Australia Is The Only Developed Country To Still Have Trachoma

11/02/2016 5:08 AM AEDT | Updated 15/07/2016 12:51 PM AEST
The Fred Hollows Foundation

Almost 40 years ago, I had the privilege of being involved in one of this country's most important medical projects, the National Trachoma and Eye Health Program.

Run by the Royal Australian College of Ophthalmologists, the program set out to eliminate the potentially blinding disease, trachoma, and other eye conditions in rural and remote communities. For the first time, we also set out to record the status of eye health in rural Australia.

Fred headed up the program and we worked closely with a core team and up to 1000 people who supported the program, right across Australia. Our teams visited more than 465 communities and screened about 100,000 people, 62,000 of whom were Indigenous Australians. They found that nearly half of Australia's Indigenous people had trachoma and, in some regions of the Northern Territory and Western Australia, the rate was as high as 80 percent.

This was astounding to all involved, considering that the condition was rarely found outside of these communities in mainstream Australia.

It was a tremendous honour and privilege as a middle-class Australian woman to work on this program. It was a shocking, long and hard few years on the road. But my passion to walk alongside Indigenous Australians as they tackle health problems is as strong today as it was then.

The real heroes of the program were the Aboriginal workers, community members and others who helped with the logistics and made sure we could do the work on the ground. It's not possible to remember all of their names, but without them there's little doubt the program would have failed.

There were just two Aboriginal-controlled medical services at the start of the program and 13 by the time it finished. There are now hundreds around Australia. Our program was probably the first time Aboriginal people had been asked to help deliver services to their communities.

Today, I'm joining a group of those remarkable people who worked on the program in Bourke to recreate a leg of the journey. It's a special and sad time of year, as February 10 marked 23 years since Fred passed away. He's buried in Bourke, a NSW town which was very special to him because of his great love for the country and its people, and so we will pay tribute to him at his grave.

One of the reasons we are marking the anniversary is that, shamefully, Australia is the only developed country to still have trachoma -- an issue that needs greater intervention from government and health providers at all levels.

Thankfully, however, because of the work done 40 years ago, and in the decades since, cases in Australia are small in number when compared to the massive problems we are seeing in Africa and Asia. Trachoma is the leading infectious cause of blindness in the world today. As many as 229 million people live in areas where they are at risk of developing this crippling disease.

Trachoma is prevalent in rural areas where access to safe drinking water or sanitation (health hardware) is limited. Hot, dusty and unhygienic living conditions create the ideal environment for trachoma to flare up and spread.

Women suffer much more often and severely from trachoma than men. This is because women usually care for young children, and end up being exposed to re-infections from infected children. This is tragic because if left untreated, the infection persists and the scarring worsens over years -- until it's too late, and blindness is irreversible. In a desperate attempt to alleviate the pain of trachoma, many people resort to pulling out their eyelashes.

I recently visited the Oromia region in Ethiopia to witness the work of doctors, nurses and health workers that The Fred Hollows Foundation has trained in fighting this blinding eye disease. Trachoma is at endemic levels in Oromia; 27 million people are at risk of developing the disease and, without vital surgery, 155,000 are at risk of losing their sight. I was struck by the fact that some of the same issues that faced Australia 40 years ago are still so common in remote Africa.

The key to preventing trachoma is to help communities emerge from poverty. Trachoma generally disappears as poverty levels decrease. It is imperative that health organisations and non-government organisations continue to work to ensure better access to antibiotics, health services, water and sanitation.

A 1998 World Health Assembly resolution targets trachoma for elimination as a public health problem by the year 2020. While this is ambitious, we are making headway, and we must continue to do more to eradicate this disease all over the world.

Forty years after Fred first set out on the mission to help Indigenous Australians with trachoma, I'm sure he'd be telling us to keep getting on with the job!

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