Caroline Harper
1,435,253 views • 10:12

I'd like you to imagine, just for a moment, that your eyelashes grew inwards instead of outwards, so that every time you blinked, they would scrape the front of your eyeballs, damaging the corneas, so that slowly and painfully, you went blind.

Well, that's what happens to a person who has trachoma. Now, this little boy here, Pamelo, from Zambia, he has trachoma. And if we don't do anything, he's going to go blind.

Trachoma is a curious disease. It's a bacterial infection that's passed from person to person and by flies. The repeated infection will scar your eyelids so that they contract and they turn inside out. It particularly affects women, because they have the contact with children. So what you'll often see in places like Ethiopia are girls who have tweezers like this around their necks, and they use them to pluck out their eyelashes. But of course, that only gives them temporary respite, because they just grow back more vicious than before.

There are around two million people in the world who are blind or visually impaired because of trachoma. And we believe there may be as many as 200 million people who are at risk.

Now, it's a very old disease. What you can see is a photo of a wall of a tomb in Northern Sudan. A colleague and I were traveling in a very remote village, and we asked an old man to take us down into a little tomb. Now, on the wall, we saw two eyes. One is crying, and you can see there are tweezers next to it. Simon said to me, "My God, do you think that's trachoma?" So we sent this picture to the British Museum, and they confirmed that, yes, this is trachoma. So, thousands of years ago, the ancient Nubians were painting pictures of trachoma on the walls of their tomb. And the tragedy is that disease is still rampant in that area today. And the crazy thing is, we know how to stop it.

And what's great is that the trachoma community have all come together to pool their efforts. We don't compete; we collaborate.

I have to tell you, that's not always the case in my experience in the NGO world. We've created something called the International Coalition for Trachoma Control. And together, we've developed a strategy to fight it. This strategy is called the SAFE strategy, and it's been approved by the World Health Organization.

The "S" stands for "surgery." It's very straightforward procedure to turn the eyelids back the right way. We train nurses to do it, and they use local anesthetics. And as you can see, you can do it in somebody's front porch, if need be.

Then "A" stands for "antibiotics." These are donated by Pfizer, who also pay for those drugs to be transported to the port in-country. From there, they're taken to the villages, where hundreds of thousands of community volunteers will distribute those drugs to the people. Now, we train those volunteers, and we also help the ministries with all that complex logistics. And every one of those volunteers has a pole like this. It's called a "dose pole." This one's from Cameroon. And you can see it's marked different colors, and you can tell how many pills you should give somebody, based on how tall they are.

"F" stands for "face washing." Now, we used to have trachoma in the UK and in the US. In fact, President Carter, he talks about how trachoma was a real problem in Georgia when he was a little boy. And in the UK, the famous eye hospital, Moorfields, was originally a trachoma hospital. What we do is teach kids like this how important it is to wash their faces.

And finally, "E" stands for "environment," where we help the communities build latrines, and we teach them to separate their animals from their living quarters in order to reduce the fly population. So we know how to tackle the disease. But we need to know where it is. And we do, because a few years ago, Sightsavers led an incredible program called the Global Trachoma Mapping Project. It took us three years, but we went through 29 countries, and we taught local health workers to go district by district, and they examined the eyelids of over two and a half million people. And they used Android phones in order to download the data. And from that, we were able to build a map that showed us where the disease was. Now, this is a very high-level map that shows you which countries had a problem with trachoma.

And you may ask me, "Well, does this strategy actually work?" Yes, it does. This map shows you the progress that we've made to date. The green countries believe they've already eliminated trachoma, and they have either been through or are in the process of having that validated by the WHO. Countries in yellow have the money they need, they have the resources to eliminate trachoma. And some of them are really nearly there. But the red countries, they don't have enough funding. They cannot eliminate trachoma unless they get more. And we're quite concerned, though, that the progress to date may stall.

So when we were talking to the Audacious ideas guys, we asked ourselves: If we really, really pushed ourselves over the next four or five years and we had the money, what do we think we could achieve?

Well, we believe that we can eliminate trachoma in 12 African countries and across the Americas and all across the Pacific. And we can make significant progress in two countries which have the highest burden of the disease, which is Ethiopia and Nigeria. And in doing all of that, we can leverage more than two billion dollars' worth of donated drugs.


Now, this map here shows you the impact that we'll have — look how many countries are going green. And there, you can see progress in Ethiopia and Nigeria. Now, yes, there are some countries that are still red. These are mainly countries which are in conflict — places like Yemen, South Sudan — where it's very difficult to work. So, we have the team, the strategy and the map. And we also have the relationships with the governments so that we can make sure that our program is coordinated with other disease-control programs, so that we can be efficient. Wouldn't it be amazing if we could do this? We'd have trachoma on the run. We would be on the home straight to eliminate this disease from the whole world.

But before I finish, I just want to share with you some words from the founder of Sightsavers, a guy called Sir John Wilson. Now, he was blinded at the age of 12. And he said, "People don't go blind by the million. They go blind one by one." And in the excitement of being able to say we've got rid of trachoma for the whole country, let's not forget that, actually, this is a devastating disease that destroys the lives of individual people.

People like Twiba. Now, I met Twiba last year in Tanzania. She had had trachoma for as long as she could remember. And a couple of months before I met her, she'd had the operation. It's no exaggeration to say that this had totally transformed her life. We'd saved the sight that she had left, and she was free of pain. She could sleep. She could work, she could socialize. And she said to me, "I have my life back." And it was impossible not to be moved by her story. But there are so many Twibas. I want to find all the Twibas, and I don't want anyone to go blind in agony anymore.

Now, you know, there are so many intractable problems in this world. But this is not one of them. This is something that we can solve. And we can ensure that kids like this can grow up free from the fear of trachoma. So, for the sake of kids like this, and for the sake of people like Twiba, let's get rid of trachoma. Do you think we can? Well, yeah, if we really, really want to. Yes, we can.

So thank you.