- Published on Sunday, 14 July 2013 02:14
- Written by ORTON KIISHWEKO
- Hits: 1973
IN early 2000, it was feared by medical authorities in Dar es Salaam that an acute shortage of clean water in some parts of the country was crippling a national crusade against trachoma.
Experts had called on communities to observe cleanliness of their faces, but this had become difficult because of the critical shortage of water in most endemic areas. Trachoma is an infectious eye disease, and the leading cause of the world’s infectious blindness.
Data sheet from Helen Keller International Tanzania (HKI) shows it is spread by direct contact with eye, nose, and throat secretions from affected individuals and is the leading infectious cause of blindness and is responsible for more that 3 per cent of all blindness worldwide. During periods of water shortages, the poor disposal of feaces is the major cause of the disease, HKI experts say.
Even today, it is estimated that 1 per cent of Tanzanians are blind, while worldwide, 57 million people are blind and 31 million are visually impaired. The people, it notes, at risk are those residing in rural areas with poor provision of water and sanitation infrastructures, poor access to health services and low socioeconomic development.
In Tanzania, it goes on, trachoma is thought to be endemic in 54 districts with around one third of the population at risk, with the prevalence of active Trachoma in the country goes up to 65 per cent. According to World Health Organization, the average prevalence of the active phase of the disease in the 54 districts is 29 per cent with rates going as high as 65 per cent.
According to the most recent WHO projections, there is an estimated backlog of 214,000 cases of Trachomatous Trichiasis in the country. According to HKI, Mtwara and Lindi had an estimated combined backlog of 62,500 cases in 2006-7.
In projects across the regions, Helen Keller International Tanzania collaborates with the Ministry of Health and Social Welfare (MoHSW) in the implementation of the National Trachoma Control Programme to achieve the country’s GET2020 goal of eliminating trachoma as a source of blindness by 2020.
Local government authorities and Non-Governmental Organisations are partners at the national and local level. The components of this project follow the WHOendorsed SAFE strategy which entails: Surgery: social mobilisation, screening and surgical outreach in ten districts in Mtwara and Lindi.
Antibiotics: Support and advocacy to Council Health Management Teams in planning and budgeting for Zithromax distribution. Facial Cleanliness: Together with the Tanzania Institute of Education, HKI supports the development of a trachoma curriculum for schools which is introduced in trachoma endemic districts together with the training of science teachers on the curriculum and teaching methods.
They also do Environmental Improvement which entails advocacy to water sector partners in mobilising resources to improve the water infrastructure in communities and schools through the Ministry of Water, Local Government Authorities and other development partners.
HKI used funds from the Heart to Heart Foundation to contribute towards trachoma control in the country as the Foundation provided support for surgeries, teacher training on trachoma prevention. Coordinator- Eye Health and Neglected Tropical Diseases Helen Keller International Tanzania, Mr Peter Nyanda also says there is the Hilton funded project for five years (2008-2013), covering Mtwara and Lindi regions with possible up-scalling in the future.
The objective is to provide support to the National Vision 2020 Programme of the Ministry of Health and Social Welfare in the effective elimination of trachoma as a source of blindness. They also Support the MoHSW to strengthen their ability to strategically address trachoma in Tanzania.
For example, for the past twelve months, the organisation has been working with the MoHSW-NECP in many areas that will strengthen the trachoma programme in. For example, to recognise the 2009 World Sight Day on October 8 last week, HKI supported surgeons and medical practitioners to implement a 3-day surgical camp for trichiasis.
Other meetings attended by HKI staff where additional technical support was offered were the National Eye Care Strategic Plan development meeting and the National Prevention of Blindness Committee meeting. Over the course of the year, HKI has been instrumental in the development of the NECP strategic plan by attending and sharing technical input in several consecutive consultative meetings which also included other INGOs such as Sight Savers Tanzania and CBM.
They also led in the organisation of a trachoma partner’s meeting to be held with the NECP, JHU, CBM, Sight Savers Tanzania, the International Trachoma Initiative, IMA world Health, and Kongwa Trachoma Project in Dar es Salaam in September this year.
The main outcome of this meeting was the development of a 3-year National Strategic Plan for Trachoma, one of the first steps necessary for strategically paving the way for trachoma elimination by the year 2020. In preparation for this meeting, HKI has compiled a “Prevalence Data and Target Progress” database, which contains all existing SAFE strategy data for Tanzania.
It is our hope that all partners working in trachoma elimination in Tanzania will use this database moving forward. HKI supported Dr Bernadetha Shilio, Programme Officer with the NECP, to attend the Global Elimination of Trachoma (GET) 2020 and International Trachoma Initiative Zithromax Forecasting meetings in Geneva in April.
During her presentation to the international trachoma community, Dr Shilio shared some of the biggest challenges the NECP faces in day-today trachoma activities, such as difficulties with monitoring and evaluation of SAFE strategy components districtlevel, irregular distribution of Zithromax, low MDA coverage rates with Zithromax in areas where distribution does take place, and a low TT surgery rate at the National level.
It also supports the MoHSW to identify the key environmental change partners for trachoma control in Lindi and Mtwara. The result was the mapping exercise of all water sector partners working at district- level in the 10 districts of Mtwara and Lindi has been completed.
Interviews, focused group discussions and review of key water and sanitation literature were conducted by HKI with water and sanitation actors working with the government, NGOs, and community groups in each district in late-July and early-August.
The mapping exercise collected data on each of the environmental change initiatives currently being supported, such as their objectives, timeline, geographic location, level of community participation exhibited, and level of local government authorities’ contributions.
He said it gave them a greater understanding of; the key environmental players and their initiatives in each district to support trachoma elimination; hygiene initiatives that are linked to environmental change initiatives; future priorities and the impact this will have on trachoma elimination efforts; and what is needed for current and future advocacy and funding of such initiatives.
This information will be instrumental in Year Three as we begin to integrate surgical services and face washing with environmental change initiatives in Mtwara and Lindi. Results from this report will be presented at the partner’s meeting in September, raising the question of how do partners begin to integrate environmental change initiatives with those of trachoma elimination nation-wide. The objective, it concludes, is to increase surgical outputs and reduce the current trichiasis backlog in the two focus regions by 4000 cases.