A beautiful sight: Trachoma Elimination in Nepal

RTI | Int'l Dev
May 21, 2018 · 5 min read

By Lisa Rotondo, Director, ENVISION project. Twitter: @lisarotondo

A Nepali woman has her eyes examined during a trachoma survey. Photo credit: RTI International/Kalpana Bhandari

Remember for a minute the last time you had something in your eye. It’s uncomfortable, a nuisance, whatever it might be, an eyelash or everyday dust. It’s all you can think about. You stop mid-conversation to excuse yourself, unable to carry on with your day.

Now imagine that feeling is constant. Every day from here on out, you will continually have that feeling. Your eyes will be watery, your vision compromised. For most of us, this sounds like a nightmare. For many people in the world, this is their daily reality. But it isn’t a piece of dust — it’s trachoma, a bacterial infection of the eye. Upon repeated infection, your eyelashes actually begin to turn inward and scrape your eye. Over time, this can leave you irreversibly blind. In fact, it’s the leading infectious cause of blindness in the world.

There is, however, good news. Trachoma can and IS being eliminated. A decade ago, more than 10 million people in Nepal were at risk for trachoma. Today, I have the immense pleasure of congratulating the Government of Nepal on the elimination of trachoma as a public health problem, and I must say, it’s a beautiful sight.

A group of Nepali women work in a rice field. Photo credit: RTI International/Louise Gubb

The beginning of the end for trachoma in Nepal

Traveling to the Nepali countryside, many of the roads in disrepair, we passed beautiful, green rice fields on our way to observe treatments for trachoma in a local community. But it wasn’t the rice fields or the roads that would permeate my memories. More than anything on this trip, I was struck by the immense pride of the Nepali people — the motivation of the female community health volunteers (FCHVs), the organization and quality of surgical services being offered at a local eye hospital, the attention to data collection, which would be so crucial for long-term success. Each person I met was beaming as they showed me the work they were doing.

At the time, there was much work still to be done to scale-up treatment to all Nepalis at risk for trachoma and all those needing surgery to prevent blindness. However, my visit gave me confidence in the way forward, as there was clearly a strong foundation for Nepal’s health system.

In the years since that first trip, much has changed. Nepal has endured a series of devastating earthquakes and years-long reconstruction of infrastructure. It’s been a challenging time for the Nepali people, but amidst these hardships, a story of sight saving progress comes into view.

Nepal’s Journey to Saving Sight

Left: A young girl smiles with her dose of Zithromax during a mass treatment campaign for trachoma in Nepal. Photo credit: RTI International/Lisa Rotondo. Right: A line forms during a mass treatment campaign for neglected tropical diseases in Nepal. Photo credit: RTI International/Louise Gubb

As we approached this tremendous milestone, I got to thinking about all that has happened, and all of the lives impacted. I met a young girl on my visit and I can still picture her (in fact I often do, as it’s the background of my iPhone) smiling and holding her dose of Zithromax, an antibiotic donated by Pfizer, through the International Trachoma Initiative, which is a critical component of trachoma elimination. Her shirt nearly matched the pill, “Zithromax pink.” When I think about Nepal’s elimination of trachoma, I think of her and all the young people in Nepal that will never have to live in fear of this blinding disease. That’s what is wonderful about disease elimination, it has generational impact. There are generations of Nepalis that are able to live more healthy, productive lives. Generations that may not even know the Nepali word for trachoma, khasre.

With that, I offer my sincerest congratulations to Nepal on this accomplishment, the elimination of trachoma as a public health problem, the first in the region to do so. To our friends in Nepal’s Ministry of Health and Population and NNJS, your leadership and steadfast resolve have made all the difference. In many ways, you’ve set the path forward — a path we are happy to be supporting many other countries to walk, through our work on USAID’s ENVISION Project. We thank you in advance for sharing your experience and expertise with the global NTD community. We look forward to our continued work to ensure the control and elimination of neglected tropical diseases in Nepal.

A Nepali women smiles after the ‘last check’ for trachoma in her district. Her community, and all of Nepal, is now trachoma-free. Photo credit: RTI International/Nabin Baral

ENVISION is an eight-year project funded by the U.S. Agency for International Development (USAID) aimed at providing assistance to national NTD control programs for the control and elimination of seven targeted NTDs: lymphatic filariasis, trachoma, onchocerciasis, schistosomiasis, and three soil-transmitted helminths (roundworm, hookworm, whipworm). ENVISION contributes to the global goal of reducing the burden of targeted NTDs so that they are no longer a public health problem.

To learn more visit: http://www.ntdenvision.org

RTI | Int'l Dev

Written by

RTI's #globaldev team applies science and knowledge to improve lives in developing countries around the world. An official @RTI_INTL feed.