Christian Mission Aid

CMA's Trachoma Program in South Sudan

CMA has worked in the Upper Nile region of South Sudan since 1993, in an attempt to provide health care services to the displaced people. In 1999 we did a rapid survey in this region, which revealed that 40 - 50% of the people aged over 5 years living in the Upper Nile, have had Trachoma at one stage in their lives. Trachoma is a dreadful eye disease that is spread by flies, and it can cause blindness if it is not treated in time. We soon realized there was a need for a program, that would help us treat many of the eye diseases the people were suffering from.  

Access to health care facilities is almost impossible for the people in Upper Nile, because of the 18-year civil war that has left many of the people totally displaced in remote areas. Because the people lack access to basic health care services, having an eye disease is accepted as part of their life.

There are no roads in South Sudan, and the only way  to reach the people is by air. The MAF planes help us to transport the medical teams, the essential medication and materials for use in the Trachoma Control Program.

S A F E
The action strategy applied in our Trachoma program is referred to as SAFE.

S       Surgery for advanced cases.
A       Antibiotic treatment.
F       Facial cleanliness to reduce transmission.
E       Environmental improvements to reduce the number of flies that carry Trachoma.

S for Surgery 

CMA has a growing partnership with CBM (Christian Blind Mission), and this has contributed greatly to the success of the Trachoma program. In November 2001, we were glad to host a team of 4 people from CBM when they visited our clinic in Keew for the first time. Previously they had done a lot of work at our clinic based in Langken.

Because of a great awareness campaign before the team arrived, we saw people walking from distant villages like Old Fangak, which is 4 days away. By the end of two weeks, the CBM team managed to complete 292 eye surgeries, and 153 of them were for Trachoma.

After a series of 3 visits to the CMA clinics, the CBM team completed a total of 904 eye surgeries, and 551 of these surgeries were for Trachoma.

TPR Training

TPR (Tussle Plate Rotation) is a surgical procedure that looks very messy and complicated, to anyone who has never seen it being done before. Trachoma infections cause the eyelids to turn inward, and the eyelashes then begin to rub on the inner eye. The constant irritation caused by the eyelashes leads to blindness. So the TPR surgery helps to turn up the eyelid, and keep the eyelashes far away from the inner eye.

Dr. Jeremiah Ngondi from the Carter Center, visited the eye clinic in Keew while the CBM team was also there. He successfully managed to teach two of our CMA staff, and two CHW’s (Community Health Workers) how to do the TPR surgery. At the end of the training, the CMA nurse Martha Kariuki said, “It is easy to learn when you have an idea of how to accomplish it.  When you see the procedure being done it looks, complicated but when you do it, it is not so hard.”

The wonders of surgery 

There was a 25 year old man who was growing rapidly blind in both eyes, so when he heard about the eye doctors, he got someone to lead him to the CMA clinic. After he was examined the doctors operated on one eye first, and then after 2 days they operated on the second eye. When his bandages came off after a week, he could not believe what had happened to him. He was overjoyed by the fact that he could now see clearly, and he felt so much better than he had felt in years. Excitement filled his heart and he could not stop celebrating about what had happened to him. He was completely overwhelmed by the way God had answered his prayer in such a direct and visible way. 

On the following Sunday he went to the local church, and he quickly stood up before the people to share his testimony. He begun by thanking God for the eye surgery, and then he continued to talk about the wonderful things he had seen the eye doctors doing to restore peoples sight. His testimony went on and on, until some people in the congregation had to get up and make him sit down. 

A for Antibiotic Treatment (Zithromax) 

The use of oral and ointment treatment for Trachoma is a successful way of combating the infectious disease.  Large quantities of Zithromax (an antibiotic), are needed for use in South Sudan, because Trachoma affects a majority of the local population. Tetracycline is another antibiotic ointment we use, and it has also helped to improve the treatment of eye infections. 

This year we succeeded in distributing 24,898 Zithromax doses to the local people through our health clinics. With the great help of our Sudan staff, very many people with eye diseases can now receive effective medication, and they do not have to continue suffering in silence.

F & E for Face washing and Environmental improvements

There is very little water in the villages especially during the dry season so the people have developed interesting ways of bathing their children. The women bathe their children with  cow’s urine, but it takes a lot of patience to get the child under the cow at the right time. So the children stay with their dirty faces, until they able to get a bath.

Even when there is water, the people do not use it to wash their faces at all. Their dirty faces then attract flies, which transmit germs that cause Trachoma, and other eye infections.

Educating the people 

As part of creating awareness, our staff in the clinics has introduced rules, which stress the importance of personal cleanliness, and the use of latrines. The rules have greatly helped fight certain beliefs, which hamper the improvement of the people’s hygiene standards. 

One belief is that flies are a blessing for the pastoralists, as they signify the presence of large herds of cattle.  In reality, flies pass on disease by transferring germs from person to person, and this has greatly contributed to the increase of Trachoma.

The community health workers go far and wide in the villages educating the people about the causes, prevention and treatment of Trachoma. With the use of pictorial charts distributed by the Carter Center, the local staff is able to pass the information more effectively. This year we held 383 Village health education sessions, where the people received valuable information on Trachoma, and other health issues.

In Keew, the CMA staff target teachers in the primary school where about 200 pupils attend class. The school remains an effective way to teach the people about the importance of face washing, and the use of latrines.

In Conclusion  

The Trachoma project has been very successful since it begun, and over 2000 people affected by Trachoma have already received treatment. Currently, CMA and the Carter Center are still trying to reach the targeted 25,000 people.  

Many Sudanese people have been helped, some can see again, and many others have been saved from dreadful eye diseases. Despite the evident hardships there have been many celebrations going on in the Upper Nile region this year. Many bulls and goats have been slaughtered as the people express their joy and gratitude for the restoration of their sight. In November the local chief in Keew donated a bull because he was so happy that his daughters eyesight had been restored.  He did not just donate the bull, but he also killed it himself with one swift strike of his spear into the bull’s heart. In a matter of minutes the huge animal was skinned and its flesh was cut up into pieces that were given out to everybody who was present. Little children were not forgotten as they could all be seen going home carrying meat skewered on to sticks.

For more information, contact us at: Africa@CMAid.org