HOW YOUR SUPPORT IS CHANGING LIVES
PHOTO: MICHAEL AMENDOLIA
Special a Trachom Edition
AN EMERGENCY IN ETHIOPIA
A MESSAGE FROM OUR CEO Imagine this – every time you blink you’re in excruciating pain. Your eyelashes are turned inwards, scratching your eyes. You’ve probably never thought about it, but you blink about 19,000 times a day. And every time you blink it’s incredibly painful. What would you do? In countries like Ethiopia hundreds of thousands of people, most commonly mothers, face this pain every day. It’s caused by the infectious and blinding eye disease trachoma. Ethiopia has the highest burden of trachoma in the world. There are more than 70 million people at risk. Around the world it’s 158 million. It’s the world’s leading infectious cause of blindness. Trachoma is transmitted from one person to another particularly from children to mothers, meaning women are up to four times more likely to go blind.
WHAT IS TRACHOMA? Trachoma is the world’s leading infectious cause of blindness and is one of 20 neglected tropical diseases that affect over one billion of the world’s poorest people. Trachoma is responsible for the visual impairment of about 1.9 million people, of whom 1.2 million are irreversibly blind. Approximately 157.7 million people live in trachoma-endemic districts. Trachoma is caused by the bacterium Chlamydia trachomatous. The bacteria are spread through contact with eye discharge from an infected person – via hands, towels and sheets. Trachoma thrives in areas where there is poor sanitation and limited access to water for personal hygiene. Repeated infection damages the eyelids causing the eyelashes to turn inwards and rub painfully against the eyeball surface. It can be corrected by eyelid surgery, however if left untreated it can lead to irreversible vision loss and blindness. While children are the most susceptible to infection, the blinding effects of repeated infection do not usually develop until adulthood. Women are up to four times more likely than men to need surgery.
Blinding trachoma can be treated with a basic 10-20 minute surgery, but there is a huge backlog and people often don’t know how to get help. The infection can be stopped with antibiotics and improved sanitation and access to water for face washing. In this special edition of Fred’s Vision we look at the problem of trachoma and what The Foundation and the global community is doing to tackle it. Fred Hollows began tackling trachoma here in Australia in the 1970s and The Foundation has been committed to eliminating the scourge for our whole history. In Ethiopia last year The Foundation implemented the largest trachoma-elimination initiative in the world, supporting one in five trachoma surgeries and the distribution of one in five doses of donated antibiotics globally. But we couldn’t do it without the support of so many partners and without you, our generous donors. There’s a global push to rid the world of trachoma by 2020. I hope you can help us work towards that ambitious goal.
Ian Wishart CEO
THE FRED HOLLOWS FOUNDATION FRED’S VISION JAN 2019
PARTNERSHIPS THE KEY TO ENDING ANCIENT DISEASE The Fred Hollows Foundation is proud to be on the front-line with partners around the world working to eliminate trachoma. The International Coalition for Trachoma Control (ICTC) brings together non-government, donor and private sector organisations to support the alliance for the Global Elimination of Trachoma by 2020. As part of the coalition, The Foundation collaborates with organisations including Pfizer, the International Trachoma Initiative, RTI International, Helen Keller International, Sightsavers, The Queen Elizabeth Diamond Jubilee Trust, CBM, WaterAid, Caritas, SNV, the London School of Hygiene and Tropical Medicine and Orbis and receives funding from the American people through the United States Agency for International Development, the Australian Department of Foreign Affairs and Trade and the UK Department for International Development, the Wellcome Trust, and the END Fund. | HOLLOWS.ORG
TEAMS DEPLOYED TO TACKLE TRACHOMA CRISIS When more than 180,000 people are in desperate need of sightsaving surgery you need an army of trained professionals to tackle the problem.
One of the trachoma surgeons is Feyera Bekele, a quietly spoken 25-year-old who has done more than 300 surgeries since he was trained three years ago.
In the past four years in Ethiopia The Fred Hollows Foundation has trained more than 300 surgeons, 80,000 community members and health workers, 4,500 teachers and school health staff. All are playing a critical role in this major fight against the painful and blinding condition.
Feyera is an Integrated Community Eye Health Worker and is proud of his part in helping his fellow Ethiopians.
“So we’re teaching health workers how to do the surgery – 10 minutes of surgery that can transform the lives of these people, these mothers, and also prevent the disease from being such a big problem.”
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“I’m happy when I travel to rural areas, people bless me and give me thanks. The people around here are living in a hot climate so the disease transmission is more common. So when I treat one person many other people are able to get rid of the problem and live a healthy life,” Feyera said. Dr Wondu said Feyera is “very confident handling eyes”. “With the huge problem that Ethiopia is having we decided we couldn’t rely solely on ophthalmologists, we had to train other health workers and he is one of them,” Dr Wondu said.
PHOTOS: MICHAEL AMENDOLIA
“Initially when we started work in Ethiopia in 2013 we had to get rid of the huge backlog,” said The Foundation’s technical advisor for trachoma Dr Wondu Alemayehu, who has played a leading role training the surgeons.
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Hundreds of people patiently queue under the awnings of the health centre at rural Jeju, almost four hours south east of Addis Ababa.
Hawiti has walked for more than three hours to make the 21km journey from her modest mud hut home to the health centre.
They’ve come from far and wide because they’ve heard about the eye screenings organised to treat the incredibly painful and blinding eye condition trachoma.
“I was worried after the surgery when they put the patch on my eye but when they took it off I was very happy,” Hawiti said.
Among the nervous group sitting outside the makeshift surgery is Hawiti Tufa, a 60-year-old grandmother of four. Hawiti smiles warmly at visitors from The Fred Hollows Foundation including Global Ambassador Joel Edgerton who is keen to see The Foundation’s work first hand.
