Ethiopia

Trachoma is a debilitating eye disease that can slowly and painfully lead to blindness and Ethiopia has the highest incidence of blinding trachoma in the world. More than 74 million people live in trachoma endemic areas and 1.6 million people are blind. The disease contributes to poverty and poor living conditions lead to disease and further disadvantage. 

The Fred Hollows Foundation is part of a global effort to eliminate trachoma. In 2019, with the support of the public, the United States Agency for International Development (USAID), Wellcome Trust and the UK Department for International Development (DFID), END Fund and Australia’s Department of Foreign Affairs and Trade (DFAT) and partial support from the Australian Government through the Australian NGO Cooperation Program (ANCP), we are implementing a US$6.5million program to eliminate avoidable blindness in Ethiopia.

Oromia is the largest region in Ethiopia by area and population. Across the region, 27 million people are at risk of contracting trachoma. In 225 of Oromia’s 265 rural districts, the disease is endemic. In more than 40% of districts trachoma is hyperendemic and will require a minimum of five years of intervention to eliminate. 

Such a high burden of trachoma severely impacts the quality of life of people and communities. People who suffer eye damage and blindness as a result of continued infection are often unable to work and are reliant on the care of family members, reinforcing a cycle of poverty.

The disease disproportionately affects vulnerable groups such as women and children. Women are twice as likely as men to develop trachoma. If another family member is infected or has become blind, women and girls are expected to take on the care-giving role.

This means girls often miss out on school and women are less able to earn an income.

As part of our global efforts to eliminate this disease, The Foundation is tackling trachoma in Oromia. Elimination in Oromia will have a significant impact on global prevalence. Working under the lead of the Oromia Regional Health Bureau, we are targeting the elimination of trachoma.  

Although progress has been made in the elimination of trachoma, there is still a great need for comprehensive eye care services to improve cataract surgical services and address uncorrected refractive errors - the leading causes of blindness and visual impairment in Ethiopia. 

From 2019, The Fred Hollows Foundation began implementing a Comprehensive Eye Health project to strengthen the capacity of Oromia Regional Health Bureau to effectively coordinate, manage and resource comprehensive eye health services, and to increase access to quality and comprehensive eye care services for rural communities in the region.

Treating people with trachoma is relatively inexpensive and simple. However, eliminating blinding trachoma requires behaviour change in sanitation and hygiene.  

To achieve this, The Foundation, together with the Oromia Regional Health Bureau and other partners, is coordinating the roll out of the World Health Organization endorsed SAFE Strategy (Surgery, Antibiotics, Facial cleanliness, Environmental improvement), which is designed to treat the disease, stem its spread and prevent it from recurring. 

Successful implementation of this strategy requires the expertise, commitment and resources of a range of stakeholders, including development organisations from the water, sanitation and hygiene sector, as well as regional and local governments. An action plan is in place to guide and coordinate these organisations. Our contribution includes increasing the distribution of antibiotics in endemic districts and stepping up the number of surgeries carried out on people with advanced scarring of the eyelid. We also promote face washing and help improve access to safe water and latrines. 

Some of our key implementing partners in this program include the Federal Ministry of Health (FMOH), the Oromia Regional Health Bureau, the Oromia Regional Education Bureau, the International Trachoma Initiative, Orbis International, Sight Savers International and RTI International.

By the end of 2018, The Foundation secured support to scale up SAFE interventions across all 20 trachoma endemic zones in Oromia Region. 

The new Comprehensive Eye Health project will work to build a strong foundation for comprehensive eye care programming in the Oromia region by building on the lessons learned,  and partnerships developed (with the FMOH, the Oromia Health Bureau and other eye health partners).