Trachoma is a chronic kerato-conjunctivitis caused by Chlamydia trachomatis and is the leading infectious cause of blindness worldwide. Globally, active trachoma affects an estimated 150 million people, most of them children. About 5.5 million people are blind or at risk of blindness as a consequence of trachoma. Repeated episodes of re-infection within a family cause chronic follicular conjunctival inflammation (active trachoma), which leads to tarsal conjunctival scarring. The scarring distorts the upper tarsal plate and leads to entropion and trichiasis (cicatricial trachoma), which, in turn, results in corneal scarring and ultimately blindness.
The root of this infectious and preventable disease is poverty. Households affected by trachoma characteristically have young children living with unsafe water and inadequate sanitation. Transmission from eye to eye is by fingers, fomites (e.g., shared towels) and flies. When we did our first World Health Organisation (WHO) rapid assessment survey back in 2003, we found trachoma to be endemic in the community at levels the WHO described as a “serious public health problem”. So we set about implementing a trachoma program in the region using the SAFE strategy (surgery, antibiotics, face-washing and environmental improvement).
Having almost completely eradicated trachoma from one region, the Ol Malo eye project moved into the Kipsing last year, a beautiful but remote area inhabited by the Samburu. Last year we had a successful surgical camp last run entirely by Kenyan staff. We have a group of Samburu trachoma monitors who distribute antibiotics, educate the people to wash their hands and cover their waste as well as keep their manyattas clean. This helps reduce the number of flies which transmit trachoma.
Our trachoma program came to a temporary halt this year following the cholera epidemic; saving lives rather than eyesight became the priority. However cholera occurs for the same reasons as trachoma so the epidemic has strengthened our resolve to find new ways to improve the public health of the Samburu. The trachoma monitors continue to distribute leaky tins for cleaning hands, special trowels for burying waste and recording all new cases of trachoma. A surgical camp is planned for early next year for which we are now fund-raising.
Active trachoma with follicles visble in a Samburu child
Flies that transmit trachoma buzz around a woman and her child
Samburu women await removal of their bandages the day after surgery
