The Campaign to Save Mothers and Babies from Tetanus

A Report from A Report from the U.S. Fund for UNICEF Spring 2004, No. 7

UNICEF BRINGS EVEN mothers and their babies against maternal and neonatal tetanus (MNT),” Whitty said. “But there are GREATER MEANING TO still millions of women of child-bearing age in 57 MOTHER’S DAY developing countries who are at extremely high risk for tetanus infection. With support from our donors, What if a Mother’s Day gift could help save a I’m confident that we will help provide UNICEF and mother’s life? This Mother’s Day, U.S. Fund for its partners with the resources they need to eliminate UNICEF donors can do just that thanks to an this disease.” ambitious fundraising program launched by the UNICEF’s Mother’s Day Campaign to Save Mothers and giving opportunities get under Babies from Tetanus. way April 1 when Parfums “When UNICEF gets Givenchy and May Company will U.S. Fund for UNICEF behind a holiday, we always each make a donation of $1.20 to launch a full-court press,” said Sande H. Zirlin the U.S. Fund for UNICEF for U.S. Fund for UNICEF Senior Vice GFWC-Century Club of every sale of a special Givenchy President for Marketing and Amsterdam, N.Y. Mother’s Day gift set. The Development Diane Whitty. Mother’s Day gift set, which “Whether it’s the holiday season retails for $56, will be available at or Halloween, we offer our May Department Stores in the donors many ways to celebrate a U.S., including Lord & Taylor, special time of year by helping Filene’s, Robinsons-May, Hechts, the world’s children. Now our Courtesy of Pier 1 and Strawbridge’s. Each gift set brand is expanding to Mother’s includes the rose-infused scent Day with giving opportunities Pier 1 Gift Cards of $50 of Very Irresistible Givenchy, the through our partnerships with or more support the fight new fragrance represented by Pier 1 Imports, Parfums Givenchy against MNT. actress and U.S. Fund for UNICEF LLC, The May Department Stores National Ambassador Liv Tyler. U.S. Fund for UNICEF Company, and many other valued alliances. As “We are thrilled to continue the relationship between UNICEF can do a lot with a little, and since it only Sandra Schaff Givenchy and UNICEF, which began many years ago takes $1.20 to buy the vaccine and immunize a GFWC Women’s Club of with our first spokesperson, the incredible Audrey woman of childbearing age against tetanus, even a West Allis, Wisc. Hepburn,” said Gilles Dougoud, general manager of small gift can help protect newborns and young Parfums Givenchy LLC. “Our participation in this mothers from this deadly disease. Plus, when women program honors the work of Ms. Hepburn and are vaccinated against tetanus, their newborns are creates a new bond through the support of our also shielded from neonatal tetanus. current spokesperson, Liv Tyler. Parfums Givenchy “For more than 70 years, we’ve had an and May Company have committed to raise at effective and low-cost vaccine that can protect least $18,000.” nationwide, is distributing Mother’s Day cards repro- Building on last year’s success as the first of the duced from designs (front page) by two of its members U.S. Fund for UNICEF’s corporate partners to support and collecting donations to support the MNT campaign. MNT programs through cause-related marketing, Pier 1 “This Mother’s Day, our donors can also send Imports is making a contribution of $1.20 for every Pier 1 UNICEF E-Tribute Cards,” Whitty said. “For a contribu- gift card of $50 or more sold between April 18 and tion of $25 or more, you can send a message of love and Mother’s Day. Mother’s Day is being celebrated this appreciation and help UNICEF create a world fit for year on May 9. children. All you need to do to purchase and send an “Pier 1 has been a tremendous partner of the e-card is visit our Web site, www.unicefusa.org.” U.S. Fund for UNICEF for 19 years and has shown great Worldwide service organizations are also responsibility to the world community. Together we have getting behind the MNT campaign. Rotary International Courtesy of Givenchy an extraordinary opportunity to change the lives of District 7230 is sending a special Mother’s Day MNT This year, sales of the mothers and their newborns for the better,” said Charles appeal to an estimated 1,600 supporters in Bermuda, Very Irresistible J. Lyons, president of the U.S. Fund for UNICEF. “With Westchester County, N.Y., and three boroughs of New Givenchy Mother’s Day Parfums Givenchy LLC and Pier 1 Imports leading the York City (the Bronx, Manhattan, and Staten Island), Gift set will benefit way, more and more great brands are getting behind thanks to the leadership efforts of Rotary District MNT programs. our Mother’s Day MNT campaign, including Aaron Governor David J. Sullivan from Bermuda, Kirsten Basha. The international jewelry designer, most well Edstrom, president of the Rotary Club of Metro New known for his Baby Shoe charms for mothers, has York, and Joan Fyfe, a Rotary International U.N./N.Y. donated $7,500 to support UNICEF’s MNT programs.” representative. Sending cards is another way to support “The entire U.S. Fund for UNICEF team is rallying UNICEF’s Mother’s Day initiative, thanks to the General around our Mother’s Day work, including an effort in Federation of Women’s Clubs. The national women’s Chicago led by board members Dave Samber and organization, which is made up of nearly 5,000 clubs Evangeline Gouletas, where participating restaurants are

