Ending Suffering from Trachoma, One Surgery at a Time

"Before the surgery, I was always in pain and I couldn’t see properly. I was afraid to go outside. I rarely socialized.” 

Christine Korogo describes the effects of trachoma, an infectious bacterial eye disease. In the final stage, scarring causes the eyelid to turn inward and the lashes to scrape the cornea. If untreated, the condition, called trichiasis, leads to blindness — and, all too often, loss of livelihood.

Yaaba (grandmother) Christine is 67 years old and lives with her husband, a co-wife and elderly relatives in the village of Basnéré in Burkina Faso. Her five surviving children have grown and moved away. Her husband can’t work due to a disability, so the two of them scrape by on remittances from their children. Making ends meet is a struggle. The prospect of seeing more clearly and being able to farm filled Christine with hope.

“We had a good rainy season this year, but I wasn’t able to harvest anything,” she says.

Trachoma, the world’s leading cause of preventable blindness, has long plagued areas where sanitation and clean water are scarce. Today, 1.9 million people are blind or visually impaired because of trachoma, and 42 countries need interventions to eliminate the disease, according to the WHO.

But a major battle against trachoma is making progress. In one of the largest public health endeavors in human history, the WHO is leading an international alliance of Ministries of Health, nongovernmental organizations, research institutions and donors working to eliminate trachoma by 2020. Since 2011, the number of people at risk of trachoma has fallen dramatically, from 325 million to 200 million.

Christine heard a surgical team was coming from a town crier. The next day, she underwent a simple surgery to restore her eyelid to its normal position and prevent her from going blind. The efforts were supported by the Morbidity Management and Disability Prevention (MMDP) Project, a multi-country project funded by the United States Agency for International Development and managed by Helen Keller International.

The MMDP Project helps countries provide trichiasis surgery for populations in need. But even more important than the number of surgeries done is their quality. The MMDP Project strives to ensure that patients receive the highest quality surgery possible. It supports rigorous training and certification for trichiasis surgeons, ensuring that surgical practices meet World Health Organization (WHO) standards, and checks surgical outcomes to assure quality controls are working as expected.

During surgery campaigns, medical teams set up temporary operating rooms close to affected populations, whether in local clinics, schools or special tents. The surgeon is typically a local Ministry of Health technician who has been trained by a national expert.

Through a national program that combines mass treatment with the antibiotic azithromycin and surgery for individuals with trichiasis, Burkina Faso has dramatically lowered trachoma prevalence and is well on its way to meeting WHO criteria for elimination. In the process, the country’s health system is growing stronger, with a newly trained cadre of health professionals prepared to provide high-quality, sight-preserving surgery for emerging trichiasis cases — and move the country and the world one step closer to ending the age-old scourge of trachoma.

John Uniack Davis is the West Africa Regional Director for Helen Keller International.