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Health workers reach remote villagers in Ethiopia with tetanus vaccine

© UNICEF Ethiopia/2006/Heavens
A Hamer youth outside Turmi in the Hamer District of Ethiopia’s South Omo Zone.

By Andrew Heavens

UNICEF’s flagship annual report, ‘The State of the World’s Children’, launched on 11 December, focuses this year on the double dividend of gender equality, which helps both women and children overcome poverty. Here is one in a series of related stories.

TURMI, Ethiopia, 18 December 2006 – The town criers had been out since dawn, walking around the domed, wood-framed huts, calling out and blowing their horns.

Slowly, mothers and children emerged, gathered in a clearing and headed towards a large fig tree on the outskirts of Turmi in Ethiopia’s remote South Omo Zone.

In the middle of the crowd was a boisterous group of young women, all wearing the traditional leather skirts, brightly coloured beads and heavy metallic jewellery of Ethiopia’s Hamer people.

The children were there with their mothers to receive a life-saving package of health and nutrition interventions – de-worming tablets, measles vaccinations, vitamin A supplementation and nutritional screening – funded and supported by UNICEF and its partners.

The boisterous young women had come along to receive an extra treatment – a vaccination designed to protect them, and any soon-to-be-born babies they might be carrying, against the scourge of maternal and neo-natal tetanus.

© UNICEF Ethiopia/2006/Heavens
An Ethiopian mother and child wait in line during a round of the UNICEF-backed Enhanced Outreach Strategy outside Turmi.

Elders encourage younger women

Government health workers were waiting under the tree to hand out the tablets and administer the vaccines. They were there as part of the ground-breaking Enhanced Outreach Strategy – the largest-ever partnership between Ethiopia, UNICEF and the World Food Programme, which reaches more than 7 million children and 1.5 million pregnant and lactating women with key interventions twice every year.

“It is wonderful to see so many young women,” said Tersit Assefa, UNICEF’s Assistant Project Officer for Health in Ethiopia’s Southern Nations, Nationalities and People’s Region, which includes the home of the Hamer people in its southern-most tip, close to the border with Kenya.

“In other places, women of this age often stay away,” said Ms. Tersit. “All sorts of misguided rumours go round that the injections will sterilize them or harm them in some way. But here, the village elders are on board. They are here, encouraging the women to come along.”

Tetanus morbidity and mortality

Maternal and neo-natal tetanus may not be high on the health-care priority list of many western countries. But it still casts a heavy shadow over the more remote corners of the world, including the isolated countryside around Turmi.

Ethiopia has one of the highest neonatal tetanus morbidity and mortality rates in the world – mainly because of low overall vaccination levels and the large number of births that take place in often unsanitary conditions in the home.

© UNICEF Ethiopia/2006/Heavens
Hamer women drive bulls towards traditional bull-jumping celebrations outside Turmi in South Omo, Ethiopia.

Tetanus spores get in through a puncture or open wound – often the cut umbilical cord. Once they take hold, they can kill a newborn baby within days.

Cheap and effective vaccines can protect both mothers and children against the disease – often known as the ‘silent killer’ because of the amount of times it goes unreported. The trick is to get the vaccines to the women.

Health workers are doing the job

Turmi is more than three days’ drive across rough roads and often-flooded river beds from the capital, Addis Ababa. “Until you’ve been on the ground, you don’t realize what the challenges are in this part of Ethiopia,” said Dr. François Gasse, UNICEF Senior Project Officer for Immunization, who was observing the vaccination round.

“The disease strikes women who have no access to ante-natal care, who cannot receive tetanus toxoid vaccinations, who deliver at home without a skilled birth attendant.

“From what I’ve seen here, however, the health workers are doing the job. In the area that we visited it was hard to find any woman not immunized,” Dr. Gasse continued. “I am convinced that they will achieve maternal and neo-natal tetanus elimination. The health workers respect the communities and the communities respect the health workers. That is a recipe for success.”




14 December 2006:
UNICEF Emergency Communication Officer Andrew Heavens reports on efforts to deliver vaccines for tetanus and other diseases in Ethiopia’s remote South Omo Zone.
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