At first, a trachoma infection looks a bit like a case of pink eye: red, irritated eyes, maybe some swelling and discharge1. But for many people in the world, a trachoma infection is a serious concern. If left untreated, it can lead to severe pain, vision loss and even blindness. The bacteria that cause trachoma spread through direct personal contact, through shared towels and clothing, and through flies that have been in contact with an infected person. And there’s a simple solution for reducing its spread…
Clean water.
When communities have access to abundant clean water, they can wash their hands and faces regularly, do laundry more often, and prevent the otherwise relentless transmission of the disease. That’s why we are working hard with communities and partner organizations to make sure that the people in our project areas have access to a local, sustainable clean water source.
There’s been a lot of good news in the eradication of trachoma in recent years. In 2023 alone, Benin, Iraq and Mali each received certification from the World Health Organization (WHO) for eliminating trachoma as a public health problem. Also, the number of people at risk of getting the infection fell from 125 million in 2022 to 115.7 million in 2023, a significant reduction.2
But the hard work must go on.
Ethiopia has some of the highest rates of trachoma worldwide, with the prevalence in the Amhara Region estimated to be nearly 63 per cent. In that country, trachoma is the second leading cause of blindness overall.3
Trachoma continues to infect people in 42 countries and has caused blindness or visual impairment in roughly 1.9 million people. It remains the leading infectious cause of blindness worldwide. And the effect on the workforce in these countries is huge. According to a recent paper by the WHO, the loss of productivity due to trachoma costs somewhere between US $3-8 billion each year.4
To people like Stephen, in Narok County, Kenya, having trachoma meant not being able to support his family. The father of four, who works as a motorcycle courier, struggled with the infection for years. He tried eye drops, eyeglasses and several surgeries before the trichiasis in his right eye, caused by repeat trachoma infections, was fully resolved.
Since undergoing a successful final surgery at one of our partner hospitals, the young man now acts as an eye health ambassador in his community, making sure people know what the infection is, the role of hygiene in stopping its spread, and how to get it treated.
Years of repeat infection from trachoma causes scarring to the eyelid. This scarring can be so severe that the eyelid turns inward, causing the eyelashes to rub against the eyeball. This leads to severe pain, light intolerance and scarring of the cornea.
If left untreated, the damage to the cornea can cause vision impairment, usually between the ages of 30 to 40 years5, although it can happen in children as well. Trachoma causes 1.4 per cent of blindness globally.6
Women become blind from trachoma four times as often as men. This is likely due to frequent infections they get while caring for small children, who often pass trachoma on to others.
At Operation Eyesight, we follow the WHO’s SAFE strategy for controlling and preventing trachoma. SAFE stands for:
S: Surgery to treat trichiasis (the painful late stage of the disease)
A: Antibiotics to eliminate infection
F: Face washing and hygiene education
E: Environmental improvement including wells and latrines
The foundation for the strategy is environmental improvement, namely – providing access to clean water. Over the decades, we’ve worked with communities to rehabilitate and drill hundreds of boreholes. In recent years, most of our work with water has been concentrated in Zambia and Kenya, but we are also getting involved in more water projects in Ethiopia as we expand our programs there.
Along with drilling and rehabilitation, we work with local governments to make sure people can fix the boreholes when they break down. In Zambia, that means financing the training of volunteers called Area Pump Minders (APMs) to do routine maintenance and repair of boreholes. The program helps ensure that there is a system for repair work, with locally-available toolkits and spare parts, and that monitoring of the water supply is happening at the village level. In addition to helping their communities, some of the APMs go on to find paid work repairing privately-owned boreholes. Over the last two years, we’ve seen several women join the traditionally all-male teams, and we hope to recruit more in future.
The community involvement doesn’t stop there. We also work with volunteers to form WASH committees who help educate other people, especially children, in Water, Sanitation and Hygiene. In Ethiopia, we are working with partners to train teachers in WASH so they can pass on their knowledge to thousands of students. Our work in Ethiopia has also involved fixing up latrines and providing menstrual supplies, both of which can help keep teenaged girls in school longer.
