What is Trachoma?
Trachoma is one of the oldest known infectious diseases. A bacterial disease, trachoma is spread easily through contact with infected individuals. After years of repeated infection, the eyelid turns inward and the lashes rub on the eyeball, scarring the cornea, resulting in a slow and painful process toward complete blindness.
An Interview with Kelly Callahan
Lions are very active in the fight against trachoma. Lions Clubs International Foundation’s (LCIF) SightFirst program has awarded more than US$29 million to The Carter Center, a leader in combating trachoma for 23 projects in in Ethiopia, Mali, Niger, and Sudan. Ethiopia alone has received more than US$21 million in funding since it is the most endemic country in the world for the disease.
Kelly Callahan is director of the Carter Center’s Trachoma Control Program. She also is a Lion. In this interview, Callahan explains how she got involved in humanitarian work, her thoughts on the progress of the fight against trachoma thus far, and how it has impacted her.
During my time in the Peace Corps, we created a filter frame that proved to be extremely useful; we saw a 47% reduction in cases of Guinea worm disease the first year. Then we saw virtually zero new cases. I was asked to represent the Peace Corps at two international Guinea worm conferences. In the fall of 1996, I met representatives from The Carter Center. I met them again in summer of 1997, and they asked if I wanted to work with Guinea worm disease in southern Sudan. That fall, I went to visit. I fell in love with the possibility of helping millions of people rather than tens of thousands. In 1998, I accepted the offer and began working on Guinea worm and onchocerciasis [river blindness]. In 2001, a colleague and I carried out the first surveys for trachoma in southern Sudan. I saw a young boy about 5 years of age who needed surgery in both eyes from trachoma. It was absolutely horrendous. I knew I could do something; I knew I could help. The Carter Center was willing to assist the people of South Sudan, not only in Guinea worm eradication and onchocerciasis control, but also toward controlling trachoma. So, we started interventions to control trachoma in some of Sudan in 2001.In 2004, I transitioned to The Carter Center offices in Atlanta, where I supported the Trachoma Control Program as well as the other health programs of The Carter Center for 10 years before becoming director of the trachoma program.
The hardest thing to do is to change our own behavior. Imagine you grow up a certain way, with no access to water or sanitation. These concepts are later introduced to you but you don’t understand why they’re important. We need to help people overcome barriers to changed behaviors so they wash their faces, wash their children’s faces, build and use latrines.Beyond that, these are environmentally challenging areas. Piped water and sanitation are huge challenges for governments. How do these infrastructure developments take place? How are these large-scale systems funded in very challenging areas?
I think partnership has made the biggest difference. In 1999, we were the single entity looking at this in a big way. Our partnership with the Lions Clubs International Foundation (LCIF) and local Lions Clubs in endemic countries helped us move into more countries, expanding our scope. Then the Alliance for Global Elimination of Trachoma by the year 2020 (GET 2020) and the International Trachoma Initiative brought partnership, coordination and collaboration to the forefront. The International Coalition for Trachoma Control was created, and this brought partnership into greater focus. These partnerships and their formation have been pivotal in advancing a global program. It was sporadic at first, but it is now becoming a global program with multiple sectors working toward a common goal.
I have so many! There are two that really speak to me. First, the Lions Clubs of Uganda have a very strong female presence. The neglected tropical disease coordinator for the Federal Ministry of Health, Dr. Edridah is a Lion. The Carter Center country representative, Peace Habomugisha, is a Lion. Being with these women and other Lions, including Lion Night Ndyarugahi, and it is unforgettable seeing them strategize on how to work together to control trachoma,. These are empowered women working toward ending blindness from trachoma in their country.Second, in 2016, I attended a mass drug administration launch ceremony of Pfizer-donated Zithromax® (azithromycin), the antibiotic used to control trachoma, in Amhara, Ethiopia. In attendance were Past International President Joe Preston, his wife Joni, and Past District Governor, Hon. Dr. Med., World Laureate Tebebe Y. Berhan and Carter Center CEO, Ambassador (ret.) Mary Ann Peters. PIP Preston’s face just lit up when saw how a single dose of medicine makes so much difference. He was seeing how our partnership saves lives. PIP Preston even sang to the joy of the crowd – I cried.
The elimination of blinding trachoma is within reach. I believe we can eliminate blindness due to trachoma in the very near future in many countries… However, because of the scope of the problem in Ethiopia and some other few countries, like South Sudan, we may need a few more years, but I’m more than confident that together with the Lions we will reach our goal.
