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countries that have eliminated trachoma

Neglected tropical diseases (NTDs) affect more than 1.4 billion people in 149 countries. These diseases flourish in areas of the world where there is a lack of basic sanitation, which means that the global poor have the highest risk of contracting them. These diseases are preventable and treatable, but due to a lack of resources and aid, millions of people still suffer from these diseases that can cause them to be disfigured, disabled and may even result in death.

However, with the help of several different organizations and national campaigns, many countries have successfully eliminated some NTDs, including trachoma, which is the leading cause of blindness in the world. Trachoma is a bacterial eye infection that affects the eyes and eyelids, causing the eyelashes to turn inward toward the eye leaving patients blind.

Here are three countries that have eliminated trachoma.

3 Countries That Have Eliminated Trachoma

  • Ghana – In 2018, Ghana became the first country in West Africa to eliminate blinding trachoma. Three groups were instrumental in this effort: FHI 360 – a nonprofit human development organization; END in Africa Project (financed by USAID) and Ghana Health Service’s NTD program. Working together, the three organizations eliminated blinding trachoma over an eight-year period. From 2010 to 2018, the END in Africa Project supported the global distribution of more than 464 million NTD Program treatments for trachoma and other diseases. They also mapped disease distribution, treated at-risk populations and monitored treatment impact while also documenting successes along the road to eliminating this terrible disease. FHI 360 provided technical and financial assistance for trachoma post-treatment surveillance, which will help with further prevention of the disease. The program’s long surveillance and treatment of patients is a testament to its dedication and commitment to ending NTDs.
  • Laos – In 2017, Laos became the fifth endemic country in the world to eliminate blinding trachoma as a public health problem. Blinding trachoma was especially common among young children. The United States government had been supporting Laos since 2012 through several USAID projects, such as END in Asia and ENVISION. These projects assisted the Ministry of Health in collecting reliable data on the status of trachoma, which helped determine the correct approach to eradicate the disease. Laos was able to place ophthalmologists at national, provincial and district levels to detect and operate on cases of patients with the disease. The projects also trained primary health care workers to screen patients for trachoma, and they gave patients with less severe conditions the antibiotic eye treatments they needed. Nongovernmental organizations also helped train health volunteers in villages on ways to prevent trachoma. Education ministries invited volunteers to come to their schools and educate their students on facial cleanliness and showed how the infection spread from person to person. Laos achieved amazing success with its partners, working to not only diagnose and treat the disease but also to educate people on how to prevent trachoma.
  • Mexico – Mexico became the first country in the Americas and the third country in the world to officially eliminate trachoma in April 2017. In 2004, the Secretary of Health of the state of Chiapas formed a group of health professionals called Trachoma Brigades to implement SAFE, the strategy recommended by the World Health Organization to eliminate the disease. In their fight against this disease, Mexico provided surgery for people at imminent risk of blindness, administered antibiotics in affected communities to reduce infection in children as well as to stop transmission, promoted personal hygiene and improved environmental conditions. The SAFE strategy’s 4 interventions have been especially successful in the state of Chiapas. Trachoma was endemic in 246 communities in the state and affected over 146,000 citizens. Trachoma Brigades, alongside national, state and community efforts and international partners, eradicated this disease. Trachoma Brigades visited communities several times a year to conduct surveys, eye examinations, identify cases, administer antibiotics, educate children about proper hygiene and perform surgeries.

These three countries worked for years to eradicate this trachoma and improve their citizens’ quality of life. The combined efforts of multiple organizations and governments brought medication, surgeries and public education to these countries toward achieving this goal. In addition to Ghana, Laos and Mexico, countries such as Cambodia, Togo, The Marshall Islands, Oman and Morocco have also made progress against this disease.

It is a U.S. foreign policy objective to support the treatment, control and elimination of Neglected Tropical Diseases (NTDs). The World Health Organization recognizes 17 NTDs which currently afflict 1.4 billion people around the globe. Urge Congress to support the End Neglected Tropical Diseases Act to advance U.S. foreign policy interests and safeguard national security.