Antibiotics also go a long way to preventing and treating existing cases of trachoma. We work with local governments and partner organizations to provide these antibiotics to areas with high prevalence of trachoma. Earlier this year, we collaborated with partners in a Mass Drug Administration project in Kenya’s Narok County. Despite wet road conditions that made it challenging for crews to access all the communities, the project managed to administer the antibiotic azithromycin to more than 215,000 people!
Throughout the process, our trained community health volunteers work tirelessly to provide education on the importance of facial cleanliness and environmental improvements in stopping the spread of trachoma.
Finally, with help from our generous donors, our partner hospitals can offer surgeries free of charge to people with advanced stages of trichiasis to alleviate the pain and prevent further loss of sight.
We’re involved in clean water projects as a means of preventing trachoma, but the effects of providing clean water to communities are countless. The installation and maintenance of boreholes prevents dozens of waterborne diseases that sicken and threaten the lives of many, and that keep whole communities trapped in the cycle of poverty. Sustainable boreholes help people grow gardens full of fresh vegetables, allow them to raise livestock and improve the quality of life for everyone around them.
The effects of access to clean water are especially beneficial to women and girls. Here’s why:
Education and economic opportunities: In many communities, women and girls are responsible for fetching water, a task that can be extremely time consuming and physically demanding. This can prevent girls from attending school and women from pursuing income-generating activities. When clean water is locally available, girls are more likely to complete their schooling, and women have more time for activities that empower them economically.
Reduced gender-based violence: Providing access to clean water within communities reduces the need for women and girls to travel long distances for water, decreasing their vulnerability to the violence and harassment that they risk when collecting water.
Hygiene and menstrual health: Clean water is essential for maintaining proper hygiene, including menstrual sanitation. When women have access to clean water and sanitation facilities, it positively affects their overall health and dignity.
Community development: Women are often key contributors to the well-being of their communities. When they have access to clean water, they can actively take part in and lead initiatives that enhance the overall living conditions in their communities.
In 2023, we partnered on two new boreholes at schools in Ethiopia’s Amhara Region. In Zambia, we repaired 25 boreholes in the Mkushi District, trained 20 new Area Pump Minders and set up more WASH committees.
You can help us continue our water projects in 2024 by making a donation today. Thank you for your support!
For the community of Lukanda B in central Zambia, the rehabilitation of the local water borehole has brought new life to the village.
It is one of 38 boreholes in Kapiri Mposhi District that Operation Eyesight repaired in 2022, thanks to a team of pump minders we have trained in the area. Locally available, safe water has made a difference in the lives of parents like Mutinta.
“When the borehole broke down in 2005, I was only able to wash my children’s clothes once or twice a month,” says Mutinta. “Now I’m able to wash clothes almost every day, because there is clean and safe water nearby.”
Before the borehole was fixed, Mutinta says her 15-year-old daughter, Memory, would frequently miss or be late for school because she had to walk long distances to fetch water for the family, a task that traditionally falls to girls. When Memory did attend school, she was often tired and her schoolwork suffered.
“I’m happy that my daughter will now be able to attend school regularly,” Mutinta adds.
Chali Chisala Selisho, our country director for Zambia, says that clean water nearby will play a key role in preventing the spread of trachoma, a bacterial eye infection that leads to irreversible blindness, as well as other diseases.
“Proper hand and face hygiene and sanitation are the best lines of defence against not only trachoma but other diseases like cholera, malaria, dysentery and diarrhea, which are on the rise in the area,” Chali adds.
Thanks to the generosity of our donors and the hard work of pump minders, Lukanda B’s future is bright!
Check out our new video from Zambia and learn more about how access to fresh water and sanitation is transforming the lives of individuals and entire communities.
When you give the Gift of Sight, not only are you helping to restore sight for individuals, but you’re also helping to prevent blindness for entire communities. Communities like Chitope in central Zambia.
The Chitope water point is one of 20 defunct boreholes that Operation Eyesight-trained teams are rehabilitating across the district, thanks to a team of 20 pump minders we have trained to repair and upgrade dysfunctional boreholes.
For the 350 households in the area, this work could not come soon enough. Chitope has been without a local, clean water source for the past four years. This means women and girls have had to travel long distances to rivers and shallow wells, where water is often not safe to drink.
“Lack of fresh water in this community has in the past prevented the expansion of local health and education facilities. This means women and children have been receiving health services in a thatched hut, and many children are learning under the shade of a tree,” says Chali Chisala Selisho, our Country Director for Zambia.