UNICEF/Parker

Tetanus toxoid vac- cine supplies ready to deliver to the field. making a donation of $1.20 per patron and asking their customers to make a tetanus vaccination drive in the region that in 2003 immunized 152,982 contribution of $1.20,” said Whitty. One of the best ways for people to find women with three doses of TT (this figure does not include the nearly 50,000 out how they can support UNICEF this Mother’s Day is to visit our Web site in women immunized in Nuba last year). The syringes used in the UNICEF- the weeks leading up to Mother’s Day. It will be a clearing house of informa- supported vaccination drive were auto-disable, meaning they can only be tion on all of our MNT giving opportunities and, as always, will also provide a used a single time, a key defense against spreading the HIV virus. fast and convenient way to donate online. With everyone’s help, we can put Dr. François Gasse, UNICEF senior project officer for immunization, an end to MNT and allow more babies a healthy start in life.” closely monitors the vaccination campaign that is under way in Sudan. He has also worked with UNICEF colleagues in the Nuba Mountains. WITH CEASE-FIRE IN SUDAN, UNICEF “When I visited the region, you could see the remains of the recent violence, with bridges destroyed and replaced by temporary bridges that PROTECTS MOTHERS AND BABIES are not very safe,” said Gasse. “You also see health centers that are destroyed, which has made it only more difficult for the population to For more than two decades, civil war blocked humanitarian relief access minimum health services. In every guest house we stayed in, there agencies from saving lives in central Sudan’s highly remote Nuba is still a bunker to protect staff from bombs if there Mountains region. Aerial bombing raids and is an air-raid alert. But there is now a peace landmined fields even kept relief convoys from process, and it has allowed us to go in and entering the region during famines. immunize women in the Nuba area against tetanus. Today, due to a cease-fire in Africa’s I feel it is a big success.” longest and costliest civil conflict, UNICEF and its The vaccination drive in Sudan got a big partners are now helping to bring basic health boost last year when a revolutionary pre-filled services to the people of the Nuba Mountains. The injection device called Uniject™ was used by immu- country’s prolonged war has caused 2 million nization teams in the Nuba Mountains. The syringe, deaths, many from disease and starvation, and manufactured by the U.S. Fund for UNICEF’s long- uprooted 4 million people from their homes. time partner BD (Becton, Dickinson and Company), “We are stuck in the middle,” Kaka consists of a one-inch needle attached to a sealed Mahjubua, eighteen, told the Washington Post, blister pouch pre-filled with a single dose of explaining that the Nuba Mountains were cut off vaccine. Because handling a Uniject requires no during the war by both government and rebel special training, it’s easy for even local villagers to forces. “We fear our health is spoiled because of give injections. The simplicity of the device makes it it.” She spoke to reporter Emily Wax last December possible to immunize two women a minute. At that while proudly approaching a line to receive her rate, about a thousand women can be protected first vaccination for tetanus, which was provided UNICEF/Parker against tetanus in just over eight hours. by UNICEF. 0Preparing for MNT vaccina- “Nearly any lay person can be trained to Last November, 49,099 women of child- tions in southern Sudan. safely administer the TT vaccine with Uniject in less bearing age in the Nubas received their first dose of than two hours,” Gasse said, noting that UNICEF is tetanus toxoid (TT) during the first round of vaccina- planning to expand the use of Uniject throughout southern Sudan. “With few tions. Three properly spaced doses of the TT vaccine provide a woman with trained health care workers, it can take months to complete vaccination up to ten years of protection against tetanus and also protect her newborn campaigns in remote parts of the world. But with Uniject, you can easily (through passive immunity) for the first few critical months. train many volunteers and the work is therefore much faster. Also in Sudan, Although UNICEF and its partners could not work in the Nuba the windows of opportunity are few. The rainy season severely limits access Mountains until 2002, the agency has supplied humanitarian assistance in to villages, and there are only certain times of year when you can work on other areas of southern Sudan since 1989. Starting in 2002, UNICEF began a the ground. That is why the speed and efficiency of Uniject is so important.” INDONESIA: NO OBSTACLE National Program of Immunization. “Keeping within our