Email Congress to End NTDs

Jannette Aguirre
Photo: WHO

Improving Eyesight in Developing CountriesPoor vision and blindness are problems that many people in developed countries take for granted. Most people know that they will be able to get contacts, glasses, laser eye surgery, or any number of other solutions to their vision problems. However, there are 246 million people around the world who are living with a visual impairment, and 39 million people are totally blind. This data may seem trivial compared to the more than 650 million people living in extreme poverty, but these issues are closely linked. Many living in extreme poverty or with a low income suffer from some form of visual impairment. Poor eyesight makes it very difficult for people to escape the cycle of poverty, so improving eyesight in developing countries would help address many other poverty-related issues, including education and equal rights for women.

At first, it seems like vision is unrelated to the issue of poverty. Though vision is rarely discussed compared to other issues such as malnutrition, violence and healthcare, eyesight is an overlooked problem in many areas of poverty. Nine out of ten blind people live in developing countries, and most of them are in poverty.

When ignored and untreated, poor eyesight can cause or worsen conditions of poverty, and the conditions of poverty can also cause poor eyesight or blindness. Without access to proper healthcare and treatment, many people living in poverty contract eye diseases that could have been easily treated, but instead they are blinded. This makes their already difficult situation even more desperate, because they are unable to better educate themselves or get a job to support themselves. Poor eyesight and blindness compound the issues of poverty, so addressing and improving eyesight in developing countries is an important part of addressing the cycle of poverty.

Most of the 246 million people with a visual impairment just need corrective lenses to fix their vision. There are a variety of programs that can recycle old eyeglasses to give to those who need it. These programs keep thousands of glasses out of landfills and give them to someone who can use them.

Blindness may seem like a much more difficult problem to address, but about 80 percent of the world’s blindness is treatable or preventable. Over half of the world’s blindness is caused by cataracts, and a simple 15-minute operation would cure these people. These solutions seem relatively straightforward, yet poor eyesight is often an unknown factor when many people address poverty.

The solution is simple: provide proper eye care and corrective lenses to address these problems. However, implementing this is more difficult. In many areas where people have poor eyesight, there are dozens of other difficulties as well. For example, Africa has only ten percent of the world’s population, yet it has 19 percent of the world’s blindness. The rate of poor eyesight in Africa is the result of a variety of causes, but the main factor is poor healthcare.

Many diseases such as HIV/AIDS and others that cause or worsen poor eyesight go untreated due to the sparse and insufficient healthcare systems. The number of eye care personnel is in many areas even lower than the number of healthcare providers. For example, in South Africa, there is only about one optometrist for 17,600 people. With disproportionate numbers like this, it’s no mystery why eye care is practically nonexistent in many areas.

Tackling the vision problems in developing countries is an enormous task. Most organizations begin by treating trachoma, refractive errors, cataracts, and childhood ocular conditions. By treating these four causes of blindness and poor vision, millions of lives can be turned around. People are given the power of sight, and with it, they are better able to get an education or a job.

However, preventing the larger causes of poverty is the key to preventing blindness. Improving eyesight in developing countries helps end poverty, but it is a two-way relationship. Since so many preventable and treatable eyesight problems are caused by poverty, ending poverty will also prevent many of the eyesight problems that deepen the existing conditions of poverty. Promoting health and education leads to better eyesight, and better eyesight in turn leads to better overall health, better economic standing, and more independence. Instead of a downward cycle in poverty, improving eyesight can lead to an upward spiral where conditions get better and better for those whose vision is treated.

Rachael Lind

Photo: Flickr

Artificial_Intelligence
Silicon Valley superpower Google is developing artificial intelligence technology that is intended to help the world solve some of its healthcare issues. Teaming up with the U.K.’s governmental healthcare structure, they hope their new invention will be able to detect and prevent eye diseases and blindness.

In collaboration with its subsidiary DeepMind, a company that uses complex algorithms to teach computers how to better analyze information and learn from it, Google will introduce about one million eye scans to DeepMind’s algorithms. They hope the artificial intelligence system will be able to analyze scans and conclude a diagnosis faster than ever before. This has the potential to allow doctors to treat a patient before a “point of no return.”

