Trachoma in Ethiopia

On The Road to Soddo: Ethiopia leads the world in blindness and eye impairment. Trachoma is endemic in the districts of Soddo, Alaba, and Gurage where these photographs where taken, during December, 2006. Hospitals and field clinics are few and far between. While community wells and latrines are continually being dug, many people carry water often many kilometers to homes with no latrines. Blindness here means a life of destitution and begging. The world health organization estimates 37 million blind people and 124 million visually impaired people worldwide. Trachoma is the world’s leading cause of preventable and treatable blindness. This documentary photography presentation is supported by Orbis Canada and the Canadian International Development Agency, both of which support medical, water, and sanitation projects in Ethiopia. A mega highway project funded by the World Bank using Chinese contractors proposes to build and upgrade blacktop highways in a country where most of the population doesn't wear shoes.

Asra Tsakik, the Field Coordinator for Orbis International checks the eyes of Workete Gujama. Her corneas have scarred over as a result of an advanced complication of trachoma called trachomatous trichiasis, which turns the eyelashes inward to scratch and scar the cornea with every blink.

School children line up in a village near Alaba to have their eyes checked by nurse Asra Tsakik, the Orbis International Field Coordinator. He is looking for the presence of follicles, inflammation, or scarring. For the early stages of trachoma, a six-week course of antibiotics (with tetracycline, erythromycin, or sulfonamides) is prescribed, or a single dose of azithromycin.

Aberash Abera, 10, has come with her mother to an Alaba District field clinic to see if she qualifies for surgery that will relieve the scractching of her cornea by inward turned eyelashes. Nurse Asra Tsakik, the Orbis Field Coordinator is looking for the presence of follicles, inflammation, or scarring. She qualifies for surgery because she has more than 5 eyelashes on each eye turned inward. For the early stages of trachoma, a six-week course of antibiotics (with tetracycline, erythromycin, or sulfonamides) is prescribed, or a single dose of azithromycin.

Trachoma is the world’s leading cause of preventable blindness. In the regions of Ethiopia around Alaba, Soddo, and Gurage, where these images where taken, this disease was pandemic during December, 2006 Caused by fly-born bacteria, the infection turns the eyelids inward, scratching the eyeball, causing unbearable itching and scarring that inevitably leads to blindness if not treated, early, with what amounts to a dollar's-worth of antibiotics, or one half -our surgery performed by specialized nurses. Today, 1.3 billion people still can’t access clean water. 2.6 billion people can’t access proper sanitation, and an estimated 14 million people die from treatable diseases. A staggering 2 billion more - almost a third of the world’s population - are infected and debilitated from treatable diseases. These shatter families, jolt economies into negative growth, and destabilize security and food supplies. Trachoma is one such disease.

Melesech Achiso is 15, her eyes have been infected many times, and her eyelashes have turned in and scarred the corneas. Her early symptoms were not treated, the follicles swelled into gray pimples, and small blood vessels grew inside her corneas. The only possibility for restoring her sight is a cornea transplant. She is here to see the one visiting ophthalmologist, who comes to Soddo once a year, for one month, from Addis Ababa. "This list is just too long for one surgeon" Dr. Getenet tells me. The chance of her receiving a transplant is virtually none.

Sister Genet Bogala has performed more than 30 trichiasis surgeries this week. She operates on Sherefa Ali, 30, while Keddr Mengi, 45 waits outside for his turn with the field nurse. Nearly 2600 such surgeries were performed in Gurage district in the last 10 months.

Sister Genet Bogala has performed more than 30 trichiasis surgeries this week. She operates on Sherefa Ali, 30, while Keddr Mengi, 45 waits outside for his turn with the field nurse. Nearly 2600 such surgeries were performed in Gurage district in the last 10 months.

This “old man” is 62 years old. He requires medication for tuberculosis, and his blindness is likely from untreated trachoma. His family fears that they will be forced to move him to Ghanzi, off the farm where they all work, away from his family, because he is old and sick and a liability to the rancher.011: Trachoma is the world’s leading cause of preventable blindness. In the regions of Ethiopia around Alaba, Soddo, and Gurage this disease is pandemic, where these images where taken, during December, 2006

Amaredtt Turq, 41, undergoes trichiasis surgery. The procedure involves making a one half inch incision through the upper eyelid, and then sewing it together so as to pull or "flip" the eyelashes away from the cornea, thus preventing further damage to the cornea. Sister Bogala tells me that they do surgery when more than five eyelashes are scratching the cornea. Up to that point they suggest antibiotics and epilation until more severe trachomatous trichiasis develops. After surgery the patients are given a topical antibiotic and told to come back in a week to have the stitches removed.

