Trachoma Elimination in Ethiopia – making a difference with F&E

Ethiopia is the country with the largest burden of trachoma globally – 44% of all active trachoma. In 2018, Ethiopia also counted for over 62% of all Trachomatous Trichiasis surgeries done globally. Within the SAFE strategy, F&E (facial cleanliness and environmental improvement) is important to underpin S&A (surgery and antibiotics) interventions and ensure elimination is sustained. For the last six years, CBM and partner ORDA have been complementing the work of The Carter Center, by investing in F&E activities in Amhara Region through the Amhara Trachoma Control Programme (ATCP).

Work has focused on community ownership, advocacy for sustained behaviour change and support for the development of accessible WASH infrastructure. In some of the target districts, baseline levels of TF (Trachoma Follicular infection) were as high as 73% when this support started.

Over this time, over 630 protected water points were constructed to provide communities with safe and accessible water. To improve hygiene, almost 20,000 pit latrines were constructed, most with handwashing facilities. Regarding behaviour change, over 130 Trachoma School Clubs were established to promote facial cleanliness, engaging children to teach their peers. It is estimated that over 840,000 adults and 150,000 children have benefitted during this period from an investment of over 4.7 million Euro.

The drivers of change in trachoma prevalence are complex and any reduction in prevalence cannot be attributed to one specific intervention alone. However, it is encouraging that in districts that have had at least 5 years of intensified F&E interventions, the observed reduction in the active trachoma has been on average over 50% with some as high as 70%. The ATCP is also a great model of collaboration as it works in close partnership with the communities, with government at all levels and other NGOs. Collaboration, we believe, means that improvements are more likely to be sustained.

Aman is fifty and has been disabled from birth. He lives in Wagehemera zone in Amhara region. Due to the social stigma of  his physical disability, even though he could walk with a stick, Aman was not allowed to go to school and neither did his parents seek medical help. ‘In my community this is often seen as God’s punishment.’ Aman was the main provider for his family, but his income was not enough to meet their needs. When CBM’s partner ORDA supported the Mybulit spring development, Aman was hired by the community as guard for the water point. Not only does he receive a small monthly salary but he earns additional money by fetching water for families:

“The work of ORDA/CBM changed my life. Now my family fetches at least 120 litres of clean water per day… my children are healthy because they wash and bathe. I’m not afraid to catch diseases like trachoma… because we have clean water and we know how to protect ourselves.” says Aman.

Images: Top – Schoolchildren using a hand dug well, funded by CBM, at a primary school in Ethiopia ©CBM/Diemer. Bottom – Aman from Ethiopia sat holding his walking stick and smiling.