Trachoma Initiative in Africa

Coordinating sight-saving surgery in Mozambique

Since 2014, RTI has supported Mozambique’s ambitious efforts to eliminate trachoma as a public health problem. A painful bacterial eye infection, trachoma—in an advanced stage called trichiasis—can cause eyelashes to painfully scrape the cornea and ultimately lead to visual impairment and blindness.

In addition to scaling up treatment for trachoma through the U.S. Agency for International Development’s ENVISION project, RTI is helping to restore the sight of thousands of people with trichiasis. Through the Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative in Africa, we support efforts by Mozambique’s Ministry of Health (MOH) to expand access to a simple surgery that corrects in-turned eyelashes caused by trichiasis and restores vision. We provide coordination and technical support to the project’s implementing partners—Light for the World and Sightsavers—and ensure the project is on track to meet its goals.

Thanks to decades of efforts led by the MOH, Mozambique is making excellent progress to reduce rates of trachoma and trichiasis. The country is on track to eliminate trachoma as a public health problem by 2020.

Expanding Access to Surgery

Through the initiative, more than 2,000 case finders have been trained to locate people in need of trichiasis surgery. Once identified, cases are confirmed by an ophthalmic technician, and the patient is transported to the point where the survery will take place. A trained trichiasis surgeon carries out the procedure. In Mozambique, Trust partners have trained 20 surgeons and managed more than 5,000 cases of trichiasis. When the project began in 2014, more than 20,000 people were expected to have trichiasis in Mozambique. By 2019, we aim to support the MOH to reach almost all of these cases with surgery to help Mozambique achieve elimination thresholds for trichiasis countrywide.

Individuals impacted by trichiasis are often from Mozambique’s most marginalized and remote communities; now that more accessible cases have been addressed, we are working with the MOH and implementing partners to create strategies to address cases in these more difficult-to-reach areas.

Sustaining Progress Against Trachoma

In Mozambique, RTI is working with implementing partners and the MOH to integrate surgical activities into the broader health system. For example, we and our partners are supporting Mozambique’s provinces as they develop plans to manage future trichiasis cases after the project is completed and elimination has been achieved.

We are also complementing ongoing efforts to prevent trachoma by promoting community health messages on hygiene and sanitation and improving access to safe water and proper sanitation—both critical elements to eliminating the disease. For example, soaps are distributed to patients after surgery as an incentive to promote face washing. We also work closely with WaterAid, and, when possible, efforts are made to incorporate messages on water, sanitation, and hygiene into project activities.

By coordinating efforts to expand access to this sight-saving surgery, we are proud to be part of an initiative that is improving vision, and helping people return to their livelihoods—and we look forward to continuing to build a foundation for Mozambique to sustain this progress into the future.