I have been to a lot of troubled places, but none compares to Sierra Leone. I have told friends — and it is literally true — Rwanda seems like heaven compared to Sierra Leone. In the rural areas, there is one doctor for every 200,000 people. Only a third of those in rural areas has access to clean water. Malnutrition runs rampant. The grinding poverty is inescapable. Hope is hard to nourish.  

Click here for photos of Cynthia’s trip to Sierra Leone with Salma Hayek.  

In addition, Sierra Leone has a distinction no country wants: the worst place in the world for children. Of the 177 countries in the world, Sierra Leone, the small and staggeringly poor country on the West coast of Africa, holds that distinction. Dead last. One in five children never make it to their fifth birthday. One of the major killers is a disease that we think of as a "rusty nail" disease: Tetanus. While here in America, a quick trip to the doctor’s office can remedy exposure to tetanus, in the developing world it is a major killer of mothers and their infants. A shocking  21% of all causes of infant deaths in Sierra Leone are tetanus related, all the more shocking because tetanus is totally preventable by a vaccine that costs seven cents per dose.

In the developing world, mothers are often infected by contaminated instruments during childbirth. It similarly spreads to their infants when traditional birth attendants cut the umbilical cord with an unsanitary knife, or, as is often the case, the umbilical cord is dressed by the traditional method of packing it with dirt, clay or cow manure.

Medical experts we talked to say tetanus is one of the most painful ways to die, as all the patient’s muscles constrict in spasm. Death is virtually certain for infants.   

This past fall, I traveled to Sierra Leone with actress and producer Salma Hayek to see firsthand the scope of the problem. Hayek has taken on the cause of tetanus as spokesperson for the Pampers "One Pack = One Vaccine" campaign to support UNICEF’s efforts to eliminate tetanus by 2012. For each pack of specially marked Pampers diapers sold, parent company Procter and Gamble donates the cost of one Tetanus vaccine to UNICEF. The North American campaign has generated funding for more than 45 million vaccines since the beginning of 2008.

“What really excited me about this was the concept of mothers from around the world working together to protect children,” she said to me. “The thought of somebody in Los Angeles, where I come from, purchasing the one pack of Pampers … By doing this, that they were going to do anyway, they could … provide one vaccine for another mother somewhere else in the world, someone they don’t know … These anonymous women around the world coming together to protect women and to protect children was really exciting.”

A good deed in a struggling world. It was an extraordinary trip, both painful and illuminating. Tonight on "Nightline" (ABC at 11:35 PM, check your local listings), we’ll show you the result. I hope you watch.

Click here for photos of Cynthia’s trip to Sierra Leone with Salma Hayek.