Ethiopia – Reducing trachoma

The Fred Hollows Foundation (TFHF) has commenced work in Ethiopia to reduce the high levels of trachoma. The methodology used is following the World Health Organisation (WHO) trachoma reduction strategy of SAFE (Surgery, Antibiotics, Face washing and Environment). TFHF have had great success delivering the first two components of the program, Surgery and Antibiotics, in the Oromia region to over 5 million people so far…

Project Background Eye washing and student power

…The Face washing and Environment improvement stages of the program (without which the long-term eye health gains are difficult to sustain) have proved more difficult. Lack of water infrastructure at a local level means there is no regularly available water for face washing.  There is also an urgent need to reduce the other important contributors to trachoma – dust and flies.

HH was invited by the TFHF to visit Ethiopia and develop a trial program to propose ways to remediate these environmental problems and complement their existing program.

It takes around US$65 (yes $65 is correct it is not a typo) to provide the sight-restoring surgery and antibiotics (the S and A) so the budget for improving the living environment (the F and E) has been set to the same amount.

A village visit and several briefings by the Ethiopian team at the TFHF put the challenge clearly.

  • Ensure the 10 water wells supplied by government partners can distribute water to 10,000 villagers who live over an area of 30 square kilometres
  • Most importantly, ensure the precious water ends up on the faces of children and not cause undue stress on the many other demands like drinking and cooking which compete for the water
  • Measure the volumes of water, produced by all the hand pumps, distributed to each part of the village, so that changes in the prevalence of trachoma can be solidly linked to increased water availability and use
  • Develop ways to enable local villagers to maintain the pumps to ensure the water supply is sustained
  • Develop better ways to deliver sanitation (for this read toilets and the safe disposal of human waste) to 10,000 people, to reduce the fly population and improve health generally

In 2014, HH completed an initial visit and determined:

  • A suitable location for the trial program
  • The key infrastructure components currently available and possible improvements to water supply and toilet facilities
  • Local partners, skills and future project workers
  • Potential roles for WS trades, WPC and IAPMO to assist in the works

The TFHF decided that a small scale trial project would not register on the radar of the ‘big contributors’ to world trachoma elimination unless they were involved in all stages of the project and committed funds to the trial.

At the request of HH, IAPMO and the WPC met with the TFHF in Sydney to discuss lobbying the ‘big contributors’ to play a role in any trial program by having a WPC representative join the International Coalition for Trachoma Control.

Design Solutions 2x2x2 Design Challenge - Newcastle, Sydney and Brisbane

In the interim, HH proposed and conducted 2x2x2 design challenges, for design and medical students, to find ways of using limited amounts of water to achieve efficient face and hand washing. These events have been held in Sydney, Brisbane and Newcastle. The ideas noted in the challenges will provide valuable detail for the final design.

2x2x2 Design Challenge

HH partnered with Universities in Sydney, Brisbane and Newcastle to ask students from design, engineering and health faculties to develop ideas to contribute to the HH designed toilet for Ethiopia.

The challenge was to develop, design and construct a prototype solution to successfully use less than 2L of water per person, per day (the estimated maximum water available in an Ethiopian village devoted to these specific activities) to achieve the following in order of priority:

  • washing faces (eyes)
  • washing hands
  • water stored for other uses (such as extra water for drinking and cooking)
  • washing a concrete toilet floor with wastewater from uses 1 and 2 above

Click below for the full report on what each group of University students proposed.

TIPPY TAP precedent for the 2x2x2 challenge

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