Sierra Leone: In honor of Fatima

October 10, 2008

U.S. Fund for UNICEF President and CEO Caryl Stern recently visited Sierra Leone with Pampers "One Pack = One Vaccine" campaign spokesperson Salma Hayek and Pampers representatives, to witness the effect of tetanus on mothers and newborns, and the positive impact of the Pampers/UNICEF program. She sent this post from the field.

sierra-leone1.jpg
© UNICEF/ HQ98-0510/Pirozzi
SIERRA LEONE: An adolescent girl holds her baby in her lap near Freetown, the capital.

UNICEF's Dr. Yvonne Hardy and I sat on the floor with 19-year-old Memunata as we watched her tiny newborn daughter struggle for her life in a small crib next to her. Memunata had given birth to her first child exactly seven days prior. The delivery took place at home with the assistance of a traditional (but unskilled) birth attendant.

The labor went well by all accounts, and the baby girl screamed and cried on her arrival as anyone would expect. But within 48 hours, the baby was crying relentlessly and stopped nursing. Her jaw was clenched shut.

Memunata was frantic and found the birth attendant who told her to go to a local health facility. When she arrived at the clinic, the baby was diagnosed with tetanus and immediately referred to Ola During Children's Hospital, the only pediatric facility in Sierra Leone.

Yvonne went to the hospital in the early afternoon to meet with Memunata and her baby in advance of the rest of our group.

We arrived in time to learn that Memunata had just expressed her breast milk into a plastic cup, eager to feed her baby with a syringe. But the baby couldn't take it. We heard tiny gasps and watched as the baby convulsed, her back arched and her arms locked. She did that every so often, over the course of a few hours. The pain she was feeling was obvious. We all felt it.

U.S. Fund for UNICEF President and CEO Caryl Stern recently visited Sierra Leone with Pampers "One Pack = One Vaccine" campaign spokesperson Salma Hayek and Pampers representatives, to witness the effect of tetanus on mothers and newborns, and the positive impact of the Pampers/UNICEF program. She sent this post from the field.

sierra-leone1.jpg
© UNICEF/ HQ98-0510/Pirozzi
SIERRA LEONE: An adolescent girl holds her baby in her lap near Freetown, the capital.

UNICEF's Dr. Yvonne Hardy and I sat on the floor with 19-year-old Memunata as we watched her tiny newborn daughter struggle for her life in a small crib next to her. Memunata had given birth to her first child exactly seven days prior. The delivery took place at home with the assistance of a traditional (but unskilled) birth attendant.

The labor went well by all accounts, and the baby girl screamed and cried on her arrival as anyone would expect. But within 48 hours, the baby was crying relentlessly and stopped nursing. Her jaw was clenched shut.

Memunata was frantic and found the birth attendant who told her to go to a local health facility. When she arrived at the clinic, the baby was diagnosed with tetanus and immediately referred to Ola During Children's Hospital, the only pediatric facility in Sierra Leone.

Yvonne went to the hospital in the early afternoon to meet with Memunata and her baby in advance of the rest of our group.

We arrived in time to learn that Memunata had just expressed her breast milk into a plastic cup, eager to feed her baby with a syringe. But the baby couldn't take it. We heard tiny gasps and watched as the baby convulsed, her back arched and her arms locked. She did that every so often, over the course of a few hours. The pain she was feeling was obvious. We all felt it.

tetanus1.jpg
UNICEF/ HQ02-0277/Pirozzi
A card illustrates the risk factors and effects of tetanus, part of a flip chart used to advocate vaccinations against tetanus. The card shows (left-right, top-bottom): the target group " women of childbearing age; the rigid body and arched back that are symptoms of tetanus in a child; a woman who has cut herself in a field, possibly introducing into the wound tetanus spores found in soil; and common agricultural tools that can carry tetanus from the soil.

Only 10 percent of babies with tetanus survive, but the doctor who tended Memunata's daughter told us he was hopeful she would recover. Although there was no tetanus antibody serum for humans in all of the country (it's just too expensive), he had given her what they did have"horse antibody serum"along with valium to calm her spasms. The doctor wanted to put the baby in an oxygen tent too, but the hospital was completely out of oxygen.

Our UNICEF Team took turns going into the room with Memunata and her daughter. As I stood in the room during my turn, it suddenly took on an even more terrible air. I watched with horror as Memunata's tiny baby girl tried to draw in a breath and then seemed to just stop. As the color drained from her hands, turning her beautiful brown skin to a dull grey, we knew the worst had happened"we knew that she was gone.

In the moments of silence between coming to that realization on our own and then hearing Yvonne lean in and whisper, "I think the baby has passed," there were no appropriate words to say. What can one say?

Earlier, Memunata had told us that her baby was not yet named. Out of tradition, she was waiting for her eighth day before she would do so. She was going to call her Fatima in honor of Memunata's favorite sister.

Fatima never made it to her eighth day of life. She weighed less than five pounds and spent most of her life in agonizing pain.

We all bore witness to this, and it is fair to say the group was in shock. We had left home little more than 24 hours earlier knowing that it would be difficult to accept the juxtaposition between our daily life experience and what we would see when we got to Sierra Leone. But this