DeepMind, a London-based artificial intelligence startup acquired by Google for $500 million, is an expert at making computers behave and think like humans. They were praised for teaching a computer to master Atari system games. The computer was able to beat world masters.

Now, Google hopes to harness the cognition powers of their computers to serve the world’s sick. Although as of now the system is implemented at just one of the National Health System hospitals in the U.K., it has a global reach in its implications. More than 100 million individuals worldwide are inflicted by vision problems relating to diabetes or age. This technology could help all those millions to prevent their eye diseases and vision loss before they are even aware they have it. For global health advocates, this is a very promising innovation that could find widespread success

Google has been diligent in designing groundbreaking solutions to intractable problems. The tech giant and its umbrella company, Alphabet, have been investing a large amount of resources toward global health. Businesses are beginning to realize that investing in a healthy world returns profit, and benefits everyone.

Connor Borden

Photo: U.N. Multimedia

Smartphone App Blindness Kenya
The product of collaboration between The London School of Hygiene and Tropical Medicine and a group of Kenyan doctors, The Portable Eye Examination Kit (or PEEK), is a smartphone app that promises to help deal with blindness in Kenya, Business Daily Africa reports.

According to PEEK’s official website, any smartphone equipped with the app can provide accurate eye tests by taking high quality photos of the retina. Such photos will enable an ophthalmologist to “view cataracts clearly enough for treatment classification, detect signs of glaucoma, macular degeneration, diabetic retinopathy and signs of nerve disease.” The app displays its versatility in that it will also help doctors with identifying other health problems including “severe high blood pressure and diabetes.”

According to their website, PEEK’s developers believe that this advanced technology simplifies the process of retinal analysis, saving users considerable time and effort, compared to the traditional method of using an ophthalmoscope.

In a March 3 article, Ventures Africa reported that PEEK has recently been launched in the Trans-Nzoia county in Kenya. As it is explained later in the article, this particular county was chosen due to its high rate of vision problems. In an interview with Ventures Africa, one of the co-founders of the app Dr. Hillary Rono said that “out of the 2.5 million people in the region, 80 percent have eye problems that, if not checked, would lead to avoidable blindness.” More surprisingly, “five in every 1,000 people in the region are blind,” Dr. Rono continued.

PEEK has been brought to use in up to 350 schools in Trans-Nzoia, as reported by Business Daily Africa. Ventures Africa reports that “21,000 school children in the district and 900 were found visually impaired and were referred to the Kitale County Hospital Eye Unit for treatment.”

PEEK has already made considerable strides in combatting blindness in Kenya, and its developers hope to expand the project in the future. According to Business Daily Africa, the app is in line with Operation Eyesight and Christian Blind Mission, sponsored by the Standard Chartered Bank. The project has “helped to restore sight to more than 8,000 children,” said the bank’s chief executive Lamin Manjang. “The project has a target to reach 120 million people globally.”

Although considerable progress has been made in the fight against blindness in Kenya, much work remains to be done. “With around 1 in 10 men and 1 in 20 women color-blind, it’s important to be aware of what you can and can’t see,” says PEEK’s website. Developers are still exploring ways to add new capabilities to the app, including a wider range of color blindness and contrast tests.

Hoa Nguyen

Sources: Peek Vision, Business Daily Africa, Ventures Africa
Photo: TechIslet

Sweet-Potato‘Alafie Wuljo’ – otherwise known as healthy potato – has recently become one of Ghana’s most famous crops. This sweet potato variety was introduced in a USAID project in order to counter vitamin A deficiency, a condition that weakens the immune system and can lead to blindness. The project’s main goal is to improve the livelihood and nutritional status of Ghana’s most vulnerable populations.

Sweet potatoes are primarily beneficial to children, whose vitamin A requirements can be met simply by eating the healthy potato. Notably, the 2008 Ghana Demographic and Health Survey states that “28 percent of Ghanaian children under the age 5 are stunted, 7.5 percent are wasted, and 13.9 percent are underweight.” Therefore, the emerging sweet potato is necessary to improve the health of starving and malnourished children.

