Universal Health Coverage

12 December 2018

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On International Universal Health Coverage Day 2018, we are celebrating the 76,000 people who have accessed surgery and the 14.5 million people who have accessed treatment thanks to the Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative – while remembering the millions of people still at risk of going blind from this devastating infection.

Universal health coverage (UHC) means that every person—no matter who they are, where they live, or how much money they have—should be able to access quality health services without suffering financial hardship. UHC is essential to eliminating trachoma, the most common infectious cause of blindness in the world.

Working with national Ministries of Health and members of the International Coalition for Trachoma Control, the Trust’s Trachoma Initiative is helping people in 12 Commonwealth countries access the surgery and antibiotics they need to be free of trachoma. Sightsavers is coordinating efforts in Africa, while the Fred Hollows Foundation is coordinating in Australia and the Pacific. Trachoma is a bacterial infection that, without access to the appropriate healthcare, will cause someone’s eyelashes to turn inward and scrape the surface of the eye. This scars the cornea, causing excruciating pain, and will eventually lead to irreversible blindness.

Although a huge number of people remain at risk of going blind from trachoma, estimated by World Health Organization (WHO) to be 158 million people as of April 2018, the efforts of the Trust’s Trachoma Initiative and others has enabled 70 million people to become free of this risk in just four years.

To date, the Trust’s Trachoma Initiative has enabled 76,000 people with the most advanced from of trachoma to undergo surgery and provided more than 14.57 million people with antibiotic treatment to reduce the spread of infection, two key elements of the WHO-approved SAFE strategy (surgery, antibiotics, facial cleanliness, and environmental improvements), which holds the key to eliminating trachoma for good.

As part of its lasting legacy, the Initiative is also supporting governments to strengthen their health systems; something that is essential to ensuring universal health coverage is one day achieved. To date, the Initiative has held just under 200 training sessions for trachoma surgeons, meaning people will be able to access effective surgery for as long as there is need.

A hut in rural Kenya.

Around 39,000 people have also been trained through the Initiative to travel from house to house to find people with trachoma and link them to surgery or treatment. This technique, known as ‘sweeping’, helps to ensure coverage is truly universal by reaching people who are sometimes left behind, such as women and people living with disabilities.

Nalari Nchoe, a midwife from Oloriri Village in Narok County, Kenya, is one such person to benefit from trachoma surgery. Her story illustrates how the Trust’s Trachoma Initiative contributes to expanding healthcare access, not only by providing direct treatment but by unlocking the potential of those who, in turn, help bring healthcare to others.

“I had trachoma for almost two years, says Nalari. “It kept coming and going until one day the pain was so excruciating I could no longer go about my duties.

“I was staying in the house, doing nothing all day long. I started to see myself as a nuisance whenever I asked my children to pull out my offending eyelashes and imagined myself as one old lady being dragged outside with a stick to guide me around.”

Touching on her illness and its effect on her job as a midwife, Nalari describes it as a “crushing feeling”.

“It is frustrating not being able to help with what you know and do best,” she adds.

After Joseph Siololo, a local Community Health Volunteer, identified Nalari’s eye ailment as a case of trachoma she was able to access the surgery she needed and has now returned to work.

“He [Joseph] brought the doctors to our nearest school to treat us since we don’t have a hospital or dispensary nearby,” explains Nalari.

“My life is very different than when I had this disease. I’m no longer in pain and I don’t worry about going blind. I’m also able to do my home duties and take care of my family and livestock. To make it even better, I’m continuing with midwifery.”