Global Handwashing Day: Orbis's fight against trachoma

October 2019

This Global Handwashing Day, we want to highlight our efforts in Ethiopia towards eliminating trachoma, the world’s leading cause of infectious avoidable blindness.

Trachoma is still a major cause of blindness and low vision in rural Ethiopia; with 37.5% of the world’s trachoma found there. Orbis has been working in rural areas of Ethiopia since 2002, partnering with the International Coalition for Trachoma Control (ICTC), the Carter Center, Sightsavers, Fred Hollows Foundation and the Ethiopian government to implement the World Health Organisation's SAFE (Surgery, Antibiotics, Facial Cleanliness and Environmental change) strategy to eliminate blinding trachoma as a public health problem.

In 2002, we were working in just three districts, administering around 400,000 doses of Zithromax, an antibiotic which prevents trachoma infection. Last year (2018), we distributed more than eight million doses of antibiotics across 93 districts and carried out over 10% of the global number of surgeries to tackle the late stage of trachoma (TT). This year, we are working in 124 districts across southern Ethiopia.

Without measures in place to prevent and treat trachoma in its early stages, repeated infection can lead to trachomatous trichiasis (TT), a painful condition in which the eyelids turn inwards, scratching the cornea each time a person blinks. Left untreated, TT can lead to permanent blindness.

Good hygiene practices, including the availability of clean water and children being educated about the importance of washing their hands and faces, are crucial to preventing the infection in the first place.

In just one of our projects in southern Ethiopia, funded by the UK government’s Department for International Development (DFID), Orbis treated nearly three million people annually with antibiotics to tackle trachoma infection and provided more than 20,000 surgeries to address the painful, late stage of trachoma.

This five-year project also reached every primary school and community in the Hadiya & Yem and Sidama districts, with innovative messages highlighting the role that hygiene plays in the fighting the infection. These messages were delivered in a number of ways, ranging from informative dances at community events, to school eye care clubs, which use performance and song to teach other pupils about the importance of facial hygiene.

As a result, we reached more than 900,000 primary school students across all 882 schools in the project area. We also installed water tanks in 195 schools, enabling both students and staff to wash their hands and faces and to help stop the spread of infection.

In all our trachoma elimination work, our SAFE strategy activities include:

• Surgery: we train nurses like Tsehay to operate on TT, which protects the patient’s sight and ends their pain

• Antibiotics: distribution of antibiotics, donated by Pfizer, to everyone in an affected community, through Mass Drug Administration (MDA)

• Facial Cleanliness: we work with water, sanitation and hygiene partners to promote access to water and sanitation, and raise the awareness amongst adults and children of the importance of clean faces for preventing infection

• Environmental Improvements: closely linked to the F component, we work with partners to promote access to water and sanitation

Using this strategy, Orbis has helped to reduce prevalence of trachoma significantly in the areas we work. Surveys to track the impact of our work show that, as of June 2019, 24 districts no longer need MDA and 16 districts no longer need surgical interventions.

However, despite significant progress, Ethiopia still carries the world’s highest burden of trachoma. As we move forward into 2020, we are committed to continuing interventions to eliminate trachoma, and use the learnings from our work to help hone and improve our efforts tackle this painful, blinding infection.