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.

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.

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