operational budget costs was one of our biggest chal- TOO GREAT TO SAVE lenges. Luckily, managing tools developed by WHO have MOTHERS AND BABIES helped us prioritize how we allocate resources.” Health workers on the front lines were also It’s no easy feat vaccinating women and confronted with obstacles. In the northwest province of children in the world’s fourth most populous nation, Aceh, where eight high-risk districts are located, armed especially when the task requires covering thousands of rebel conflict in the region initially hindered the effort. islands and working in provinces like Aceh that are torn Immunization dates set for last summer had to be by civil conflict. But Indonesia has succeeded in jumping postponed because the continuing struggle disrupted those hurdles and is on the road to eliminating maternal UNICEF/Ingrid Hilman health services and caused local residents to flee. But in and neonatal tetanus. the fall, health workers were able to finish the first round Dr. Jane Soepardi of Since 1990, reported neonatal cases in the of vaccinations in two of Aceh’s eight districts. the Indonesian Southeast Asian country have dropped from 1,427 to 64 In addition to civil conflict and cost, traveling in Ministry of Health (l.), in 2002. Indonesia is also near completing immunization Indonesia’s vast archipelago is a constant challenge that UNICEF’s Dr. François of all women of child-bearing age, bringing the country requires using several modes of transportation. Gasse, and Suprihatin, closer to eliminating MNT and being validated by the “It can take up to four days to reach a village,” a midwife, checking World Health Organization (WHO) in 2005. said Ingrid Hilman, UNICEF health officer in the the status of tetanus “It’s remarkable,” said Basil Rodriques, UNICEF Indonesia country office. “Sometimes health workers immunizations in a regional immunization officer in Bangkok, Thailand. have to travel by car, boat, and on foot just to get to one village in Kandangan “Indonesia is making such a great effort, despite civil subdistrict. place. In some provinces like Papua, you can only get unrest in some areas. It’s not an easy task to take on.” there by flying or walking.” Made up of more than 17,000 islands, with 6,000 The immunization program’s ongoing success of them inhabited by an estimated 201 million people, and relentless effort is largely due to the Indonesian Indonesia is one of 57 countries combating MNT and government’s support and a solid health system that working with UNICEF, WHO, and their partners to provides basic maternal and child health care, believes eliminate MNT worldwide. Dr. François Gasse, UNICEF senior project officer for Indonesia had already made significant immunization. headway in 2000 by eliminating MNT in 83 percent of its Indonesia is also taking a long-term approach to 341 districts. Only 59 districts remain at high risk and are protect others from tetanus. About 95 percent of the focus area of the MNT immunization program, which Indonesian children, both boys and girls, attend primary is targeting nearly two and half million women of child- school and are receiving the tetanus toxoid vaccine bearing age. during their first three years of school. So far, Indonesia has completed the first round Although Indonesia is on the right track to wipe of immunization in 90 percent of those districts, where UNICEF/Ingrid Hilman out MNT, support will still be needed to keep immuniza- recent data show that at least 1.3 million women have tion programs running and make sure that the deadly Women wait for been reached, with results still pending in some districts. disease doesn’t return. tetanus vaccinations at The country is also close to finishing the second round. “We need to be on the safe side,” Gasse said. a local health post in But vaccinating the women proved to be a test of “Just because Indonesia receives validation as having Sumba Barat district. endurance for health workers and government officials. eliminated MNT, doesn’t mean MNT is gone forever. We “Resources are always limited in a big country still need commitment from donors to sustain that hard- like Indonesia,” explained Dr. Jane Soepardi, Chief of won success.” Standardization for the Indonesian Ministry of Health’s ONGOING MNT IMMUNIZATION ROUNDS* OCTOBER 2003 THROUGH FEBRUARY 2004

Oct. Nov. Dec. Jan. Feb. UNICEF/02-0263/Pirozzi Countries 2003 2003 2003 2004 2004 A young woman in Mali receives a dose of TT Burkina Faso 1 1 1 1 vaccine with a Uniject tm. Cambodia 1 2 9 4 9 1 Ethiopia 5 3

Ghana 11

Guinea 8

Haiti 3

Indonesia 60

Kenya 7 7 3

Mali 20 20 Myanmar 19 Nepal 1 1 5 2 1 Sudan 2 1

U.S. Fund for UNICEF/Qualter-Berna Uganda 5 27 Immunization cards keep Yemen 17 track of the dates on which women receive Zambia 8 their vaccinations.

