How my clotheslines helped eliminate trachoma
One morning at the village health center, unaware that they were launching the annual trachoma mass drug administration campaign, I offered to help Shawit, the health extension worker, carry medical supplies to the center of town where we would set up a “pop-up” post in front of the elementary school with a few other health center staff.
I noticed, while carrying a stack of boxes down the street, that I was drawing quite the crowd of children wondering where their then-strange and exciting new neighbor was going. Among them was a child we all call “Network” for his ability to spread information throughout the town in a matter of minutes. By the time we reached our destination, several hundred people from the town and surrounding rural area had gathered on the street corner to receive their dose of Zithromax, a medicine to address trachoma, as well be screened by health workers for any eyelashes touching the eye, a sign of advanced trachoma which requires surgery.
When a Peace Corps Volunteer first gets to their town, they often have many great ideas for things they want to help accomplish. But most Volunteers quickly realize that opportunities to help their community often arise from spontaneous circumstances and an open mind. When I first arrived to my community in northwest Tigray, I spent my days walking around the health center, watching the staff work and trying to make friends while not getting in the way.
As a Volunteer new to the language, my town and the Ethiopian health care system, I quickly became overwhelmed as I worked my way through the crowd, finally reaching the center, where I met two health extension workers and a midwife from my health center. We all exchanged looks as if to say “it’s going to be a long day” as we set our supplies on the ground and began to set up our station. The crowd’s eagerness to receive their medication and screening (probably combined with a curiosity to see what the ferenji or “foreigner” was doing) created a mob of people pushing from all sides to get our attention. This went on for about eight hours. Exhausted, I left with my colleagues, wondering if there was anything I could do to make their jobs easier.
I spent the evening planning a new system for carrying out the trachoma campaign and gaining the courage to implement it in the morning. I woke up early the next day, walked to the location where the campaign would be and, using the rope I used to hang laundry, roped off an area with various stations. When the staff arrived, they greeted me with a confused look and one person even began taking the rope down. I tried the best I could to explain the system, but realized that with my then-very limited language skills, the staff would just have to give me a chance and we’d learn as we went.
Minutes after the staff arrived, people started flooding the street, many
of the children pressing themselves against the roped area to get a look at
what we were doing. One father emerged first from the crowd and into the
measuring area with his two children. I marked his children’s hands with the
number of pills or dosage of syrup they should receive with a washable marker.
They then proceeded to receive their medication and surgical screening. After
the crowd watched the system in action, they began to form a line at the
registration station. It was so effective that I even had time to talk to
some of my neighbors that stopped by and show children how to wash their hands
and face.
By the end of the day, Gebre Kiddan, the health center director, had come over to see the new system and to show other health center staff the process. We all left that day having seen almost twice the number of people as we had the previous day and feeling accomplished as a team. I was so proud to see my system being implemented during the measles campaign the following month, and again during the campaigns this year.
I consider the trachoma campaign to be my first major success in my town, not only because I was able to play a small part in making the health center staff’s difficult jobs a little easier, but because the camaraderie I built with the staff laid the foundation for my future success at the health center throughout my service. It also allowed me to access and form relationships with many members of the community (especially mothers and children) that I had not previously encountered.
I didn’t know this then, but I have since learned the importance of that success. Ethiopia has one of the highest burdens of trachoma in the world. The campaign I was implementing was part of a national effort to eliminate trachoma, a neglected tropical disease, from Ethiopia by 2020. Critical to that success is reaching as many people with the medicines as possible, something my efforts helped the local team to do. I was even more proud to learn that my home country has been supporting treatment for trachoma in Tigray for several years through USAID’s ENVISION project.
I look forward to hearing about the day that this blinding disease is no longer an issue in my adopted village, and knowing that I played my part in this larger effort.