When every blink of the eye hurts


"Did my daughter deserve this? Recently she came home crying," laments Beneberu Ababu, 30. "She ran into an iron bar projecting out of a house wall at eye level. She simply overlooked the obstacle." Like all twelve-year-olds, Shebere Bonte just wants to learn and play. But her sight is now limited. Her right eye constantly hurts. "At school I can’t see properly what the teacher writes on the board," she says. "My eye is so watery that I can’t read." Often she is unable to concentrate due to the stinging sensation. "It can’t be compared to anything else and is much worse than a head- or stomach ache," says Beneberu Ababu. "The eye itches and burns. It’s terrible." Mother and daughter both suffer from trachoma, a disease that has long-since been eradicated and forgotten in Europe. It is an insidious disease in which one’s own eyelashes become the greatest enemies. “It feels as though my eyelashes are jabbing into my eye,” says Shebere.

Children often infected

Trachoma is Ancient Greek and translates into "rough eye." Most of those who suffer, catch the bacterial infection in childhood. They are often infected by their siblings or mothers, who use the same apron to dry their children’s tears and wipe it over their faces. The unhygienic conditions in the arid areas of the Ethiopian highlands are ideal for the spread of bacteria chlamydia trachomatis. They attach themselves to the inside of the upper eyelid. The body tries to protect itself by forming lymph follicles, yellow-white elevations. The eyelids swell up, become heavier and droop. When the follicles burst, scars form on the inside of the eyelid, causing surface tension. The outside of the eyelid with the eyelashes turns inwards and they rub against the cornea with every blink of the eye.

Anyone who has experienced an annoying grain of sand in the eye will appreciate the suffering of these patients. The incessant rubbing of the eyelashes damages the surface of the cornea and makes it cloudy. The afflicted person often asks another family member to pluck his/her eyelashes. But after only a few days the newly-grown eyelash stubble rubs and scrapes against the eyeball more than ever before. The patients urgently need a minor operation to correct the eyelid to prevent the eyelashes from touching the eyeball. Without this operation they will sooner or later lose their eyesight.

Particularly children and women are affected. While the fathers toil in the fields, there are many sources of reinfection between children and mothers at home in their huts. 138,000 Ethiopians have already lost an eye due to trachoma or are blind in both eyes. In comparison: that is more than the entire population of Würzburg. Ten times as many Ethiopians – 1.3 million people – are suffering in the advanced infection cycle, through which they will lose their eyesight if they do not receive treatment.

Eyeball damage

Shebere and her mother each have trachoma in the right eye; the left eye is not yet affected. Early in the morning they started out from their hut to the medical centre at Dengore, an outpost of civilisation in the highlands in the Menschen für Menschen project area Midda. At the centre they meet two dozen further patients, all of them waiting to be treated by nurse Debesh Bekele. However, the trachoma specialist from Menschen für Menschen is unable to help some patients. When she lifts their swollen eyelids, instead of a healthy iris she sees a damaged eyeball which is turbid and milky-white, as though it was covered by a veil.

30,000 Operations

But Shebere’s right eye looks much better than four weeks previously, the nurse notes. The girl has bathed her eye every day with clear water, as Debesh Bekele instructed her. Thanks to the eye ointment she prescribed, the infection has been reduced. Now Shebere can undergo surgery. She lies down on the couch in the treatment room. "Don’t be afraid!" says the nurse calmingly. Shebere nods. "Only the injection will hurt for a moment," says Debesh Bekele. "Don’t move!" she warns, before anaesthetising the eyelid with an injection. Shebere keeps still, as brave as the farmers’ wives treated by Sister Debesh before her. The nurse routinely makes a tiny incision in the eyelid and sews it up with stitches so that the eyelashes no longer rub against the cornea.

"Children only need three stitches," says Debesh Bekele. The operation takes no more than fifteen minutes. "I’ve been doing it for more than ten years and am very quick," says the 35-year-old, not without pride. She and other specialists from Menschen für Menschen have saved the sight of no less than 30,000 patients. Alone today Dabesh Bekele will be operating on 25 men, women and children.

"No, the operation didn’t hurt," reports Shebere, as Debesh Bekele wraps a bandage around her eye. Her mother is the next in line. "The girl is lucky she came so early," says the trachoma specialist in the brief break in surgery. "In less than a year her eye would have been lost."

Only the poor get sick

Due to the large number of cases Debesh and her colleagues can hardly keep up with the operations. So Menschen für Menschen has decided to place an emphasis on prevention. "We go into the villages and tell people how they can protect themselves from trachoma," says the nurse. "We explain how important it is to wash one’s face every day – even if water is in short supply and each drop is priceless." In addition, the mothers learn in instruction courses that they should not wash all their children with the same cloth. Overall, the trachoma problem cannot be seen in isolation, explains Debesh Bekele: "It only occurs where people are very poor and don’t have enough water for washing." When Menschen für Menschen constructs wells in the villages that is also a part of health care and helps in the battle against trachoma.

Campaign against infection

In cooperation with the Carter Center, a US aid organisation, Menschen für Menschen has initiated trachoma campaigns for the entire population in the project areas of the Amhara region. Every year over the next three years a total of 350,000 people will receive a pill with the antibiotic acithromycine – a logistical challenge in these remote districts without roads. In this way it is hope to curb the spread of trachoma in the long term. After three years only one in ten inhabitants should then be suffering from the eyelid infection. In Midda, where the little patient Shebere lives, 60% of the people are still suffering at least in the first stage of infection with itching and secretion.

Reborn people come for aftercare

The sky is growing dark as Debesh Bekele disinfects the eye of the last of today’s patients and injects a local anaesthetic. A cloudburst starts, rain and hail pelt on the corrugated iron roof of the building, producing a deafening noise. The room becomes dark. The nurse asks those present to move away from the door so that she can use the remaining light from outside – there is no electricity to power surgical lamps in Dengore. But Debesh Bekele routinely completes the minor operation. With a smile of satisfaction she takes off her latex gloves. "Patients come with terrible pains. Many of them have to be guided by their relatives. They are depressed and have lost all hope," she says. "I operate, and for aftercare they come as reborn people: healthy and happy."


CHF

Beneficiary:
Donations account:
Account Number 18180018
Bank Code 701 500 00
BIC SSKMDEMM
IBAN DE64701500000018180018
Donations account:
Account Number 18180018
Bank Code 701 500 00
BIC SSKMDEMM
IBAN DE64701500000018180018
Spendenkonto:
Postkonto 90-700000-4

Stiftung Menschen für Menschen Karlheinz Böhms Äthiopienhilfe, 8002 Zürich

IBAN-Code:
CH97 0900 0000 9070 0000 4
BIC SSKMDEMM
IBAN DE64701500000018180018
Trachoma