The International Potato Center (CIP) plans to reach 15 million households in the next 10 years by responding to the demand for the orange-fleshed sweet potato. The CIP director states, “We can soon claim to have reached a milestone in our history by reaching one million households in Africa with sweet potato – preventing blindness and stunting in children along the way.”

The little orange potato has assisted Ghana’s vulnerable communities while also bringing camaraderie to villages. At one of the communities’ harvest celebrations, young children were taught how to cook the potatoes and now everyone wants to grow these crops.

The expansion of crops in Ghana, however, is not the only focus of USAID’s project to diminish malnutrition in Ghana. Aside from agricultural initiatives, efforts to improve the lives of villagers include areas such as clean water, sanitation and hygiene. All of these factors are interrelated and can work together to improve standards of living.

Through the use of new crops in Ghana, USAID aims to decrease chronic malnutrition, measured by stunting, by 20 percent through the U.S. Government’s Feed the Future Initiative and Global Health Initiative, the Office of Food for Peace development programs, resilience efforts and other nutrition investments.

Megan Hadley

Sources: USAID 1, USAID 2, JSI, The World’s Healthiest Foods, My Joy Online
Photo: Google Images

Trachoma_Treatment
According to the International Trachoma Initiative (ITI), trachoma remains the world’s leading infectious cause of blindness. Pfizer Inc., along with several partners has been working to provide critical trachoma treatment, particularly for patients in developing countries.

Trachoma is an infectious disease caused by bacteria. It is spread through contact with eye discharge from an infected person – via hands, towels, sheets and in some cases, eye-seeking flies. The infection thrives in areas with poor sanitation and limited access to water for personal hygiene.

Without treatment, trachoma develops into a condition called trichiasis. Trichiasis causes the upper eyelids to turn inwards and scrape the eyeball, a painful condition that eventually leads to blindness.

In 2014, the World Health Organization (WHO) estimated that 232 million people were at risk for developing trachoma. Studies indicate that trachoma is endemic in 51 countries with more than 80 percent of sufferers concentrated in 14 countries.

To help combat the spread of trachoma, Pfizer along with ITI and the International Coalition for Trachoma Control announced the corporation’s 500 millionth donation of the tablet Zithromax, a trachoma treatment antibiotic used in countries across Africa and Asia.

The partners are working together as part of an Alliance for the Global Elimination of Trachoma by 2020 (GET 2020) led by the WHO. The Alliance is an expansive collaboration of more than 100 governments, non-governmental organizations and private sector partners.

https://www.youtube.com/watch?v=UgN4pcFGik0

Together the group has implemented a WHO recommended strategy called SAFE:

Surgery to treat the blinding stage of the disease

Antibiotics to treat infection

Facial cleanliness to help reduce transmission, and

Environmental improvement including access to water and sanitation.

ITI pointed out trachoma was once endemic in Europe and the United States. Before the use of antibiotics, trachoma disappeared due to improved living standards.

Today, antibiotic treatment provides a short-term cure, especially when the whole community is treated. However, reinfection can occur, typically within six months if hygiene and the environment don’t improve. For this reason, it is essential that the full SAFE strategy is in place in trachoma-endemic communities.

Paul Emerson, the Director for ITI said, “Trachoma traditionally affects the people at the end of the road, they’re the forgotten people, they are people with a very little political voice. Because trachoma is a hidden disease it is very difficult for people to care. Well, we do care. And we want to reach all of those people.”

Kara Buckley

Sources: Carter Center, Sight Savers, Trachoma Coalition, Trachoma.org
Photo: Google Images

himalayan cataract project
In an attempt to aid the blind, ophthalmologists Dr. Geoff Tabin and Dr. Sanduk Ruit founded the Himalayan Cataract Project. Their goal was to provide and implement adequate hospital quality standards in areas that do not always have basic electricity and water needs satisfied. The two aim to deliver the highest possible quality care for the lowest possible cost.

The prevalence of blindness in developing countries is astounding and, as explained by the Himalayan Cataract Project website, “malnutrition, inadequate health and education services, poor water quality, and a lack of sanitation leads to a high incidence of eye disease.”

