centre with a doctor from a developing country.

The nutrition centre was part of the main health centre in Bazzama. On our way in we had been shown sacks of corn syrup blend and cans of oil supplied by the World Food Programme. They were for malnourished children, pregnant woman and lactating women in the surroundings villages, many of them refugees from the Central African Republic.

Health Centre Bazzama Cameroon

I had seen food supplies such as these on news programmes but never firsthand. It was alarming to see them and to hear of the children in desperate need of nutrition. The Chief of the health centre, Mr Simon Sembong, explained that malnutrition was primarily due to poor quality food as many children survived on a diet of cassava, but that the quantity of food available was also an issue.

As he explained that children brought to the health centre were given an appetite test to see if they were able to eat and given high-calorie plumpynut if they could, my thoughts drifted back to the times I had spent in hospital being fed high-calorie nourishment drinks as a result of my anorexia. For completely different reasons I knew what it was like, as an adult, to feel the effects of starvation. I could imagine nothing worse than a child experiencing that level of suffering.

Seeing the scales on the consulting room floor, the diagram on the wall showing how acute malnutrition should be treated, and hearing about the vast numbers of children who die each year simply because they do not have adequate nutrition, it hit home that these children have no choice whatsoever in what they eat or whether they eat, and this is the reality for large numbers of the communities in Africa and across the developing world.

My thoughts turned to my own daughter and how different her life is in comparison. She has access to more food than she will ever need. We are both fussier about food than we need to be, and I am certainly more conscious of my size than I need to be. Yet we have our health and we take it for granted. There is no such luxury here.

As the emotion of the occasion overwhelmed me, I stepped outside to compose myself and gather my thoughts. To my left was a boy lying next to his mother suffering from malaria, too weak to sit up. He was seven years old, the same age as my daughter.

Mother and baby Cameroon

Something changed in me that day and I knew from that point on I would appreciate what I had, alter my attitude towards food, continue to look after my health and never ever put it at risk again.

We cannot solve all the problems of the developing world, but eliminating tetanus is one thing we can achieve in our lifetime. It is just one small step. Life is hard here, really hard. All children deserve the best start in life they can possibly have. For children in the developing world, a life with no risk of contacting tetanus is a step in the right direction.

If you can help these communities and others like them, please do.

Pampers and UNICEF campaign website

UNICEF UK

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The harsh reality of motherhood in the developing world

Our visit to the health centre in Bazzama highlighted the importance of outreach services in transporting essential supplies and vaccinations to the surrounding villages and refugee camps. From there we travelled on to Ngamboula, 7km away, to see these outreach services in action and speak to pregnant women who have just received their tetanus vaccines.

The villagers were extremely warm and welcoming and the children joined in with a celebratory song they had prepared for our arrival.

The children were particularly excited to see us and it was wonderful to see them gathering round, smiling and chatting. They were fascinated by our cameras and amazed to see images of themselves for the first time.

Children in Ngamboula Village Cameroon
Jemma’s iPhone proved a huge hit. The children were amazed by the technology and loved touching the screen.

Children in Ngamboula Village Cameroon
Once again their homes were very modest yet there was a strong community spirit and a much livelier atmosphere than had been evident in the other places we visited.

It was in Ngamboula that we met Madame Adrienne Ndande who had come to talk to us about the vaccination session she had just attended. There turned out to be a great deal more to her story than we had realised and proof that you never really know what someone is going to disclose until they actually start talking to you.

Madame Adrienne, aged 25, was half way through her fifth pregnancy. She explained to us that she felt proud that she and her baby were both protected from tetanus and her eyes lit up when we asked her what she liked best about being a mother. She said she loved caring for her children, being called Mum and seeing her family grow.

Then Adrienne said that she had lost two of her children, one aged 18 months from malnutrition and the other aged 19 months from asthma. Her last bereavement had been two weeks previously.

The conversation quickly changed from a positive, upbeat discussion about the benefits of vaccinations, to a more sombre one as the reality of infant death in the developing world and the dreadful distress this causes was sitting there in front of us.

Madame Adrienne’s situation, sadly, is not untypical. The infant mortality rate in Cameroon is 74 per 1000 live births*. One child out of seven in Cameroon will not celebrate its fifth birthday. Many of the women we spoke to during our time in Africa reported they had lost babies and young children too.

The Pampers and UNICEF campaign is helping women like these.

*UNICEF Cameroon statistics

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Tetanus and the work that still needs to be done

I travelled to Cameroon with the Pampers and UNICEF team to see the success of their partnership in helping to eliminate maternal and newborn tetanus and to see for myself the work that still needs to be done. During our time in Ngamboula we met two women and their families who had not been vaccinated against tetanus because they believed the injections would harm them in some way. As a result, they all remained at risk of contracting the disease.

Between them Madame Pelagie and Madame Yvonne had had 17 pregnancies. Fourteen of their children were still alive. Madame Pelagie, the younger of the two women, was holding her seven month-old twins when we spoke to her outside her mud hut. She did not know her age but her husband said he was 23. She looked little older. Her eldest child was ten years old. It seems that when girls start having their periods here, they start having children. Many of the pregnant women we had seen in the village looked very young.

