In many low-income countries, including South Sudan, certain diseases continue to pose significant risks to the health and survival of women and girls. Among these, hepatitis E, tetanus, and hepatitis B are critical threats, especially to pregnant women and newborns. These diseases can have life-or-death consequences, not just for the mothers, but for their babies as well. Vaccines for these diseases exist, but many women in high-risk areas still lack access to them, leaving them vulnerable to preventable illnesses.
Hepatitis E is a waterborne infection that primarily affects the liver, and it is particularly dangerous for pregnant women. The disease has a high mortality rate among expectant mothers, with figures ranging from 20 to 30 percent, especially during the third trimester. Hepatitis E outbreaks are common in regions with poor sanitation, where water contamination is a major concern. Pregnant women are particularly vulnerable because the disease can lead to severe complications and even death. For many women in remote areas of South Sudan, the symptoms of hepatitis E, such as fever and body aches, are often mistaken for common pregnancy discomforts, delaying diagnosis and treatment. If untreated, the disease can be fatal.
Fortunately, there is a vaccine, HEV 239, developed in China, which has shown great promise in preventing the disease. Médecins Sans Frontières (MSF) launched a vaccination campaign in South Sudan in response to an outbreak in 2023. This was one of the first large-scale vaccination efforts to target an active hepatitis E outbreak, demonstrating the potential of vaccines to curb the spread of this deadly disease. However, hepatitis E remains under-recognized, and many people, especially pregnant women, are still not receiving this critical protection.
Tetanus is another disease that poses significant risks, especially for newborns. The bacteria that cause tetanus are widespread in the environment and can infect babies through the umbilical cord if it is cut with unsterile tools or in unsanitary conditions. Newborns with tetanus suffer from painful muscle spasms and rigidity, making it difficult for them to feed. The disease often results in death if untreated, with as many as 90 percent of affected newborns dying. Vaccinating pregnant women against tetanus is essential, as it provides crucial antibodies to the baby through the placenta, offering some protection against the disease during the neonatal period. Despite progress in reducing the global incidence of neonatal tetanus, many women and girls in low-income countries continue to miss out on this life-saving vaccine.
Hepatitis B is another viral infection that can be transmitted from mother to child during childbirth. It is highly contagious, much more so than HIV, and can lead to chronic liver disease, including cirrhosis and liver cancer. The disease can be prevented with vaccination, which is crucial for women who have been sexually assaulted, as they are at a higher risk of contracting hepatitis B. MSF provides post-exposure vaccinations to women who have been victims of sexual violence, offering protection against both hepatitis B and tetanus. However, this protection is only effective if administered within 72 hours of exposure. Hepatitis B remains a significant global health threat, with millions of people living with chronic infections and hundreds of thousands of deaths each year.
Access to healthcare in South Sudan is extremely limited, with many people living in remote and difficult-to-reach areas. MSF’s hospital in Old Fangak is the only healthcare facility providing care to tens of thousands of people, offering essential services such as maternal immunization and antenatal care. However, much work remains to ensure that all women, especially those in high-risk areas, receive the vaccines they need to protect their health and the health of their babies. Vaccination campaigns and health education are key to improving awareness and access to these vital immunizations.
In conclusion, while vaccines for hepatitis E, tetanus, and hepatitis B are available and can save countless lives, many women in South Sudan and other low-income countries still lack access to them. These vaccines are critical not only for the women’s health but also for the survival of their babies. With continued efforts in vaccination campaigns, public health education, and access to healthcare, it is possible to reduce the impact of these diseases and improve the health and well-being of women and girls in vulnerable communities.
