91ÊÓƵ

Conventional wisdom says trachoma — the leading cause of preventable blindness worldwide — can only be treated, not eliminated. But Teshome Gebre, The Carter Center's point man for trachoma control in Ethiopia, hopes to defy that wisdom. He is convinced that trachoma's blinding and debilitating effects can be stopped before the end of the next decade, the targeted goal for global trachoma elimination.

"We cannot wait until 2020," he says. "We can do it much earlier, and we are going to show the world it can be done."

Gebre's confidence stems from the significant recent achievements he has seen take place in trachoma treatment and prevention. To date, The Carter Center has supported the construction of nearly 610,000 pit latrines and the distribution of more than 10 million doses of the antibiotic azithromycin across six African countries.

The drugs treat active cases of trachoma, and the toilets target unsanitary conditions that help the disease spread.

"We can't believe it," Gebre says of the latrine boom. "A sustained effort, without giving up, made the difference. A boom in one district caught on in another. Then it was just like fire - it just went on."

Today, that fire continues in some of the most trachoma-endemic areas, including Ethiopia's rural Amhara Region. There, with instruction from Carter Center-trained local volunteers, many families are building their own latrines and learning to practice better hygiene, such as washing the face and hands.

These simple lifestyle improvements counteract the spread of trachoma-causing bacteria through contaminated materials and black flies that land near the eyes. The latrines reduce the fly population by eliminating their breeding grounds — exposed human feces.

In Ethiopia, alone, where an estimated 1 million people suffer from severe trachoma — called trichiasis — The Carter Center has overseen the construction of more than 350,000 latrines since 2004 with help from its partners, the Conrad N. Hilton Foundation and Lions Clubs International Foundation.

The latrines are part of the four-pronged approach to trachoma control that includes eye surgery, antibiotics, face and hand washing, and other improvements in sanitation.

Gebre and other leaders expect to see fewer cases of trichiasis which can cause eyelashes to turn inward and scrape the eye, leading to irreversible blindness. But the most dramatic and unexpected outcomes of the trachoma control strategy relate to women, who are three times more likely than men to develop blinding trachoma due to their frequent contact with children, the main reservoirs of infection.

As improved sanitation reduces the incidence of trachoma, many women are able to fulfill their responsibilities to their families and communities without impairment from the disease's effects.

And, in cultures that have traditionally required women to wait until darkness to defecate, latrines now give women the freedom to relieve themselves when they choose.

"In short," says Gebre, "what we are doing is empowering women, empowering people, empowering communities."

As the sense of empower-ment continues to grow, particularly among women, it is evident on the clean and shining faces of Ethiopian children. Their smiles reflect hope that they may see the end of trachoma's ravaging effects in their lifetimes, a reality The Carter Center and its international partners are committed to fulfilling.

Learn more about the Carter Center's Trachoma Control Program >
Latrine Program a Hit: Project Deals with Health, Gender >