GOOD NEWS: The Trachoma Storybook #endingtrachoma in WA

August 26th, 2021

Australia is the only developed country that has endemic trachoma.

Almost all cases of trachoma are detected in remote Aboriginal communities. The Environmental Health Trachoma Project #endingtrachoma  aims to reduce the incidence of trachoma and skin infections in ‘trachoma at risk’ Aboriginal and Torres Strait Islander communities in remote WA. The Western Australian Trachoma Storybook showcases the health promotion and environmental health projects in remote communities of WA to prevent and reduce trachoma.

The #endingtrachoma project utilises cartoons, songs and fun activities to educate about the cause of Trachoma and how to minimise prevalence.

What is Trachoma and how is it transmitted?

Trachoma is the leading infectious cause of preventable blindness. It is responsible for the blindness or visual impairment of about 1.9 million people worldwide, and remains a public health problem in 44 countries. Of these 44 countries, Australia is the only developed country and almost 100% of our trachoma cases occur in Aboriginal communities. The World Health Organisation (WHO) set a target to eliminate trachoma worldwide by 2020, and to assist with this developed the ‘SAFE’ strategy. The SAFE Strategy includes a comprehensive approach including surgery, antibiotic treatment, facial cleanliness and environmental improvement.

Transmission occurs through facial contact and hand to eye contact via contamination of personal items such as towels, clothing and bedding. Poor environmental health conditions such as poor hygiene, crowding and lack of functional bathrooms are recognised as key contributors to trachoma in remote Aboriginal communities.

Reducing Trachoma in WA

A recent project example in the Trachoma Storybook was in two Ngaanyatjarra Lands (NG Lands) communities where audits of people’s private bathrooms conducted by the Aboriginal Environmental Health Worker’s revealed many plumbing issues which were preventing families from practising good hygiene. The #endingtrachoma team worked with the plumbing contractors employed by Housing to coordinate a community visit. As people’s bathrooms and drainage were being fixed by the contractors, AEHWs installed 45 acrylic mirrors at the height of a child, 28 towel hooks, provided 153 cakes of soap, installed 39 hand and face washing stickers and checked washing machine worked and clothes lines were functional. The project was successful in talking to 25% of residents about the importance of and routines of hygiene and hand and face washing.

At the end of that week, the project had visited 51 of the 54 community houses and identified:

  • 106 plumbing issues with 55% directly affecting the ability to wash
  • 11% of houses had no hot water
  • 35% of houses had no or a non-working washing machine
  • 8% of houses had no power
  • 66% of houses had evidence of pests (mostly cockroach)


This data correlates with NSW Housing for Health data collected through the robust testing and survey framework at SF1 of houses over 20 years in NSW, before any Priority Fix Items and Major Fix work was done: 


  • 74% of houses had a functional hot water tap to the shower with only 64% having a functional shower rose
  • 44% of houses had hot water temperatures above the minimum of 45C and below the maximum of 62C
  • 22% of houses had no or a non-working washing machine
  • 3% of houses had no power
  • 32% of houses had evidence of pests (ants and/or cockroaches)


This data continues to reinforce the importance of the HLP’s in priority order, not only to reduce the incidence of trachoma in children especially 0-5years, but reduce the negative link for all residents of poor housing and health. Read the Trachoma Storybook here and more targeted research and information about the project and Trachoma in Aboriginal communities here.