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Lessons from Uganda: how educating communities about hygiene can help to combat trachoma

Leah Wohlgemuth, October 2017
A girl is washing her hands under a yellow container.
© Karel Prinsloo/Sightsavers

“We work with a range of partners to help improve community health messages”

When treating trachoma, attention has tended to focus on the role of antibiotics and surgery. However, trachoma is easily transmitted from person to person, usually by dirty hands or faces, so good hygiene is vital to prevent the disease spreading.

Trachoma intervention programmes are now widening to also include the role of facial cleanliness and environmental improvements, focusing on education and hygiene behavioural change. These play a critical role in stopping trachoma infections from being contracted and spreading, and therefore determine the long-term success of elimination programmes.

Since 2016, I have worked in a team on The Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative, dedicated to delivering hygiene behavioural change programmes to help combat trachoma in Uganda.

As well as funding improvement in facial and environmental cleanliness, the Trust and RTI/ENVISION fund trichiasis surgeries for communities among 17 districts in the Busoga and Karamoja regions of Uganda. There are significant challenges in reaching the people who live in Karamoja in particular. It is a very impoverished, highly rural area, and has a high nomadic population, with many people moving regularly across the border to South Sudan and Kenya, making them difficult to locate and involve in programmes.

We work with a range of partners to help improve community health messages and encourage good hygiene practices by tailoring our approach according to the needs of communities and incorporating trachoma messaging into existing program and partner activities. These partners include The Carter Center and Johns Hopkins University Center for Communication Programs at national and regional levels, Water Missions in Busoga region, and Water Aid, Concern International and World Vision in Karamoja region.

A 12 year old boy washes his face.
© Javier Acebal/Sightsavers

"We must continue to share our lessons from the field"

Those of us working on eliminating trachoma understand the importance of working closely with the water, sanitation and hygiene (WASH) sector. Cross-sector collaborating has always been challenging, but recently tremendous headway has been made in Uganda through involvement with existing organisations and networks and working with the WASH sector on national sanitation and school sanitation guidelines to emphasise the link between water, sanitation and hygiene, and neglected tropical diseases.

While progress continues to be made, there are obstacles in the road towards trachoma elimination. Therefore, as a global community, we must continue to share our lessons from the field.

Work in collaboration with organisations already established in the regions

A key facet of the approach in Uganda has been to work with WASH partners who are already embedded into the community. We have found success in working alongside known entities who have already built trust, relationships and a presence in the communities. Our programmes have also benefited from the infrastructure that these WASH organisations are putting in place, such as access to clean water, latrines and hand and face washing stations, which help to encourage healthy behaviours connected to trachoma elimination.

A man washes his hands outside a mud hut.
© Ruth McDowall/Sightsavers

"Incorporating hygiene and trachoma messaging into existing WASH lessons"

Integrate trachoma messaging into existing WASH programmes

We work with our partners by building upon their programmes with additional information about trachoma and hygiene practices, such as hand and face washing, that are critical to the elimination of this blinding disease. This includes incorporating hygiene and trachoma messaging into existing WASH lessons, community meetings and community-led total sanitation. Integrating trachoma messaging into existing WASH strategies and materials means that time is not spent creating a whole set of new materials that would then run in parallel to the other health and hygiene work.

By Leah Wohlgemuth, Technical Advisor at Sightsavers

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