Questions the complacency with which some people approach “routine vaccinations.” Tonight, here in Ghana we are treating this child of four who is suffering from tetanus. His jaw is locked closed and any sudden noise causes his arms and legs to spasm violently. He has no puncture wound – most people with tetanus don’t – so the site of infection is unknown. We’re treating him with IV diazepam to relax his muscles, and IV fluids to prevent dehydration. Paralysis of his diaphragm from advancing tetanus is a clear risk, yet if this happens we’ll have no means to provide artificial ventilation. All this could have been avoided, of course, by assuring that he was indeed vaccinated.