The following is by ITI Senior Program Associate Birgit Bolton about her recent trip to Nepal.

Health workers in Nepal have started surveys to confirm whether the country has eliminated blinding trachoma as a public health problem. I recently visited Dhangadhi, a small town located near the border of India, to participate in training workshops to teach these health workers how to conduct three survey methods to determine if there is any active trachoma left in communities that implemented the SAFE strategy years ago. SAFE stands for surgery, antibiotic distribution, facial cleanliness and environmental improvements.

The three survey methods include eye exams to look for clinical signs of trachoma, ocular swabs to test for the bacterium Chlamydia trachomatis that causes trachoma, and blood tests to determine whether individuals have antibodies specific to Chlamydia trachomatis. During my fieldwork, I met a family who received two rounds of mass drug administration (MDA) with Zithromax®, the antibiotic donated by Pfizer to treat and prevent trachoma. They were also some of the first individuals to be examined for this surveillance effort where they learned they do not have clinical signs of trachoma. It was definitely a happy moment, especially since women and children are most often afflicted by this disease.

The mother, Fulmati Choudhary, daughter, Kewot Choudhary and granddaughter, Anu Choudhary, age 6, have neighbors who had trachoma so it has been a real public health concern for their village of Sri Lanka.  While the SAFE strategy was implemented, residents learned that they have to wash their hands and face to reduce infection, and build and use latrines to keep their homes clean and free from the flies that spread trachoma from person to person.  They also understand that even though the threat of active trachoma has been eliminated and MDA is no longer needed, it is important to continue with the “F and E” components of SAFE. The community is grateful to Nepal’s National Trachoma Program for distributing the free antibiotic and other services, such as surgery, to correct eyelashes that have turned towards the eye.

I was very humbled to have the opportunity to meet these beneficiaries and experience their appreciation of a healthy life. It's so exciting to visit a country that is just two years away from reaching its elimination goals. It’s also validating that this global effort to end blinding trachoma is feasible – not just for Nepal, but for all countries that have this disease. I look forward to sharing my insight of Nepal’s success with other countries so their national programs can benefit and ultimately reach their own elimination goals.