Chali says many families in Chitiope also depend on raising cattle and goats for their livelihood, which leaves them susceptible to diseases like blinding trachoma, spread by flies. Local access to fresh water will allow residents to wash their hands and face with clean water, helping make fight the spread of trachoma.
“This newly-fixed borehole will help transform this community, thanks to our donors and our community partners.”
Give the Gift of Sight this year to help transform the lives of individuals and communities.
Just three years ago, many would have thought backyard gardens were impossible in Zambia’s arid Sinazongwe district.
Today, when I visit the villages in and around the area, I see families growing their own food – corn, vegetables, even peanuts. I see the smiling, healthy faces of children on their way to and from school. I see well-fed goats, chickens, cows and other livestock. I see communities thriving.
It’s proof that bringing local access to clean water makes the impossible, possible.
Operation Eyesight began working in Sinazongwe in 2001.Over the last three years, in partnership with the Zambia Department of Water Affairs, our focus has been rehabilitating defunct and dysfunctional water boreholes in the area, as well as drilling new ones. To date, we have drilled 106 boreholes and rehabilitated 96 more around Sinazongwe – bringing clean, fresh water to communities that previously lacked local water sources.
Why rehabilitate boreholes rather than just drill new ones? Unlike drilling a new water borehole which takes time to identify a location and install necessary infrastructure, rehabilitation of previously drilled (by other NGOs) and non-functioning boreholes costs less and brings many quick wins for communities. Therefore, borehole rehabilitation makes the best use of every dollar spent.
Clean water and avoidable blindness
Operation Eyesight’s mission is to prevent blindness and restore sight. In Sinazongwe, trachoma was one of the leading causes of preventable blindness. I use the past tense, because our partnership with local communities to improve access to clean water has reduced the prevalence of this devastating infection in the district.
Trachoma is a bacterial infection that leads to irreversible blindness if left untreated. Although trachoma can be treated with antibiotics if caught early enough, lack of access to fresh water and inadequate hygiene are significant contributors to this painful disease’s spread through villages and communities. So, in Sinazongwe, bringing access to fresh water is the most effective way to address preventable blindness at its root cause, as well as prevent the transmission of many other illnesses and diseases. When people have access to fresh water, they can wash their hands, faces and clothing and prevent the spread of infection.
I often explain to our donors and hospital partners that you can’t tell people to wash their face if they have no clean water. Our team works in these communities every day and we are now starting to see behavioural changes where people are washing their faces more frequently. We are therefore addressing the root cause – and not the effect – of the problem.
I have personally seen the shift that takes place when clean water comes into a community. It’s an impact that extends beyond eye health, hygiene and improved health outcomes generally.
Downstream benefits
Access to water targets a range of different issues, especially for those responsible for drawing water: women and children.
In my work with Zambian communities over the past four years, I have found that bringing water closer to home actually improves school attendance in the majority of schools and communities where we are working. In fact, in areas where Operation Eyesight is working, we are seeing more girls in school than boys. It’s actually giving girls a chance to get an education.
Why? Because they don’t have to walk long distances fetching water from water holes, rivers and streams. This labour-intensive process leaves them fatigued when the time comes to go to school later in the day.
When water is far away, families are unable to store enough for their household. They may have enough for cooking and drinking, but do not have enough for washing and cleaning. Additionally, depending on its source, water may not be safe to drink. On the other hand, when clean water points are closer to home, it means families have enough water in their household at any given time.
Getting the whole community involved
We know that community ownership and maintenance of a borehole ensures its longevity. I have seen first-hand that partnering with local community leaders to form Water, Sanitation and Hygiene (WASH) committees – comprised of both men and women – helps spread awareness in the community about how to use and maintain the borehole and ensures its longevity.
Experience has taught us that children can be our greatest teachers. School WASH clubs are also making waves in their communities, building healthy hygiene habits among students by encouraging them to wash their faces when they arrive at school. Health education sessions are also helping make children ambassadors for proper hygiene when they go back to their own families.
Replicating success
Part of what makes Operation Eyesight so unique is our philosophy of not only empowering communities to look after their own water sources, but also our ability to scale and spread these successes.
