Nine months in Cambodia is bound to be a life changing, fabulous experience, of that I have no doubt.
Meanwhile, I am signed up to a news service from East Timor and the other day I read an announcement about a vaccination program in Timor which sounded incorrect. Here’s the correspondence that ensued.
You just never know when you reach out, who you might meet, what you might learn, and where it might lead you!
I have concerns about a couple of comments in your email. I am a Public Health Nurse involved with vaccination programs in Australia.
Tetanus shots are no longer recommended every ten years. Per the Australian National Immunisation Handbook, the childhood course of tetanus containing vaccine should be completed by 17 years of age, after which the next booster is recommended at 50yo unless travel to high risk countries, or a Tetanus prone wound occur – in which case refer to the handbook, at http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/handbook10-4-19 I don’t know what the recommendations for Tetanus containing vaccine are in East Timor, but it is likely that the old recommendation of ten yearly boosters is no longer recommended there either, unless they remain a high risk country.
My second concern is with the claim that Tetanus has been eliminated from East Timor. Tetanus is a bacteria which survives in soil and causes human infection when spores from contaminated soil enter a wound site in an inadequately protected person. It would not be possible to eliminate Tetanus from a country, because of it’s survival in many soil environments. Perhaps no cases of Neonatal Tetanus occurred in East Timor in 2012, but this does not mean the bacteria has been eliminated from the environment, nor that Tetanus disease (which still occurs occasionally in Australia – at least 24 cases between 2001 and 2007, but probably more as it is considered to be an under-notified disease) has been eliminated, nor that neonates are not still at risk of the disease in high risk situations such as birthing in unclean environments.
Thanks for considering my comments.
The author replied:
Thank you for your email. Kiwanis International is working in partnership with UNICEF to eliminate maternal and neo-natal tetanus. My understanding and I appreciate your comments as I am not a nurse, is that once the Mother has been vaccinated the correct number of times (which from memory is three) then she is immune and all her future babies are also immune. I know that tetanus is always in the soil and the main idea of the program is to educate people about clean health procedures during birthing. It is UNICEF who makes the call about when a country is clear. All Kiwanis does is raise some of the money needed.
When the immunization program started there were over 40 countries where the disease was still active and it is down to 28 at last count. If you click on Kiwanis.org and then the Eliminate Project it will give you the details of which countries are successful and which are still in progress. Carrie Bickmore from Channel 10’s “The Project” is the UNICEF Ambassador for the program and we will be hearing from her on the night.
My comments about 10 years were personally anecdotal and do not reflect the “official” position of either UNICEF or Kiwanis International. I just want to save more future children and get as many people as possible to the dinner so that we can donate more money. It would be great if you could come along and ask some strong questions to engender a robust discussion. I appreciate that I need to be more careful about what I say.
Thanks so much for your reply.
It was really interesting to hear about your work, and I certainly didn’t mean to sound critical – rather just keen to clarify information which sounded incorrect.
I am guessing that UNICEF have some sort of criteria that they use to declare a country “Tetanus Free”, which relates to low numbers of cases of disease, rather than no disease. Given that even countries like Australia do still see Tetanus, it was a surprising thing to read, but I will look into UNICEF’s information at the weekend and learn more!
The “ten year booster” thing is something that is in our collective consciousness, and there’s nothing wrong with what you said, because the current recommendations are potentially confusing and can’t be said in a single phrase the way “ten yearly boosters” can be! In Australia many people are actually over-vaccinated now, because many vaccine providers don’t follow the new recommendations due to theme being so confusing.
It sounds like fabulous work that Kiwanis is doing and when I look at UNICEF on the weekend, I’ll also look at Kiwanis. I am quite excited by all the good work going on in East Timor, where I had the privilege to volunteer briefly last year. Next month I am going to work in Cambodia for nine months, on a TB program with MSF, and so feeling excited about that too, but after my time in Timor, my heart is still there!!
It was great to get your email, and I look forward to finding out more about the work Kiwanis does!
The author’s reply:
I do hope you enjoy some service club surfing on the net. I would be most keen to have a coffee with you if at all possible before you go to Cambodia. I have been to Timor twice and am planning to set up a business in Dili and would love a good chat! <And included a phone number>.
Kiwanis International home page has this to say about the Eliminate Project (and I had no idea of the success with Iodine Deficiency Disorders that has already been achieved, either).
With The Eliminate Project, Kiwanis International and UNICEF have joined forces to eliminate maternal and neonatal tetanus. This deadly disease steals the lives of nearly 60,000 innocent babies and a significant number of women each year. The effects of the disease are excruciating — tiny newborns suffer repeated, painful convulsions and extreme sensitivity to light and touch.
To eliminate MNT from the Earth, more than 100 million mothers and their future babies must be immunized. This requires vaccines, syringes, safe storage, transportation, thousands of skilled staff and more. It will take US$110 million — and the dedicated work of UNICEF and every member of the Kiwanis family.
Kiwanis and UNICEF joined forces to tackle iodine deficiency disorders, achieving one of the most significant public health successes of the 20th century. Now, they are eliminating MNT from the face of the Earth. And in doing so, the project will reach the poorest, most neglected mothers and babies with additional lifesaving health care. The end of this one disease means the beginning of better health for so many families.
As I suspected, the definition of “elimination of Tetanus” is not about zero cases of Tetanus, which would be a very difficult, if not impossible thing to achieve. But UNICEF define it as “MNT elimination in a country is defined as neonatal tetanus rate of less than one case of neonatal tetanus per 1000 live births in every district of the country.” http://www.unicef.org/health/index_43509.html
Kiwanis International’s website page “History of Global Campaigns” says this about the elimination of Iodine Deficiency Disorder, which is also interesting:
Partnering with UNICEF, Kiwanis successfully completed its first global campaign for children to virtually eliminate iodine deficiency disorders (IDD), the leading cause of preventable mental disability. Kiwanis raised and leveraged more than US$100 million, which helped change lives in 103 nations. The number of households estimated to be consuming iodized salt has jumped from less than 20 percent in 1990 to more than 70 percent, and the effort has been heralded as one of the most successful health initiatives in the world.
Kiwanis International and UNICEF have now joined forces to save the lives of babies and their mothers by eliminating maternal and neonatal tetanus (MNT), a disease that kills one baby every nine minutes. UNICEF Ambassador and actor Tea Leoni delivered the announcement at the 95th Annual Kiwanis International Convention.