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At a glance: Haiti

Penetrating the remotest areas of Haiti to eliminate maternal and newborn tetanus

By Jean Panel Fanfan

Continuing the effort to foster an environment where children have access to health services is just one of the 25 achievements we are celebrating as we approach the 25th anniversary of the Convention on the Rights of the Child (CRC).

Annual measles deaths dropped 78 per cent from 2000 to 2012, representing an estimated 13.8 million lives saved by measles vaccination. Likewise, tetanus deaths among mothers and their newborns dropped significantly, from 200,000 to 59,000 annually between 2000 and 2010, due in large part to immunization and to improved birthing practices.

Haiti is not shying away from the challenge of penetrating its hardest-to-reach areas with the tetanus vaccine. After all, there are almost 1.3 million women who need vaccinating, if the country is to achieve its objective of ending maternal and neonatal tetanus, for once and for all.

© UNICEF Haiti/2014/Fanfan
Marlène Jean is one of dozens of women in the remote community of Milord who have had their third tetanus jab as part of a national campaign against maternal and neonatal tetanus.

MILORD, Haiti, 7 March 2014 – Marlène Jean’s face is stoic, as the needle punctures her flesh. She is among dozens of women receiving their third vaccination. Haiti is carrying out a nationwide campaign against maternal and neonatal tetanus.  Marlène Jean’s village of Milord is in South-East department.

After her jab, Marlène Jean attends an awareness session held by one of the vaccinators. “I have always lived in Milord, with my husband and two children,” she says. “I finally learned that vaccination against tetanus is important for the health of both mother and child.”

Marlène Jean is 32 years old. The goal is to reach the nearly 1.3 million women who, like her, are 15–49 years old – of childbearing age – across all departments.

A fatal disease

Maternal and neonatal tetanus is a serious disease, with a high fatality rate for newborns. It can be prevented if women are vaccinated against tetanus.
Nearly 50 per cent of cases of tetanus in the Caribbean occur in Haiti.

© UNICEF Haiti/2014/Fanfan
The campaign is targeting women of childbearing age across the country. Vaccination agents have to cover long distances, sometimes on foot, to reach all areas.

A remote village

Milord is a three-hour drive from Jacmel, the main town of South-East department. The road from Jacmel to Milord skirts the side of a mountain. Crevices and cliffs are never far away.

The region is isolated, and there is no health centre or school. Public services are lacking; there is no electricity. Houses are scattered, at a distance from one another.

A steadfast objective

UNICEF is supporting the Ministry of Public Health and Population to eliminate maternal and neonatal tetanus in the country by 2015. It is vital to reach the hardest-to-reach areas, like Milord, and the municipality of Bainet, also in South-East.

Mercedes Marie Alexis has been head nurse for Bainet for nearly 23 years. She coordinates all vaccination activities. “Health centres are really far from these areas,” she says. “Most of the time, people do not receive all doses of the vaccine, because they have to walk a lot. It is therefore essential to organize the vaccination posts to reach all women of childbearing age and children and protect against tetanus.”

Town criers announce the vaccinations. Nurse Alexis urges women who come for vaccination to carry the message to those who may not have heard the alerts.

© UNICEF Haiti/2014/Fanfan
A vaccination post inside a school in the municipality of Bainet. Nearly 50 per cent of tetanus cases in the Caribbean occur in Haiti. Achieving vaccination coverage is critical to eradicating the preventable disease, which is highly fatal among newborns.

During the third phase of the campaign, vaccinators and social mobilizers from the Ministry of Public Health and Population travel great distances, sometimes on foot. They have been known to endure six hours of walking under the sun and through persistent harsh winds to reach every woman.

“If we are not going to them, because of the distance, they will not come to us,” says Nurse Alexis.

A mother reached

Marlène Jean is lucky. She lives less than ten minutes from the vaccination site, so the trips to get her jabs have been quick. Many women in the area have walked more than two hours to get vaccinated.

The first two rounds of the campaign achieved more than 100 per cent of the target. UNICEF immunization specialist Jackson Ernsly says that the current year’s campaign is being carried out in the 65 high-risk communes, while next year’s campaign will take place in the remaining 75.

Learn more about UNICEF’s programmes in Haiti

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