Crossing African borders to fight trachoma: no one should be left behind

25 May 2018

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To mark Africa Day on 25 May, Sightsavers Uganda country director Dr Johnson Ngorok discusses his work treating the nomadic Ateker population.

Dr Ngorok helps to oversee a project offering sight-saving treatments to the Ateker community, who are spread across several country borders. The project is part of The Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative, and several partners have come together across Uganda, Kenya, South Sudan and Ethiopia to reach people who need treatment, wherever they are from.

Dr Ngorok says: “Trachoma is the world’s leading infectious cause of blindness and starts off as a bacterial infection that can be easily treated. Without treatment, over time it causes scarring to the eyelid that makes the eyelashes turn inward (called ‘trachomatous trichiasis’) so with every blink they scrape against the eye and can eventually cause permanent blindness.

“Thanks to programmes like The Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative, momentum is gathering to eliminate trachoma as a global health problem, but there are still millions of people at risk of this blinding eye disease and the vast majority of them are in Africa. There are many obstacles to ending this painful but preventable eye condition on the African continent, and to mark Africa Day I wanted to talk about one of the challenges, which I have had the personal privilege to see overcome.

Johnson Ngorok with his family.

Johnson (far left) with his family.

“Many of our people fall between the cracks in health plans”

“I am from the Ateker people and we live a nomadic life, crossing country borders in Uganda, Kenya, South Sudan and Ethiopia. The migratory nature of our floating population and the fact we tend to live in extremely remote areas means we are out of the loop of the formal health system.

“It is hard to reach many of our people who do not live in areas connected by roads, and often fall between the cracks in health plans, including the elimination of trachoma.

“The disease is awful: not only can the condition lead to blindness, it is also excruciatingly painful. So it is important to do all we can to prevent people from getting it. We can stamp out the disease and no one should be left behind, no matter where they come from.

“To try to combat these issues, The Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative brings together several partners across countries. Together we set up a specialist camp to treat trachoma in remote areas, and identified 27 kraals, or villages, in the Kotido and Moroto districts of Uganda and the Turkana county of Kenya, where there are many people affected by trachoma.

© The Queen Elizabeth Diamond Jubilee Trust.

“Groups of health workers drove hundreds of kilometres a day to the most isolated and impoverished communities, seeking out those who could have their sight restored and, as a result, their lives transformed. Roads were often so bad that they had to climb hills and rocks on foot, in order to reach to remote settlements.

“More than 4,000 people were examined and treated for eye conditions. Antibiotics and ointments were given out, and those who needed it received trichiasis surgery. Health, education and advice was also shared about the importance of sanitation and access to water, to prevent further spread of trachoma: the infection is spread from person to person and by flies.

Surgeon Maurice Oduor sits in a village, wearing green scrubs.

Kenyan Ministry of Health surgeon Michael Samal treats trachoma trichiasis patients during a Sightsavers community mobile outreach in the Kamnyaep village, in Turkana West County, Kenya. © Ashley Gilbertson/The Queen Elizabeth Diamond Jubilee Trust.

“There was also treatment and care for those with cataracts – a condition responsible for more than half of the world’s blindness. Often these screenings, treatments and consultations took place outside homes, on foot without chairs, due to the rural settings.

“Being from the Ateker tribal group myself, I was proud to be able to reach out and meet people who speak the same language as me, but are separated by international borders across four different countries.

“It had seemed an impossible challenge, yet thousands of vulnerable people were protected from the risk of going blind. It just shows what innovative thinking, determination and collaboration can do.”