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January 23, 2006
Beating trachoma—one village at a time

paige rohe is a writer in the carter center office of public information.

My mother believed you got trachoma from crying,” says Neter Nadew, a 36-year-old Ethiopian mother of four and sufferer of trachoma. Nadew’s mother was forced to pluck out her eyelashes to prevent the onset of blindness from the disease. Today, thanks to The Carter Center’s Trachoma Control Program, Nadew knows face washing and good environmental sanitation prevent trachoma.

The leading cause of preventable blindness in the world, trachoma is a bacterial eye infection endemic in communities with limited access to medical care, health education and environmental sanitation. The disease most particularly devastates women’s lives; three out of four blind women in endemic areas lost their sight due to trachoma.

Young children bear the heaviest trachoma burden and are the main source of infection for other people. Transmission takes place when the bacteria move from the eyes of young children to the eyes of an uninfected person through any of several ways: flies that seek out people’s eyes, touching of eyes, mothers’ shawls, bed sheets, pillows, towels, etc.

Mothers and young women, as traditional caregivers for children, are more often exposed to the disease over their lifetimes, making women more likely than men to suffer from blinding trachoma. The disease’s advanced stage, trichiasis—an inward turning of eyelashes that leads to corneal abrasion and eventual irreversible blindness—causes extraordinary pain and develops during a woman’s prime.

The Carter Center, in partnership with six African countries (Ghana, Mali, Niger, Nigeria, Sudan and Ethiopia), implements the World Health Organization’s SAFE strategy to reduce trachoma infections. SAFE stands for:
• S—surgery for those at immediate risk of blindness;
• A—antibiotic therapy to treat individual active cases and reduce the community reservoir of infection;
• F—facial cleanliness and hygiene promotion to reduce transmission; and
• E—environmental improvements to change living conditions for the better and reduce risk of transmission.

In Ghana, Mali, Niger and Nigeria, The Carter Center focuses on the “F” and “E” components, as well as health education to reduce trachoma. In Ethiopia and Sudan, the center implements the full SAFE strategy. So far, program efforts have improved thousands of lives and empowered some of the world’s poorest and most marginalized populations.

Overwhelming support from village leaders and low construction costs have allowed communities in Ethiopia, Nigeria, Mali and Niger to surpass latrine-building goals, and programs in Ghana and Sudan are expanding to include latrine construction.

With the center’s help, many communities are taking initiative and establishing their own effective ways to prevent trachoma. In Ghana, local radio stations broadcast trachoma education shows, which radio listening clubs listen to through wind-up radios purchased and donated by The Carter Center. In Nigeria, 173 villages in the Plateau and Nasarawa states have organized regular clean-up days, benefiting more than 100,000 people and instilling a sense of pride and unity among community members.

Trachoma is horrific, but as these communities have shown, it can be beaten—one child, one mother, one village at a time.

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