These woman wait to be treated for Trachoma. One of the woman has a charcoal burn on her temple, which is a home remedy for the burning Trachoma causes the eyes. Caused by fly born bacteria, the infection turns the eyelids inward, scratching the eyeball causing unbearable itching, and scarring that inevitably leads to blindness if not treated, early, with what amounts to a dollar of antibiotics, or one=half hour surgery performed by specialized nurses. Today, 1.3 billion people still can’t access clean water. 2.6 billion people can’t access proper sanitation, and an estimated 14 million people die from treatable diseases. A staggering 2 billion more - almost a third of the world’s population- are infected and debilitated from treatable diseases, which shatter families, jolt economies into negative growth, and destabilize security and food supplies. Trachoma is one.

Trachoma is the world’s leading cause of preventable blindness. In the regions of Ethiopia around Alaba, Soddo, and Gurage this disease is pandemic, where these images where taken, during December, 2006 Caused by fly born bacteria, the infection turns the eyelids inward, scratching the eyeball causing unbearable itching, and scarring that inevitably leads to blindness if not treated, early, with what amounts to a dollar of antibiotics, or one=half hour surgery performed by specialized nurses. Today, 1.3 billion people still can’t access clean water. 2.6 billion people can’t access proper sanitation, and an estimated 14 million people die from treatable diseases. A staggering 2 billion more - almost a third of the world’s population- are infected and debilitated from treatable diseases, which shatter families, jolt economies into negative growth, and destabilize security and food supplies. Trachoma is one.

Gachore Mekengo, 62, has just sat up from the bench where he had surgery. A friend receives antibiotics from the nurse and then will help him walk home. When I ask Gachore how he feels. He tells me that the most painful part was when the nurse "put the needle in my eyelid".

Soddo School for the Blind. These children are the lucky blind ones, because they get to learn brail, and read and write. The teachers are also blind. The Montessori method is used , “because of its tactile nature” says Teferi Kebede who has been teaching at this school for nearly 20 years. Grade 6 teacher Ma Mo Madebo, 46, was the first student at this school. The WHO estimates the cost of childhood blindness in the world, in lost earnings, to be between 8 and 27 billion. 90% of people who are blind live in developing countries. Worldwide, up to 70% of childhood blindness is preventable.

Soddo School for the Blind. These children are the lucky blind ones, because they get to learn brail, and read and write. The teachers are also blind. The Montessori method is used , “because of its tactile nature” says Teferi Kebede who has been teaching at this school for nearly 20 years. Grade 6 teacher Ma Mo Madebo, 46, was the first student at this school. The WHO estimates the cost of childhood blindness in the world, in lost earnings, to be between 8 and 27 billion. 90% of people who are blind live in developing countries. Worldwide, up to 70% of childhood blindness is preventable.

During eight days in December, 2006, dozens of CIDA supported Orbis workers spread out over six districts and 150 villages to administer 300,00 doses of Zithromax. The antibiotic given once a year over three years will protect against Chlamydia trachomatis, the bacteria that causes trachoma, for at least ten years.

Kokate Morchera, 40 was blinded by trachoma when he was 12 years old. His daughter, Eyasu, leads him around wherever they go. She is his eyes. They live mostly by begging. I met them walking along the road near Soddo. Water shortage, flies, poor hygiene, and crowded living conditions are at the root of trachoma. Under the right conditions, the fly born bacteria Chlamydia trachomatis is as persistent as it is ancient.

Kokate Morchera, 40 was blinded by trachoma when he was 12 years old. His daughter, Eyasu, leads him around wherever they go. She is his eyes. They live mostly by begging. I met them walking along the road near Soddo. Water shortage, flies, poor hygiene, and crowded living conditions are at the root of trachoma. Under the right conditions, the fly born bacteria Chlamydia trachomatis is as persistent as it is ancient.

Hot Springs are a source of relaxation and health including giving relief trachoma infections which make the eyes feel full of burning sand.