Ngamboula Village Cameroon Africa

Madame Pelagie had received no vaccinations and had never visited a hospital, nor had any of her seven children. As she had her first five children at home alone in unhygienic surroundings, the risk of them contracting tetanus would have been very high. She explained that once her babies were born she would leave them on the floor and go and get help from a relative who would cut the umbilical cord with bamboo. She received some help from the village’s traditional birth attendant for the birth of her twins but still went through a high-risk birth with no professional support on hand.

Tetanus is caused by bacteria that lives in dead and decaying matter in soil, animal dung and faeces and develops when bacteria contaminates an open wound. The bacteria works as a nerve toxin (poison), affecting the central nervous system and causing painful and uncontrollable muscle spasms. Anyone can contract maternal and newborn tetanus if they are not vaccinated; however, it is usually women and newborns living in remote areas with no access to antenatal care or immunisation that become affected.

All Madame Pelagie’s children will have been put at risk of contracting the disease and remain at risk while they remain unvaccinated. She explained to us that she was scared of needles and worried that the needle would break and end up in the body.

Madame Yvonne, aged 42, was convinced that vaccinations would make her children ill. Her children were aged between seven weeks and 22 years. None of them had been vaccinated and, in fact, she had little understanding of what tetanus was or why vaccination was important. While her husband had some understanding, he was also unaware of the risks of remaining unvaccinated.

Again, Madame Yvonne had had all her babies at home alone, apart from the time she had given birth in the bush. She had been working on a nearby farm when her contractions started and there was no time to find shelter. The risk of herself or her newborn baby contracting tetanus would have been extremely high. One of her children had received a vaccination in the past but Madame Yvonne explained that it had given him a fever for two days so she had decided against any further vaccines for any of her children.

A crucial part of the MNT elimination campaign in Cameroon involves educating women, like Madame Pelagie and Madame Yvonne, about tetanus, the importance of being vaccinated and dispelling any inaccurate beliefs they may have. It was obvious from our visit that further work still needs to be done in this area. Fathers, too, needed to appreciate the importance of their wives and children being vaccinated.

As I watched many children during my time in Cameroon playing happily in the soil, it was worrying to know that there will be many who remain at risk from the bacteria that lives there. A simple course of vaccines could eliminate that risk and give them a much brighter future.

Boys with toy car Cameroon

Maternal and newborn tetanus (MNT) still threatens the lives of 170 million women and their newborn babies in 40 countries around the world. In 2010 (according to WHO), it has been calculated that approximately 59,000 newborns die annually from newborn tetanus, and thousands of women from maternal tetanus. Even though MNT is easily preventable with a simple vaccine, one baby till dies needlessly of newborn tetanus every nine minutes.

Together we can change that.

Pampers and UNICEF

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Vaccinations, delivery suites and thoughts of home

On the last full day of our field trip to Cameroon, we attended a vaccination session at the health centre in Bertoua and visited the regional hospital where I really hoped the delivery suites would be better than those we had seen so far.

The vaccination session confirmed what I had already learnt during my week in Africa: the message about tetanus was getting through and women were turning up to be vaccinated even if that meant travelling long distances.

Yet the birthing conditions at the hospital, considering they were supposed to be the best in the area, were alarming. Although the gynaecologist’s consulting room looked highly clinical and hygienic, the delivery suites (one of which could accommodate three women giving birth at the same time) were hot, unhygienic and contained metal beds which looked horrific. As I left one room I noticed a dirty red rag lying on the floor. Again, there were no resuscitation facilities, no oxygen, not even a bag and mask for those babies needing extra help.

It seemed then running water and a metal bed was the best on offer in Cameroon when it came to giving birth. A delivery at the regional hospital cost US$12. A full ante-natal check and basic health screening cost US$50 which is beyond what the majority of women can afford. Living in conditions of extreme poverty, it is not surprising that the majority of women have to give birth at home with no professional support in conditions which are unhygienic at best and life-threatening at worse.

Having spent time with new mothers, expectant women, traditional birth attendants, social mobilisers, doctors and a range of health professionals, and having witnessed the conditions in which the majority of families live and the conditions in which women give birth, it is clear that to be vaccinated against tetanus is an absolute necessity.

As we returned to the relative luxury of our hotel in Yaoundé, my thoughts returned to home, to my child and my life, a world away from this one. The field trip had been an amazing experience — emotional, educational, shocking, sobering, thought-provoking, life-changing. Within 24 hours I would be back in the familiar surroundings of home, yet knowing I would never forget these communities.

Pampers UNICEF Cameroon group shot
Today, in mid-October, I think of them often.

I always will.

The Pampers and UNICEF campaign runs from October to December. For every Pampers product purchased with the “1 pack = 1 life-saving vaccine” logo, Pampers will donate the cost of one 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. Helping to eliminate a disease as deadly as tetanus really is as simple as that.