# of districts # of districts # of districts receiving Round 1 receiving Round 2 receiving Round 3 *data subject to change U.S. Fund for UNICEF RECEPTION HONORS working abroad. The grant will support UNICEF’s goal of 333 East 38th Street immunizing over 1.26 million Cambodian women and 6th Floor PRINCESS OF DENMARK training more than 2,700 birth attendants and health New York, NY 10016 workers in 35 districts. The funds will also enable UNICEF A champion of children was honored when the to work with the country’s National Immunization Program 800-4UNICEF U.S. Fund for UNICEF and UNICEF Denmark co-hosted a in investigating cases of tetanus, improving monitoring, reception at Aquavit restaurant in New York City on Corporate Partnerships and helping to achieve elimination status from WHO. January 20 for Her Royal Highness Princess Alexandra of and Alliances Diana Brittan, chair of the Community Fund said, Denmark, a staunch UNICEF advocate. The princess is 212-922-2547 “We are delighted to be supporting UNICEF’s project to Patroness of the Danish national help eliminate maternal and Foundation Giving committee and a supporter of neonatal tetanus in Cambodia. 212-922-2507 their fundraising campaign to Our international program is help eliminate MNT in Laos. Major Gifts aimed at helping the most vulner- In addressing the guests, 212-922-2549 able people in disadvantaged including major donors, corp- parts of the world, and UNICEF’s orate leaders, U.N. ambassadors, Office of Gift Planning project will do just that.” and Danish nationals, Princess 866-486-4233 UNICEF UK has also Alexandra talked about her expe- been awarded a grant of $82,000 Non-Governmental rience visiting UNICEF MNT for the MNT program in Uganda Organizations programs in Thailand and her U.S. Fund for UNICEF/Hershkowvitz from Jersey Overseas Aid, one of 212-922-2618 deep commitment to saving the the committee’s most dedicated lives of young mothers and Her Royal Highness Princess donors. The funds will help to babies. She also encouraged Alexandra of Denmark immunize nearly 69,000 women of people to become personally addresses guests at the child-bearing age in Uganda’s involved in the campaign to MNT reception in New York. Pader District, train traditional eliminate MNT. birth attendants, and provide The princess’s efforts on safe-birthing kits. behalf of the MNT campaign have received substantial Community-based fundraising in the U.K. has also coverage in the Danish media, generating awareness and raised money for MNT. Soroptimists International, a financial support throughout the country for UNICEF volunteer service organization for women in business, Denmark’s efforts to rid Laos of this deadly disease. management, and the professions, raised funds for MNT in Uganda from April 2003 to April 2004. They started by UNICEF UK UPDATE promoting “T for Tetanus” events, holding Mad Hatter Tea Parties and other tea-themed activities to raise Although UNICEF UK’s MNT fundraising money. To date, the appeal has generated over $26,000 campaign wound down in January 2003, continued efforts from Soroptimist clubs all around the U.K. Another $10,000 during the year have pushed the total raised so far to has been raised by Soroptimists on the isle of Jersey, $4 million. Countries benefiting from the UK campaign who organized an island-wide campaign involving local include Cambodia, Ethiopia, Kenya, Mali, Tanzania, and businesses and schools. Uganda. Another dynamic group, Inner Wheel Most recently, the committee received a grant of International, has adopted the worldwide MNT campaign over $1.1 million from the Community Fund to support for three years. In 2003, they raised over $32,000, and UNICEF’s MNT program in Cambodia. The Community members will continue to support the appeal for another Fund is a major grantmaker, distributing money raised by two years in an effort to help UNICEF meet its goal of elim- the U.K. National Lottery to charities and voluntary groups. inating MNT by 2005. It gives grants within the U.K. and to U.K. agencies