People, not statistics: A last check for trachoma in Nepal

RTI | Int'l Dev
Apr 26, 2018 · 5 min read

Photos and interviews by Nabin Baral; text by RTI staff

Photo Credit: RTI International/Nabin Baral

Most of us have our eyes checked at some point in our lives. We’ve read the letters on the chart, covering each eye, and maybe even had the dreaded ‘puff’ test. But you’ve probably never had someone knock on your door and ask to flip your eyelids.

But the people of Gorkha know that teams coming to their district and flipping eyelids is part of ensuring that their community is healthy. Our latest ENVISION In Focus video follows a team of eye specialists as they conduct a historic ‘last check’ for trachomatous trichiasis (TT) — an advanced form of trachoma that leads to blindness, if left untreated.

USAID has supported Nepal’s efforts to fight neglected tropical diseases (NTDs), including trachoma, since 2009. From mapping the burden of disease, to distributing preventive treatments, supporting follow up surveys, and strengthening national and regional NTD-fighting teams, American assistance has been critical to Nepal’s progress against these diseases.

Watch and read the stories from survey team members and residents of Gorkha to find out what this survey and getting rid of trachoma will mean for the people of Nepal.


Shekhar Sharma makes his way through Gorkha district with a team conducting a survey for trachomatous trichiasis. Photo Credit: RTI International/Nabin Baral

Shekhar Sharma has worked for local NGO, Nepal Netra Jyoti Sangh, since 2002. Using WHO’s SAFE strategy (Surgery, Antibiotics, Facial cleanliness, Environmental improvement), Nepal’s Trachoma Program has been working to eliminate trachoma, with antibiotics donated by Pfizer through the International Trachoma Initiative.

I have received much satisfaction in this work because trachoma was once the second leading cause of blindness in Nepal, and we had identified 20 districts as endemic for trachoma. We fought against trachoma in these districts and implemented the SAFE program. Now we are in the process of validating our country as trachoma-free. This has helped to increase the socio-economic conditions of our people and country. It has brought social change also.


Bishal Dhakal checks the eyes of a woman in Gorkha district for signs of trachoma. Photo Credit: RTI International/Nabin Baral

Bishal Dhakal has been working in eye health for one year. He received training on trachoma surveys from the Himalayan Eye Hospital with support from RTI International through . Since 2009, USAID has supported Nepal’s NTD-fighting efforts, including mass treatment campaigns and surveys like the one in Gorkha.

I had theoretical knowledge of trachoma before the training, but after the training I received practical knowledge on the disease. I learned about the level of blindness that trachoma can cause. I am happy that no case of TT was found in the surveys. We even surveyed remote villages.


Bijaya Paudel interacts with Chandra Kumari Dani, 98, after surveying her eyes. Photo Credit: RTI International/Nabin Baral

Bijaya Paudel has worked in the Himalayan Eye Hospital in Pokhara for 12 years as an eye assistant.

I am happy that I got the opportunity to work in Gorkha district for this survey. I was able to counsel many people on eye health. Trachoma is related to personal and family hygiene; since we have not diagnosed any cases [during this survey], it shows that society is more aware of hygiene and it shows the effect of the SAFE strategy. The eye is one of the most vital organs in our body, that is why I work in eye care.


Jyoti Rayamajhi, a female community health volunteer (FCHV), supports the survey team to reach the community in Gorkha district. Photo Credit: RTI International/Nabin Baral

Jyoti Rayamajhi is a Female Community Health Volunteer (FCHV) in Nareswor village.

I help the people of my village and community to keep their health in better condition. My main role is to make people aware about personal hygiene and to communicate about health services they should take when they have a health problem. Before becoming an FCHV, I knew about trachoma. It is my duty to tell people about how to prevent the disease through good hygiene and ways to get rid of the disease. In the future too, I will send any cases to the hospital. I am happy that no cases of TT were found in my village.

We are looking forward to some good news coming out of Nepal in 2018!

Salina Sirmal, with her one year old daughter Rubina. Photo Credit: RTI International/Nabin Baral

Contributions from Mike French, Joshua Sidwell, and Laura Cane.

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.

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