The fight against trachoma - Fiona Steele, Mt Allen
Community Nurse
The eyes of young people in the remote central desert community of Yuelamu are getting better. Three years ago, 76 per cent of school age kids (5-9 years) tested had active trachoma. Today, the infection rate is down to 24 per cent.This dramatic turnaround is the result of a community committed to wiping out a disease that starts in the young, but if left untreated, often leads to permanent blindness as people get older.
Yuelamu Community’s Remote Area Nurse, Fiona Steele, says the Yuelamu community has led the fight against trachoma, and if more communities could achieve the same dramatic reduction, the disease’s foothold in central Australia could be broken.
Trachoma is an infection that can cause scarring on the inside of the eyelid. Over time, this can cause the eyelashes to turn inward, rubbing against the unprotected eyeball and ultimately causing blindness in older people. In places like Yuelamu, where it is dry and dusty, the disease is more common. Australia is the only developed country in the world that still has high levels of trachoma.
“As part of the Healthy School Age Children program, we screen for trachoma,” Fiona says. “Based on the infection rates we have been doing two community-wide treatments each year and each time we do a treatment the community flocks to the health centre. They don’t want this disease destroying the sight of any more people.
“Eyes play an important part in the teaching and learning of Aboriginal culture. People here communicate a lot using their hands – gestures can mean so much more than words. Losing sight denies them the opportunity to hunt, to contribute to the learning of the young, to record the beauty of this culture through art.
“Although trachoma starts in the young it is the older people – those who we need to teach the young the traditional ways – who lose their sight.”
Fiona, who, with husband Barry, has been in Yuelamu for more than five years, says the success of Yuelamu in combating trachoma is based on building a strong community awareness of the issue and of what people can do to reduce the spread of the disease.
The health clinic is just a small part of Fiona’s health practice. Most of her work is done in the streets, in the general store, or in people’s homes. “I don’t just wait for people to come and see me at the clinic. Each day, as I go about my life in our community, I talk with people about things that are happening and their health and the health of their families.”
Fiona hopes the downward trend in infections with trachoma at Yuelamu will allow her to one day focus on targeting infected households rather than the current community-wide treatments. But this will depend on other communities also making inroads into infection rates.
“People here move around a lot and trachoma is easily passed from person to person. We need every community to do its bit in getting the disease under control. Once it is back in our community it will spread through usual contact.
“The simple message is people can reduce the chances of getting or passing on trachoma if they follow some simple rules about keeping eyes clean, washing hands and faces as often as possible and also getting their eyes tested regularly to see if they need treatment.
“We can’t get rid of the dust and flies but we can get rid of trachoma if the community works together.”
The Australian Government is investing millions of dollars to address both the symptoms of vision problems, and also the underlying social and environmental factors that contribute to poor eye health in Indigenous communities.
It is providing more than $58 million towards the early detection and treatment of eye and ear health conditions, which includes funding for intensive eye surgery weeks in Alice Springs and an increase in funding for the Visiting Optometrists Scheme. It also includes $16 million to boost services combating endemic trachoma in Indigenous communities.
The investment by the Australian Government is critical to supporting people like Fiona Steele, who are working at the coalface of Indigenous eye health.
For more information about what you can do to protect your vision or the vision of the people you care about, visit www.health.gov.au/eyehealth .
Facts about Trachoma
Trachoma is an eye disease that mainly infects the young but can lead to permanent blindness in older people.Trachoma is easily treated with the antibiotic azithromycin.
There are other ways to stop trachoma besides medicine, such as:
- washing face and hands at least morning and night;
- keeping the number of flies down by proper and frequent rubbish disposal;
- avoiding exposure to dust as much as possible; and
- having an annual eye check, such as the Healthy School Aged Kids (HSAK) screening.
Page currency, Latest update: 14 October, 2010