The benefits and quick wins that come with locally-available fresh water are not limited to Sinazongwe but can – and are – being replicated in other parts of the country and African continent. In 2021 we drilled five new boreholes and rehabilitated 51 more in communities in Zambia’s Central province and have similar projects underway in other parts of Kenya.
Our approach to empowering communities and amplifying impact is what makes Operation Eyesight so unique. We are targeting vision loss and preventable blindness at their root cause.
Replicating our approach, while taking into consideration the unique needs and strengths of our communities of work, we are bringing entire communities back to life, health and prosperity.
Every morning, Sarafina walked over two hours to fetch water from a small marshland three kilometres from her village. After being used by many people in the surrounding villages, the water would get muddy and the banks slippery and dangerous. To avoid this, Sarafina tried to always be one of the first people to get to the marshland, so she could draw the clearest water for her family. This meant she had to leave her house by 4 a.m. each morning.
Sarafina’s village, Penti, has a borehole that was drilled by the government in 2004, but unfortunately, the borehole broke down in December 2020. This forced the nearly 200 people of the village to return to drawing water from holes dug in the marshland. Not only was this difficult for Sarafina and other women in her village, but it was also dangerous. Several months ago, a woman was assaulted in the dark on her way to collect water early in the morning.
Thanks to support from our donors, we recently rehabilitated the borehole, and the people of Penti have clean water once more. For Sarafina and the other women, the rehabilitated borehole has brought a lot of relief. No more early morning long walks to the water hole; no more fear of being ambushed in the dark; no more danger of slipping in the mud and getting hurt; and no more carrying heavy buckets of water for more than three kilometres at a time.
“I am very happy that, once again, I can draw water from the village borehole,” Sarafina shared. “This makes life much easier for us. Now I can get water even at night because it’s near and safe. No one was ever walking to the water hole in the night because, here, a lot of danger lurks in the dark. Having a water source nearby is protecting women and girls from many forms of danger.”
Access to clean water is critical to preventing bacterial diseases, such as blinding trachoma, and it also significantly reduces the burden on women and girls and leads to safer, healthier communities. Donate today to help provide clean water for more villages like Sarafina’s.
In June 2021, Karen and her husband welcomed a healthy baby boy, Peter, into their family. Like all new mothers, Karen was overjoyed but also exhausted. This exhaustion was compounded by the fact that the borehole in Nkumbaisha, her village, had stopped working in May 2020. With a newborn in the household, Karen needed a lot of water every day for cleaning and washing.
Without a functional borehole nearby, she had to fetch water from a ditch dug in the nearby marsh. Not only was the water dirty, but it was also dangerous for women and children to fetch water from the ditch as it was quite steep and slippery. Collecting the water required considerable physical strength to lift the heavy buckets of water out of the ditch, which was especially challenging for Karen while she was pregnant and for the first few weeks after giving birth.
With support from Operation Eyesight’s donors, the borehole in Nkumbaisha was rehabilitated in July 2021. For Karen and many other mothers like her, this was a turning point in their lives and a huge source of joy. “Since May of last year, it took me more than two hours to fetch a single bucket of water,” Karen explained. “Now, I can access clean water within five minutes. I am extremely relieved! This will help us improve our hygiene and give me more time to focus on my son.”
Karen is relieved to know that she now has the ability to keep her family clean and healthy. Every day, she washes her baby’s clothes and prepares nutritious food for her family. The food is grown, washed and cooked with clean water and served on clean plates.
Access to clean water leads to safer, healthier communities. Donate today to help more families like Karen’s get accessible, clean water sources near their homes.
Regina is a 36-year-old mother of five who lives in Zambia’s Sinazongwe district. To provide her family with clean water, she visited her village’s borehole every day until 2018, when the borehole became dysfunctional and stopped providing clean water. At that point, the next closest borehole was 10 kilometres away.
In communities like Regina’s, providing water is generally the responsibility of the women and children of the household. With such a long distance to travel to collect clean water, they were unable to do anything else, including attending school.
When they didn’t have enough clean water, they were forced to collect from unclean sources, and Regina’s household usually suffered from diarrheal diseases. They also faced the risk of contracting trachoma, a painful bacterial disease that can lead to permanent blindness. All this sickness and daily walking took its toll on Regina and her children, and it interfered with her children’s ability to get an education.
