Water, sanitation and tackling trachoma in Ethiopia

CBM volunteer, Theresa, on a visit to CBM's programme in Ethiopia which tackles blinding trachoma
Author:Theresa Baird
Posted on: Friday, 5th January, 2018

Theresa Baird has been working with CBM UK as a volunteer research intern for the last two years while she studies for the Advanced Diploma in International Development at the University of Cambridge Institute of Continuing Education. She is particularly interested in the role of improving access to water, sanitation and hygiene in tackling diseases like Trachoma.  In this blog, she writes about visiting one of CBM’s trachoma programmes in Ethiopia in 2017.

As part of the research for my Diploma, I was fortunate to be able to visit one of CBM’s programmes tackling the blinding eye infection trachoma in Ethiopia last year.  

Trachoma is a highly contagious eye infection that causes the eyelids to turn inwards, leading to excruciating pain and, if left untreated, blindness. CBM has actively sought to treat, control and eliminate blinding trachoma in some of the poorest countries of the world for over 40 years.

Globally, Ethiopia is the country with the highest trachoma burden. While significant progress is being made to tackle the disease – in Dessie Zuria District for example, the area I visited, the percentage of people affected by the disease has fallen from 45% in 2006 to around 17% - it still blights the lives of far too many people.

Tackling diseases like trachoma requires a long-term, holistic approach. CBM and our partners are working to tackle trachoma using the “SAFE strategy”:

  • Surgery – to save the sight of people with advanced trachoma symptoms.
  • Antibiotics – to treat the infection and stop the symptoms advancing.
  • Face-washing – teaching rural communities the importance of basic hand and face washing that will help prevent trachoma infection.
  • Environmental improvements – giving better access to water so families can keep their faces, clothes and bedding clean, and encouraging the construction and maintenance of basic toilets to decrease flies - these are all sustainable ways to reduce the chances of infection.

Improving water, sanitation and hygiene (WASH)

Improving sanitation and hygiene is vital to preventing the spread of trachoma. The infection is spread by eye-seeking flies, which breed on human faeces left visible on the soil surface due to open defaecation or poor maintenance of latrines. Rural communities in developing countries are the hardest hit by this disease because many struggle to access clean water or need to share face-washing cloths, spreading the infection further.

In Dessie Zuria, CBM and our partners have been working closely with the community to improve access to water and help them protect themselves from trachoma. Water supply solutions are discussed and agreed with the villagers, who then set up their own WASH Committees to manage and maintain them.  The solution may be a borehole or, as shown here, a new spring fed well available to all the community. 

Local Village Health Communicators are trained and form a key part of the WASH Committee and two of them explained to me the huge difference this has made to their lives. They now understand and teach other villagers about how Trachoma infection of the eyes is transmitted by flies, dirty hands and contaminated clothes. But, even more significantly, with clean water available, they are now able to take action and wash their faces three times a day or more, encouraging others in the village to do the same.

Before the improved well was constructed, they could only collect a small amount of dirty water, green with algae (just one 10-15 litre jerry can of dirty water a day for their family). Now, they can collect five jerry cans of lovely clean water to wash their faces, clothes and bedding more often, to improve hygiene to reduce Trachoma disease transmission and so prevent blindness. This is a remarkable community driven project that will make a difference for generations to come.

School programmes protect the next generation

Faud (aged 8) washing his face at the wash station

At a school in the rocky highlands above the town of Dessie I met Seid, a student. He’s been an Ambassador for the CBM funded Anti-Trachoma School Club for three years. His school has more than 900 students and they proudly showed me their face washing stations next to their basic toilets.

“Children did not have any idea about trachoma before the programme,” Seid told me.

We talked about how the many flies around the school would feed on the discharge from children’s eyes, repeatedly transmitting the infection from child to child.

Seid is passionate about helping spread the sight saving advice to prevent trachoma infection. In his village, he has seen the debilitating effects of the late stages of the disease for himself:

“There were three people affected by (the advanced stages of) trachoma. Two have had surgery – they were nearly blinded by their in-turned eyelashes. It was a free service. For the third one it was impossible to save her sight as her eyes were too damaged so she is now blind.” 

Kemila (age 23) washing her hands with her daughter (Ikeram, age 6) at the new water supply

Now the children and young mothers in Seid’s village know how to avoid the cycle of repeated infection through good hygiene and access to antibiotics, but it is a race against time to find the older people across the district with advanced symptoms of trachoma to provide surgery before they lose their sight completely. 

It breaks my heart how easily this disease can be spread, but it gives me hope to know that preventing the infection is possible and to see how much has already been achieved. There is still a huge amount to do and it won’t happen overnight, but by working with our partners and communities then we can give people the power to protect themselves and their families from blindness.

You can help keep communities in Ethiopia SAFE from Trachoma – find out more and set up a regular gift today.

Images: Top - Theresa Baird on a project visit to CBM's programme in Ethiopia. Middle - Faud (aged 8) washing his face at the new wash station at his school near Dessie. Bottom - Kemila (age 23) washing her hands with her daughter, Ikeram (age 6), at the new water supply in Dessie Zuria.


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