President Carter became a Lion when he left his US Navy service. His desire to help the poorest of the poor, coupled with Lions’ desire to be Knights of the Blind and look at diseases over the long term have made a lasting impact on me and my choices. I look at what we can do through the noble efforts of Lions- Carter Center partnership and I am energized. What an effective partnership! Over 400 million treatments and over 600 thousand sight-saving surgeries. I’m honored to be part of this.
SightFirst has achieved the following accomplishments in fighting trachoma in partnership with the Carter Center:
These maps show the prevalence of early-stage trachoma in children ages one through nine in Amhara, Ethiopia, in 2007 (top) compared to 2016 (bottom). The LCIF-Carter Center partnership has made tremendous strides in reducing the burden of this disease in Ethiopia and elsewhere.
International efforts to treat and eliminate trachoma follow the WHO-developed “SAFE” strategy. This evidence-based strategy has four components.
S: Surgery, to reverse trichiasis (the late, blindness-causing stage of the disease when the eyelashes turn inwards and rub on the cornea);
A: Antibiotics (Azithromycin, Zithromax©), to treat active infection of the disease;
F: Facial cleanliness, to increase personal hygiene and thus reduce the opportunities for disease transmission; and
E: Environmental change, to improve access to water and sanitation.
The SAFE strategy has proven to be an effective and judicious intervention for millions of people. Nyuking Galwak is a living testimony to the power of this intervention strategy. At only 30 years old, Galwak’s situation was dire. She has lived with her infant son in a refugee camp in South Sudan since 2014. Poor sanitation within the camp and lack of access to clean water had led to blinding trachoma in both of her eyes.
Lions supported the outreach clinic that provided Galwak’s sight-saving surgery and taught her about the importance of washing her hands and face. The pain has subsided and Galwak is no longer in danger of losing her vision because Lions stepped in when she needed them most.
The Role of Sanitation
Antibiotics and surgeries are only part of the solution to the trachoma problem. Another key component is environmental change. Providing household latrines helps to control fly populations. Increasing access to clean water encourages personal hygiene. Separating animal and human living space and safe handling of food and drinking water also are important improvements that impede the spread of trachoma.
The Future for Mali and Niger
The SAFE strategy has been championed by Lions and the Carter Center in both Mali and Niger since 1999. As a direct result of surgeries, antibiotic administration, health education training and environmental improvements, both countries are on track to eliminate blinding trachoma by the year 2020.
It is estimated that over 20 percent of those blind from cataract in the world live in China, and every year there are 400,000 new cases. One cause of this continued increase is that a large number of township/county hospitals do not have ophthalmology clinics nor adequately trained manpower and equipment.
To address this great need, Lions Clubs International Foundation (LCIF) partnered with the National Health and Family Planning Commission (formerly named Ministry of Health) and the China Disabled Persons’ Federation on the SightFirst China Action (SFCA) project. SFCA was officially launched nationwide in 1997.
Phase I of SFCA ran from 1997 to 2002, supporting 2.2 million cataract surgeries in China and establishing surgical eye units in 104 rural counties that previously had none.
Phase II ran from 2002 until 2007. During this phase, nearly 3 million cataract surgeries were performed, and eye care infrastructure was strengthened by creating secondary eye care units at hospitals in 106 underdeveloped counties throughout the country.
Phase III, which lasted from 2012 through 2016, was mainly aimed at verification of elimination of blinding trachoma in China by 2016. Assessment of 16 provinces, autonomous regions and municipalities which were historically known as endemic for trachoma or economically depressed, proved blinding trachoma was no longer a public health threat.
SFCA greatly promoted blindness prevention and treatment within. Millions of people have received sight-saving surgery, and countless more have been spared the devastation of losing their sight due to these efforts.
As the first international volunteer service organization in China, Lions Clubs International is proud that this partnership created one of LCIF’s largest and most successful SightFirst programs.
Currently, Lions leadership and Chinese leadership are in conversations regarding a possible Phase IV of SightFirst China Action.
Lions, LCI and LCIF work tirelessly every day to #makevisioncount, especially for children.
Children around the world are affected by a range of eye diseases and conditions, impacting their abilities to learn and socialize when left unaddressed. As they grow, poor vision may impact their ability to gain employment. According to the World Health Organization, an estimated 19 million children are visually impaired. Of these, 12 million children are visually impaired due to refractive errors, a condition that could be easily diagnosed and corrected. Another 1.4 million are irreversibly blind and in need of various types of adaptation assistance.
