“Maybe the most important of all, just to show people who have been hopeless in the face of trachoma for 10,000 years that something can be done about it, and that the people who are suffering from it themselves can help themselves, by getting rid of flies, by washing their face and so forth. This is very important.” - Fmr. President and founder of The Carter Center, Jimmy Carter
- 75% of blindness globally is preventable or curable.
- The leading cause of preventable blindness is trachoma.
- Ethiopia is the country most affected by trachoma.
More than 80 million people are thought to have active Chlamydia trachomatis, a disease found in areas of poor hygiene and sanitation. Not to be confused with River Blindness, trachoma is bacterial, and is spread through direct or indirect contact with the infectious agent. Repeated exposure over several years can ultimately cause blindness.
Once thought to be present in most countries in the world, trachoma is now concentrated in the most poverty-stricken regions of Africa, Asia, Central and South America, Australia and the Middle East. The World Health Organization’s Alliance for the Global Elimination of Blinding Trachoma has committed to stamping it out by the year 2020.
What happens…
This man is in the final, blinding stage of trachoma, called trichiasis, where the eyelashes turn inward, scratching the cornea. To relieve the pain, he uses a technique common in Ethiopia: he epilates. Using tweezers, he has plucked out every single eyelash.
Trachoma affects the lining of the eyelid, causing it to form granule-like bumps, and to appear red and irritated. Repeated infections over the years cause the underside of the eyelid to scar. The scar tissue pulls the eyelid inward, so that the eyelashes scratch against the cornea, a condition known as trichiasis. The constant rubbing against the globe of the eye is painful, and causes sensitivity to light and particulate matter, like dust and smoke. Within just 18 months, it can begin to cause irreversible visual impairment. If not surgically corrected, it causes blindness.
How you get it…
The disease spreads when people live in close quarters, sharing bedsheets or washcloths with an infected person. In some of the most affected areas of the world, including Ethiopia, the main vector of the disease is Musca sorbens, an eye-seeking fly that feeds off of ocular discharge of an infected person. When it later lands near another person’s eye, it spreads the disease. Musca sorbens breeds outdoors in human stool, and is often found where people do not have access to latrines, toilets, or other sanitary waste facilities.
Children serve as a pool of infection for the microorganism, presumably because they tend to have dirtier faces that attract flies. For reasons not entirely known, their infections rarely progress to trichiasis or blindness. However, they do put adults in their household at risk. Parents and grandparents are often infected through close contact with children in the household, putting them at risk for visual impairment.
The S.A.F.E. Strategy…
Students learn the S.A.F.E. strategy for trachoma prevention and treatment in schools.
The World Health Organization endorses a four-pronged approach to trachoma control, known as the S.A.F.E. strategy.
S - Surgery to correct inverted eyelids, which occur in the most advanced stage of trachoma.
A - Antibiotics, namely azythromicin, to treat trachoma infection.
F - Facial cleanliness, particularly important for children, to clear off infectious ocular and nasal discharge that attracts eye-seeking flies, and which they spread to other people.
E - Environmental improvements, such as the building of latrines and access to water. Latrines help to reduce the population of flies that spread trachoma, and access to water promotes cleanliness.
In Ethiopia’s most trachoma-ridden region, the northwestern state of Amhara, the full S.A.F.E. strategy was first applied to selected areas in 2001. Today, the full strategy covers nearly every district in that area.
Tags: blindness, carter center, ethiopia, Odette Yousef, trachoma
