Three years ago, the Accelerate programme set out to speed up the elimination of trachoma in 14 countries.
Clear progress has been made as part of Accelerate, and in Côte d’Ivoire this progress has been particularly impressive. Working with the government, the programme has completed its final operations in the country to treat advanced trachoma, known as trichiasis. This painful and debilitating eye disease is one of a group of conditions known as neglected tropical diseases (NTDs).
Here, the people closest to this work reflect on their experiences, and discuss what needs to happen next to eliminate trachoma so that it is no longer a public health problem in the country.
Konan Nguessan, Sightsavers NTD programme officer for Côte d’Ivoire
“Before the Accelerate programme, we didn’t have a project for trachoma here, just funds to map the disease. So we didn’t have a clear idea of how to push the trachoma elimination process forward. For me, this process was pushed by Accelerate. And in the same year, Act to End West came and together these projects mapped 18 districts. So in 2019, the control of trachoma in Côte d’Ivoire had really started.
“There’s no guarantee that more people won’t be affected by trachoma in future. You need a transition plan so that trachoma can be managed through routine health services. The next steps are training surgeons, scaling up WASH [water, sanitation and hygiene] work in two districts and preparing the evidence for when the country is ready to declare trachoma elimination.”
Dr Djè Norbert, deputy director of NTDs, National NTD Control and Prevention Programme
“In Côte d’Ivoire, the fight began by mapping trachoma. Of the 57 districts mapped, 40 are considered endemic for trachoma. Of these, some received treatment by mass drug administration.
We already have a trichiasis case finder trainer. We have facilities everywhere, and we are lucky enough to have training for doctors specialising in ophthalmology. We have to continue to monitor trachoma, and so for success in the next steps, training more health workers is important so they can take care of any further cases. Together we must set up a strategy to cover all the zones, and this is what we will try to do with our partners who are helping us to reach that goal.
“The other important aspect is the WASH sector. We have to continue these activities in the field now. The WASH sector has many partners, and we have to coordinate all these activities to take advantage of what we’ve already achieved in the fight against trachoma.”
Dr Coulibaly, chief doctor and ophthalmologist, Korhogo central hospital
“I did the first campaign at home in Korhogo, in my department as assistant surgeon. After that I did the post-operative care two weeks later: the patients came and I took out the stitches, and everything went well. Today we’re in Duékoué to do the same. We’ve already worked for three days operating on the patients. Afterwards, I’ll come back to take out the stitches.
“This activity is really welcome. It’s true that this disease is in our regions in Ivory Coast. Thank god we don’t find it too often: this is the disease of poverty. But in any case, it would be a good thing to cure the cases that are already diagnosed, because it’s a really disabling disease. And when someone has this disease, it’s complicated for the person to deal with. It’s the poor who are affected: if we don’t help them, they can’t get out of it. They can’t afford the surgery so it’s necessary to visit them and to be at their side to make their life easier.”
Ouedraogo Amadou, trichiasis patient
“It started six years ago. All of a sudden it came in my eyes like a spiderweb, entering my eyes with the disease. I was being treated with ointments but wasn’t being cured.
“Several doctors who came to the village to take some pictures of my eyes. Then they decided that the best would be for me to come here, and later they called to bring me here. I felt very good after the surgery. I slept very well.”