In collaboration with partners, Lions are meeting the critical need for children’s vision services around the world through a range of programs, known as Lions Children’s Vision Care:
Lions came to Latin America in March 1927 with the chartering of a new club in Nuevo Laredo on Mexico’s northern border with the United States. Three months later, Lions expanded to Havana, Cuba.
The next two decades saw explosive growth across the region. Lions charter dates tell the story: Panama (1935), Guatemala (1941), El Salvador, Honduras and Nicaragua (1942), Venezuela (1943), Peru (1944), Columbia (1945), Ecuador (1946), Chile and Bolivia (1948).
These early clubs were marked by large membership rolls and traditional Latin exuberance. By 1941, the Havana club ranked as the largest in the world with 900 members. And the Colon Lions Club in Panama celebrated its Charter Night with “a good orchestra, colored balloons, and assorted noise-makers,” LION Magazine reported in its October 1935 issue.
Latin American Lions soon took on leadership roles in the organization, hosting the International Convention in Mexico City in 1935 and contributing their first international president, Dr. Ramiro Collazo of Havana, in 1945. The first Spanish-language Lions magazine, Los Leones, debuted in 1935 in preparation for the convention in Mexico City. Its successor, El Leon, has been publishing since 1944 and now reaches more than 47,000 readers in Latin America.
By the early 1950s, Lions were serving all across South America with expansion to Uruguay (1951), Brazil and Paraguay (1952), and Argentina (1954). The island nations of the Caribbean, including those that gained independence in the 1960s, were next in line to welcome Lions led by Barbados (1961), Trinidad and Tobago (1962), the Dominican Republic and St. Vincent (1964), and Jamaica and Grenada (1965).
Lions’ work in Latin America and the Caribbean is as diverse as the region’s peoples and cultures. And their work has had a profound and lasting impact. In Mexico, for example, Lions have built and equipped hundreds of schools since the 1940s. Lions have also answered the call when disasters strike, most recently playing a significant role in providing aid to victims of the massive 2010 earthquakes in Haiti and Chile.
But the most spectacular Lions achievement of recent decades may be the near-complete elimination of onchocerciasis, also known as river blindness, from the Americas. Transmitted by biting flies near warm-water rivers, the parasitic disease had been endemic in parts of Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela, putting more than 600,000 people at risk.
Working with the Carter Center and other project partners since 1999, Lions Clubs International Foundation has contributed US$6.3 million to fight river blindness in Latin America with local Lions providing logistical support and community outreach.
With the Lions’ help, in 2013, Colombia became the first country in the world to eradicate river blindness, according to the World Health Organization. Ecuador was declared free of the disease in 2014. Mexico and Guatemala have broken the cycle of infection as well, and as of 2015, were close to verifiable eradication. The disease persists in isolated places in Brazil and Venezuela, but hopefully not for long, thanks to the dedicated Lions of Latin America.
Explore the exciting history of Lions Clubs International with our exclusive Touchstone Stories series. Don’t forget to share these stories with new members so they gain an understanding of Lions history?
Lions Quest continues partnership with NoVo Foundation
Lions Quest, Lions Clubs International Foundation’s (LCIF) social and emotional learning (SEL) program, aims to teach life skills and positive youth development strategies. Thanks to the recent award of a US$450,000 from the NoVo Foundation, Lions Quest continues to expand their efforts in the fast-growing Eagle Mountain-Saginaw Independent School District (EMS-ISD) in Texas, USA. The program also benefits a diverse racial and socio-economic population; more than 40 percent of students qualify as economically disadvantaged or low-income, and more than 35 languages are spoken in the district.
This is the third grant Lions Quest received from the NoVo Foundation. Advancing social and emotional learning is a priority support area for NoVo Foundation given its mission to foster a transformation from a world of domination and exploitation to one of collaboration and partnership. Previous awards for US$300,000 in 2014 and US$100,000 in 2011 bring the total received by LCIF to US$850,000.
The newest award of US$450,000 is to continue to expand in EMS and develop new and innovative tools that will help implementers – and consequently, more kids – worldwide. LCIF will develop new resources to assist educators, making sure that the program has the maximum possible impact. The tools piloted under this grant will be tested for effectiveness and then disseminated to the hundreds of schools using the program each year.
For more information, visit www.lions-quest.org.
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