Globally, over 130 million people are at risk of trachoma and almost 2 million people are blind or visually impaired due to this bacterial eye infection. Without treatment, trachoma can lead to permanent blindness.
Trachoma is a disease of poverty and Sub Saharan Africa is the area most affected in the world. In the Democratic Republic of Congo over 14 million people live in areas that are endemic for trachoma and it is estimated that over 50,000 people are in need of surgery to save their eyesight. Trachomatous Trichiasis (TT) operations are required when the infection causes the upper eyelid to turn inwards so that the eyelashes begin to scrape the eyeball which will slowly lead to sight loss and eventually irreversible blindness.
Disruptions due to COVID 19
In 2019, CBM started a programme in western DRC to address this need – unfortunately it was put on hold as a result of travel restrictions due to COVID-19. The delay means that people are at risk of losing their sight, so we are anxious to restart as soon as possible. We are hoping to carry out at least 500 surgeries this year and just as importantly, provide education on the causes and nature of the disease. Knowledge on how severe infection can be prevented with better facial cleanliness and improved sanitation, can avoid the need for surgery and save sight.
CBM is committed to the elimination of trachoma as a public health problem in DRC. We have already distributed millions of doses of an antibiotic which suppresses the bacteria, but for those already affected, who have suffered from long term infection, sight saving surgery remains an urgent need.
Dr. Jacques Dawili is one of very few doctors trained in ophthalmology in this region. Based at Bwamanda, in the Province of South Ubangi, he will be CBM’s key contact to organise door to door surveys to find those in need of surgery, supervise surgical camps and oversee the follow up of patients to ensure a successful outcome. He conducted just 18 TT operations in 2020 before work had to stop due to the pandemic. He explains the impact that COVID-19 has had on the fight against trachoma in DRC.
I'm sorry that we have been unable to offer TT surgery to the population of our province, despite the fact we are keen to do so and have the capabilities. There is a complete shutdown of the work we do here, because there are currently no flights between our province and Kinshasa where the activities are coordinated and where the supplies come from. We are not being able to treat people in the community. As the time passes some of these people could lose their vision. My concern is that the number of cases of blindness due to trachoma will increase.Dr. Jacques Dawili
Dr Dawili speaks about resuming treatments once some of the restrictions are lifted:
"We have established a timetable with CBM’s technical and financial support for starting activities in May 2021, beginning with the identification of all cases of TT, followed by the training of surgeons and then surgery can start. We must act urgently to avoid blindness due to trachoma."
The impact of this short operation on people’s lives is shown by the few cases we operated on before the pandemic:
Mayanga Vumbo is an agriculture student who lives in Boto Town. He is married and has six children. He had a TT operation a year ago and talks about what has happened since:
I'm back in school now, doing the first year of orientation cycle. I now have clear vision I can now look at my class notes better, and I read without difficulty. I can now go about my business like everyone else, I plan to continue my studies to become a teacher at the primary school in my village.Mayanga Vumbo
Mokoyo Malingo is 38 years old and is an agricultural worker and housekeeper. She is a widow with six children. She talks about being able to resume her work after her operation which is vital for the survival of her and her family:
I'm very happy because the eye condition I suffered from for several years is completely solved. I thank the doctors who brought the solution to this problem. I am very concerned about my children's health, and I ask them to keep their eyes clean by washing them daily with soap. Ever since we were advised to do so, I have been ensuring they respect face hygiene. I have now resumed my field work in my coffee plantation which is the main source of family income and I hope that in a year I will see the results of that work.Mokoyo Malingo