Taking Trachoma Out of Sight: A Q &A with Lisa McKeen on Trachoma Prevention through a Pandemic

We spoke with Lisa McKeen, Chief Executive Officer at Orbis to learn more about how they are supporting the prevention and control of Trachoma in Ethiopia. Here is our Q&A

  1. What makes your organization unique?

At Orbis, we want to create sustainable solutions in the fight against avoidable blindness. That means we focus on training and technology to help support eye health professionals around the world. By training people in communities where education opportunities may be limited, we are supporting the long term eye health of everyone in that community. At Orbis, we know the specific issues in each region must addressed collaboratively, so we work with a range of local partners to develop a tailored plan to restore sight, and then put in place a long-term eye health strategy. Our approach centres around building capacity and supporting communities to develop the knowledge, skills and resources they need to tackle their most pressing eye health issues.

  1. Can you describe the impact that Trachoma has on the communities that you work with?

Trachoma remains a leading cause of blindness globally and it’s something we see often in our work, particularly in Ethiopia. While trachoma is entirely preventable, it’s a disease of poverty that spreads very quickly in communities where living conditions are crowded, and where there’s a lack of clean water and proper sanitation. What many people don’t know is that women account for 70% of all people affected by trachoma. Women are usually the ones who gather water and take care of young children, so they’re often exposed to repeated infection. These repeated infections cause the eyelashes to turn inwards and scrape the eye, causing excruciating pain and permanent damage to the eye’s surface – and eventually irreversible blindness. But the true impact of trachoma is so much worse than just the loss of sight. It strips people of their ability to go to school, or work, or take care of their family, or even to take care of themselves. It’s a debilitating and devastating disease that ravages entire communities and shatters so many lives – and naturally, this has a cascade effect on poverty and other systemic issues in these communities.

  1. What has Orbis been able to do to lessen the burden of these diseases?

For more than 20 years, Orbis has been working in Ethiopia to eradicate trachoma. It had been virtually eliminated in 24 districts of the country – but the pandemic has had a major impact on our progress. Still, in December of 2020, we were able to carry out a door-to-door mass drug administration program, administering 7.5 million doses of antibiotics across 89 districts in just one month. Along with these antibiotics, our team of over 19,000 community health workers and volunteers also delivered education messages about the importance of good hygiene practices to help people better understand how to potentially prevent a trachoma infection. Then, in late 2021, we launched another MDA program targeting a further 12 million people across more than 100 districts.

  1. What would you like Canadians to know about the work that you do?

I think it’s important for Canadians to know that conditions like trachoma are entirely preventable – they really shouldn’t exist. We know how to treat and prevent trachoma, but we need the funding to be able to tackle the disease on a mass scale.  We’ve made huge strides towards wiping out trachoma in many parts of Ethiopia, and now need to keep that momentum going. The pandemic has had an impact on our efforts, making it more time-consuming, labour-intensive and costly to deliver our MDA programs, so the support of Canadians is more important now than ever before. We can’t afford to lose ground to the disease. If we can’t deliver our planned MDA programs, the disease will come back and take hold in these communities again – we can’t let that happen. That’s why we’re counting on our donors to help at this critical time.

  1. How do you build partnerships with the communities that you work with?

We couldn’t do any of the work we do without our local partners. We rely on their local knowledge, understanding and relationships to build trust and provide on-the-ground support. We only work where we are wanted and invited by our local partners. We are not there to serve our own agenda – we work very closely with our partners to ensure we’re addressing the issues and tackling the areas of greatest need to communities. With our work in Ethiopia, we rely on a huge network of community health workers and volunteers to conduct the assessments we use to determine where the MDA programs are needed most; and then to ultimately deliver the door-to-door distribution of antibiotics and eye screening that help identify people with advanced stages of trachoma.

  1. How are the communities themselves that you work with contributing to preventing, treating, and managing trachoma?

Our team in Ethiopia is very hands-on, working with the local communities, health care providers and governments. This allows us to provide resources and training while the local community takes the lead on the projects and develops solutions that work for their individual needs. This is a much more sustainable way to support improved eye health outcomes.

  1. How does the work that Orbis is doing contribute to health systems strengthening?

When you train people in a community to provide improved care, they are not only better equipped to provide improved care to patients, they go on to train others. This cascade strengthens health care systems and is much more sustainable than simply bringing in professionals to manage a handful of cases at a time. If you give people the tools, they are able to build a solid foundation.

  1. On January 30th, we will be recognizing the 1st official World NTD Day. What does World NTD Day signify to you, as someone committed to ending neglected tropical diseases?

It is an important reminder that when we eradicate a disease in our own community, we often take on an “out of sight, out of mind” philosophy. This means that entirely preventable conditions can continue to devastate countries where the needed resources are not available. World NTD Day is a reminder to all of us that these diseases are still a problem—and that all of us can play a role in helping to prevent them.

  1. This year, we will be asking the Canadian Government and civil society to sign the Kigali. What does Canada’s signature to the Kigali Declaration mean to you and the communities you work with?

For most Canadians, we’re so fortunate to have easy access to high-quality eye care where we need it and when we need it, but that’s not the case in the countries where Orbis works. In Canada, most people haven’t even heard of trachoma, let alone experienced it – and for that we should be so thankful. Canada’s signature to the Kigali Declaration is a commitment to help ensure that, one day, future generations of people living in countries like Ethiopia also don’t have to experience trachoma – and maybe, one day, not even know what the disease is.

To learn more about Orbis & their work, please visit https://can.orbis.org/en