In 2020, Operation Eyesight rehabilitated the borehole in Regina’s village, transforming the lives of her and her children. Thanks to donor support of our borehole programs, Regina is able to collect clean water right in her own community. Her children are healthier and can attend school, and she has time to do other things, including working in her vegetable garden.
This Mother’s Day, you can help a mother like Regina provide clean water for her family. Please donate to Operation Eyesight to help prevent blindness and restore sight for women and girls. Every dollar will be used to ensure they get the quality eye health care they need right now, and well into the future. You can choose to make a donation in the name of your own grandmother or mother or another important woman in your life.
This year’s World Water Day theme is valuing water. On March 22, we celebrate World Water Day by recognizing that the value of water is much more than its price. Water is an integral part of our daily lives and impacts health, education, economics and our environment. Ensuring the availability and sustainable management of water and sanitation for all is listed by the United Nations as one of their 2030 Sustainable Development Goals. Clean water is also incredibly valuable in eye health.
Access to clean water is an important part of ending serious eye infections like trachoma, the world's leading cause of preventable blindness. Trachoma causes the eyelid to turn inward so that the eyelashes rub the eyeball. This results in intense pain, scarring of the cornea and ultimately, irreversible blindness. Although trachoma can be treated with medicine and, in more severe cases, surgery, the most effective way of reducing rates of this painful infection is to address one of the root causes, which is lack of adequate sanitation. With access to clean water, people can wash their hands, faces, clothing and homes and prevent the spread of trachoma. This improved sanitation also aids in the reduction of other serious illnesses such as diarrheal disease, upper-respiratory infections and other communicable diseases like COVID-19.
Operation Eyesight follows the World Health Organization-endorsed SAFE strategy for eliminating trachoma in areas of Kenya and Zambia. SAFE is a comprehensive treatment and prevention program that includes:
Properly implemented, the SAFE strategy permanently eliminates trachoma. One of the key factors for achieving this is drilling or rehabilitating boreholes. In recent years, we’ve shifted our focus from drilling new boreholes to rehabilitating existing, dysfunctional boreholes. The cost-savings employed by this method allow us to reach many more communities.
When a borehole is drilled or rehabilitated, we establish local Water, Sanitation and Hygiene (WASH) committees. These committees are trained on how to maintain the borehole and ensure its longevity. Properly maintained boreholes can provide clean water for decades. The WASH committees also provide community health education sessions to help people improve their sanitation habits. They incorporate messages on facial cleanliness and environmental improvements such as the proper building of latrines.
Clean water does so much more than prevent blindness. Families are able to grow more nutritious food and easily water their livestock when water is easily accessible. This leads to a reduced prevalence of illnesses resulting from poor nutrition. It also gives women and girls more opportunities. The task of hauling fresh water for long distances most commonly falls to women and girls. Depending on the area, the journey can also be dangerous, and the water from unprotected sources may not be safe. When clean water is easily accessible, women and girls have time to go to school, earn a living independently, and be actively involved in their families and communities.
Communities with a clean water source also become hubs of local trade and provide increased economic opportunities. New schools are often built near boreholes because of their central location and easy access to water. Existing schools are expanded on to accommodate for the increase in attendance resulting from more girls being able to participate in school now that they don’t have to walk far distances to fetch water. Read this story about how a borehole increased the attendance at Mweela School by 274 students.
This World Water Day, you can help bring the positive ripple effects of clean water to a community in need. Please donate today.
Access to safe water and sanitation facilities in Kenya has traditionally been a challenge, particularly in rural areas. In Ichangipusi village in Narok South District, the primary source of water used to be a laga (a seasonal riverbed).
Villagers would journey more than three hours to collect water from unprotected, shallow wells dug in the riverbed. Children, mostly girls, would bring containers with them to school so they could fetch water on their long seven-kilometre trek back home.
This labourious process to collect water came to an end in 2010, when Operation Eyesight developed a borehole in Ichangipusi village to help in the fight against trachoma, a painful but preventable eye disease that causes blindness.
It is incredible to see the impact that one borehole can have on an entire village! Our donors truly are making a difference in the lives of others. Thank you! To learn more about Operation Eyesight’s trachoma projects in Narok, visit our website.