Ethiopia has the highest burden of trachoma, the leading infectious cause of blindness in the world. The Fred Hollows Foundation is working as part of a global effort to eliminate trachoma and end this form of avoidable blindness.
The Foundation supported a large-scale trachoma prevalence survey in the Oromia region of Ethiopia as part of the Global Trachoma Mapping Project, funded by the UK Department of International Development and conducted between December 2012 and May 2013. The mapping used cutting-edge smart-phone technology to record data identifying endemic trachoma districts and paved the way for similar mapping to be undertaken across the world.
Land-locked Ethiopia has a population of more than 90 million, based on World Health Organization estimates. Its economy is largely agricultural and more than 80 per cent of Ethiopians live in rural areas, most without access to safe drinking water or sanitation. These hot, dusty and unhygienic living conditions create the ideal environment for trachoma to prevail.
In the largest and most populous state, Oromia, trachoma is confirmed to be endemic; 27 million people are at risk of developing the disease and 200,000 are at risk of losing their sight without surgery. People who suffer eye damage and blindness can no longer do productive work and must rely on the care of other family members, usually girls.
About the Program
The Fred Hollows Foundation is working in collaboration with the Oromia Regional Health Bureau to eliminate trachoma in all 225 endemic districts by 2020. The key to achieving that aim lies in implementation of the SAFE strategy (where SAFE stands for Surgery, Antibiotics, Facial cleanliness and Environmental improvements), which is endorsed by the World Health Organization and designed to treat both the active disease and its causes. We are working with the Oromia Regional Health Bureau and other partners to deliver the SAFE strategy in 35 districts over the next five years, and will support the Oromia Regional Health Bureau to raise the funds necessary to eliminate trachoma from the remaining 190 endemic districts.
The Foundation’s contribution to implementation of the SAFE strategy includes co-ordinating antibiotic distribution to endemic districts – antibiotics are relatively inexpensive to distribute, costing less than 27 cents to treat one patient. We will be targeting five million doses a year. We are also working to increase the number and quality of surgeries carried out on people with advanced scarring of the eyelid that occurs in late-stage trachoma.
A crucial element of the SAFE strategy includes educating the community about personal hygiene and encouraging the practice of regular face-washing so that it becomes habitual. The Foundation’s work in Ethiopia has a strong focus on behaviour change as well as supplying the sanitation and water supply facilities necessary to practise good hygiene.
The Foundation also continues to partner with Light for the World in the Simien Mountains Eye Care Project in the Amhara Regional State. Its centrepiece is the establishment of a modern ophthalmic unit at the hospital in the town of Debark, 400 kilometres north of the capital, Addis Ababa.
There remain many obstacles to better eye health in Ethiopia. There is a shortage of trained eye health nurses and specialist doctors – the country has only 120 ophthalmologists, and most work in Addis Ababa. Medical infrastructure, equipment and supplies are in chronic short supply.
Treating people with trachoma is relatively cheap and simple; eliminating it is more difficult but it is within our reach. What is needed is a significant scale-up of the SAFE strategy, including resources, expertise and commitment from regional and local governments and development organisations in the water, sanitation and hygiene sectors.
- Surgery - to prevent blindness by correcting in-turned lashes
- Antibiotics - to treat active infections
- Facial cleanliness - to stop the spread of infection
- Environmental improvements - to give populations better access to water and sanitation.
We’re making significant progress
Thanks to some great work with our partners, we achieved a lot in some of our key strategic areas in 2022:
Research, training and technology
- Screened 764,318 people
- Performed 81,562 eye operations and treatments, including 4,414 cataract operations and 77,148 surgeries to treat trachoma
- Treated 4,277,228 people with antibiotics for trachoma
- 128 pairs of glasses distributed
- Trained 13,490 people, including 29 surgeons, 13,343 community health workers and 118 teachers
- Educated 255,866 school children and community members in eye health
- Equipped 295 medical facilities, training centres, schools and other facilities