According to the World Health Organization, individuals in sub-Saharan Africa are often afflicted with avoidable blindness caused by onchocerciasis (4 percent), childhood blindness (5.3  percent), trachoma (6.8 percent), corneal opacities (10 percent), glaucoma (15 percent), and cataracts (50 percent).

In developing countries, life expectancy for someone who is blind is less than half of that expected for a person of the same age who can see. The blind individual is no longer able to work and therefore, one income for the family is lost. The World Health Organization also states that “a conservative estimate of the annual direct economic productivity loss due to blindness and low vision in sub-Saharan Africa was U.S. $1,830 million in 2000. Without concerted international action, it is expected to rise to $4, 374 million per year by 2020, the equivalent of 0.5 percent of GDP for the region.”

The Himalayan Cataract Project is based in both the Himalayan region and in sub-Saharan Africa. They operate through teaching ophthalmic care at basic and advanced levels, establishing self-sustaining eye centers, and performing low cost sutureless cataract operations in 7 minutes. Moreover, their efforts to create self-sustaining eye centers involve building microsurgical eye clinics in rural communities and encourage these centers to reach out to the poor who are blind in order to provide them with the care they need. The Himalayan Cataract Project makes treating blindness both affordable and accessible to the wider masses in developing countries and communities.

–Jordyn Horowitz

Sources: Global Giving, Himalayan Cataract Project, WHO
Photo: MediManage

world_globe_borgen_africa
Education is one of the very few opportunities for poor people living in impoverished, underdeveloped countries. Basic education programs provide children with the skills necessary to acquire employment, as well as basic knowledge pertaining to health, hygiene and disease prevention. And yet, according to the U.N., 250 million children — even those who have spent at least four years in school — are not able to adequately read, write or count.

While many factors play into this staggering statistic, hunger is a key culprit when it comes to the millions of uneducated children worldwide. Here’s how hunger hurts learning:

1. Children who are malnourished suffer up to 160 days of illness each year, which means 160 missed school days.

2. Vitamin A deficiency, which is directly linked to malnutrition, is the leading cause of preventable childhood blindness in developing countries; The World Health Organization estimates that each year, 500,000 children go blind as a result of vitamin A deficiency. Blindness makes it increasingly difficult for children to learn alongside their peers.

3. Malnutrition intensifies the symptoms and effects of diseases, such as malaria and measles. Children who are unable to combat these diseases lack the physical capacity to attend school and learn.

4. Malnutrition stunts not only physical, but also mental development, in young children, preventing them from reaching their full human and socio-economic potential as well as their potential to learn.

5. One out of five children born from an under-nourished mother is born with low birth weight. Low birth weight in children is linked to mental retardation, learning disabilities and blindness, all of which may prevent a child from receiving an education.

Hungry children suffer not only from malnourishment—and the litany of other harms it causes—but also from the incredible disadvantage of not being physically well enough to learn. Global education and global hunger are not mutually exclusive issues. A brand-new school with ample resources in Tanzania, for example, is useless without a classroom full of healthy children who are ready to learn.

Expecting Malaria-infected children to attend school and absorb information from excellent basic education programs is also impractical. We have a global responsibility not only to support education programs in third-world countries, but also to ensure that children are able to take advantage of the incredible opportunities education holds for them.

Due to the difficulty of learning while hungry and ill, in order to provide effective education, it is crucial that aid programs also address the global health and hunger crises in impoverished countries.

Elizabeth Nutt

Sources: World Hunger, UN.org, UN.org, Hellen Keller International
Photo: Your Mind Your Body

paran_blind
Paran is a small community that rests at the foothills of the Andes in Lima, Peru. It is an isolated little area surrounded by mountains and home to only 300 people, and one in eight of those people are blind.

The unusual rate of blindness in Paran was discovered about two years ago when a mining company sent a team of doctors to the area as an outreach effort. Most of the Paranos had never visited a doctor before then, and therefore had no one to report the condition to although they understood it was abnormal.