“I bless you and all of the team members for giving me better sight.”
Hawiti tells Joel she’s had severe eye pain for more than a year, as the repeated trachoma infections have scarred her eyelids turning them inwards until the lashes scratch on her cornea. Hawiti knows a lot of people who have had surgery for trachoma. In Ethiopia 69 million people live in areas where trachoma is endemic.
Hawiti says she has been unable to help her family for the past year because of the terrible pain in her eyes. “I usually cook for my children and family members, but I can’t because of the problems with my eyes. “As long as I am surviving with my family members I am ready to cook and feed the family.”
PHOTOS: MICHAEL AMENDOLIA
Women make up 70 per cent of those with trachoma and they’re four times more likely to need surgery than men.
Joel admits that Hawiti captured his heart. “There was something about her spirit and her energy that I really liked. She was sitting there very patiently, you could tell she was a little nervous about having surgery. But afterwards, she was so happy to have her discomfort taken away. It was a really special moment.”
HAWITI STEALS JOEL’S HEART THE FRED HOLLOWS FOUNDATION FRED’S VISION
| HOLLOWS.ORG
PHOTOS: MICHAEL AMENDOLIAI
FEATURE |
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At a school in Eastern Ethiopia, 1215 students shared one tiny tap that would only work after rain when water was flowing in nearby streams. There was no way they could wash their hands or faces and there were only four pit toilets for all of the teachers and students. These are the conditions where trachoma flourishes. But thanks to The Fred Hollows Foundation and its partners, a 5000 litre storage tank has been installed and the school now has a constant supply of running water. A new set of taps and a trough, as well as new latrines, mean the students can be taught about the importance of facial cleanliness and sanitation. Improved access to safe water and adequate sanitation, and good hygiene practices, are essential for trachoma prevention and control.
THE FRED HOLLOWS FOUNDATION FRED’S VISION JAN 2019
PHOTOS: MICHAEL AMENDOLIA
WASHING AWAY TRACHOMA
The Foundation is focused on the World Health Organization’s SAFE Strategy: Surgery to treat the blinding complications of the disease; Antibiotics to treat the active infection; Facial cleanliness to reduce the spread of the infection; and Environmental improvements to reduce the spread of the infection. At schools like this one, not only is the focus on the infrastructure of taps and toilets, but the project also trains the teachers in hygiene practices and then the teachers train the students. They use dolls, card games and role play to teach them about eye health. Students are also encouraged to teach their parents and many schools are bringing the parents in to teach them about hand and face washing.
| HOLLOWS.ORG
TRACHOMA FIGHT GOES ON IN AUSTRALIA
Fred wanted trachoma eliminated from Aboriginal and Torres Strait Islander communities. So Fred and his team undertook a momentous and vital task: the National Trachoma and Eye Health Program. That program uncovered the shocking prevalence of a disease most western countries had not known for about 100 years. Fred, Gabi and teams of ophthalmologists and Aboriginal health workers visited 465 Indigenous communities from 1976–1979 and halved the rate of Indigenous blindness. But more than 40 years on, Australia remains the only developed country in the world with trachoma, even as
REPORT |
countries like Iran, Oman, Morocco, Lao PDR, Cambodia, Nepal and Ghana have eliminated the disease. Today, after decades of work by The Foundation and countless other organisations, the elimination of trachoma in Australia is drawing nearer. Prevalence rates have fallen from 14 per cent 10 years ago to about four per cent today. The most recent surveillance report suggests that the number of communities with very high prevalence of active trachoma has fallen sharply, from around 54 in 2008, to 17 communities in 2017. In 2019, The Fred Hollows Foundation will be targeting these 17 communities, mostly in Central Australia, by working in partnership to address the surgical and antibiotic needs of the people, and implementing local strategies that promote healthy living practices to ensure trachoma is eliminated. Ambitiously, The Foundation is also embarking on an initiative that will improve the living environment for people in these high prevalence communities preventing it from returning in the future.
PHOTO: DAVID BROADBENT
In 1974 Fred Hollows said: “It is simply absurd that, in this prosperous State, 100 per cent of the Aboriginal children in some country schools have trachoma. It is scandalous that these nineteenth century diseases of poverty should continue.�
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“EVERY EYE IS AN EYE” – FRED HOLLOWS
Fred believed everyone’s sight was worth saving. Thanks to The Foundation’s regular supporters we hope to support and fund more eye operations and treatments globally than ever.
4 out of 5 people who are blind don’t need to be, but together we can end avoidable blindness. By joining our monthly giving program you will restore sight and change the lives of people living with avoidable blindness in Indigenous Australia and across the developing world. In some countries it can cost as little as $25 to restore someone’s sight. You will help deliver essential eye care to people with cataract and other eye diseases, fund medical equipment and increase the number of surgeons and eye health workers in the field. To join as a monthly giver, simply fill out your details on the form on this page, call 1800 352 352 or visit www.hollows.org/donate. Restoring sight changes lives every month. Thank you.
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Donations to The Fred Hollows Foundation are used to support our programs in Australia and overseas. The information contained in this publication is accurate at the time of printing. For more information contact fhf@hollows.org Fred’s Vision Magazine © 2017 is a publication of The Fred Hollows Foundation ABN 46 070 556 642. The Fred Hollows Foundation works for a world where no one is needlessly blind and Indigenous Australians enjoy the same health and life expectancy as other Australians. This publication may contain images of persons who have passed away. The Fred Hollows Foundation would like to acknowledge these persons and pay our respects to them and their families.