The blind and their families were hoping for treatment or glasses to cure the affliction but they were given an even more complicated prognosis. Doctors found that the condition was caused by a genetic mutation in the X chromosome. This means that women can carry it, but men are more likely to express symptoms.

The condition works by knocking out cells in the retina like pixels in a screen. Victims experience blurriness in their vision that gradually worsens until all sight is lost. Onset takes place between the ages of 10 and 40 and the ability to see at night is lost early on.

While the discovery of the disease, named retinitis pigmentosa, was a breakthrough for the people of Paran whose ancestors have dealt with the condition for over a hundred years, many feel that they were given life-changing information and then abandoned.

The discovery of the disease two years ago brought a lot of attention to the area by doctors and journalists alike. When the doctors left and Paran became yesterday’s news, the people were left without a cure and a bad reputation. What was once known as a village with sweet peaches became the town of the blind.

Even to this day the people of Paran carry a stigma and are treated as outcasts by the surrounding areas. They are unwanted out of fear of contaminating other populations and told to move far away if they choose to leave their community. The women of Paran are avoided as spouses out of fear they may pass the disease onto their children.

However, despite what may seem like bleak circumstances, the Paranos persist with amazing vigor. With no government assistance or facilities fit to accommodate blindness, the men in the area prepare for a life of darkness before total blindness sets in. People like Lorenzo, an elderly man with nobody to care for him, make the two-hour trek up and down the rocky hills they live on to the village center every day on their own.

Another man named Agapito Mateo and his two brothers are all blind. Agapito is a pastor and a farmer who never stopped tending to his peaches after losing his sight. He thanks God for his ability to continue working but insists that those less fortunate need government assistance. Meanwhile, people like Agapito work to uphold the reputation that Paran may be home to a good number of blind men, but they also grow really sweet peaches.

– Edward Heinrich

Sources: Oscar Durand, PRI, YouTube

Jimmy_Carter_Carter Center
Former president Jimmy Carter recently celebrated the 15th anniversary of his foundation’s initiative to end blindness caused by trachoma.

The Carter Center estimates that 320 million people are at risk of suffering from the painful disease. Trachoma is the most common, preventable cause of blindness worldwide. It is highly contagious and often transmitted by flies attracted to the fluid in the eye.

The disease is usually spread in undeveloped areas lacking proper sanitation and education about hygiene practices. After the resulting bacteria is introduced to the eye, it becomes infected. The bacteria is then spread as eye fluid comes in contact with other surfaces such as hands or clothes. As symptoms worsen, eyelashes can turn inwards, leading to irritation of the cornea and, ultimately, blindness.

Trachoma was eradicated in the United States in the 1970s, but continues to plague those living in poverty ridden areas worldwide. Currently, the Carter Center is focusing on the plight of millions of Africans at risk for the disease. The Center has enlisted the aid of several organizations, including the Lions Club International Foundation, the International Trachoma Initiative, the Hilton Foundation, and other health organizations in the region.

Over 30,000 healthcare professionals have received prevention and treatment education through the center’s Trachoma Control program so far. Prevention methods include hand and face washing as well as latrine building. Treatment options include antibiotics for those afflicted by the first stages of the disease. Individuals suffering from advanced stages of trachoma may elect to undergo surgery in order to correct folded eyelids.

Often, the disease transfers back and forth between family members. Due to the close proximity of contact associated with its transference, Trachoma is found more often in women and children. Women are two times more likely to contract the disease than their male counterparts. But the greatest risk is to children.

The Center estimates the nearly 20 million children are currently dealing with visual impairment or blindness from the ailment. As he contemplates the plight of Africa’s youth, Carter references his own childhood on a Georgia farm.

He recalls the annoyance of flies around his face and sore eyes. Carter credits his mother, a registered nurse, with preventing further affliction and hopes to continue to provide others with the knowledge to end the disease.

The Carter Center currently operates in Mali, Nigeria, Niger, Sudan, and Ethiopia. Through its efforts with the International Trachoma Initiative, trachoma has been eliminated in Morocco and Ghana.

Jasmine Smith

Sources: Reuters , Carter Center
Photo: Carter Center