Curing trachoma means eliminating poverty

Hollows believed in the value of the right kind of publicity. “There is a very good record of the trachoma work on film and in print. Shaun McIlwraith, the medical correspondent for the Sydney Morning Herald travelled with us at various times, and his reports and feature articles helped to advertise the program and build the widespread public support we enjoyed.”

The publicity associated with Hollows’ visits to camps through South Australia, New South Wales, Queensland and the Northern Territory in 1974 “highlighted the need for a national attack on the trachoma problem”.

This was 35 years ago.

However, one of Hollows’ colleagues at that time, Hugh Taylor, now Professor of Indigenous Eye Health in Melbourne University's School of Population Health, told Dani Cooper of the ABC in December 2007 trachoma remained entrenched among outback Indigenous Australian communities. Following a five-week survey of the Katherine region in the Northern Territory he said the continuing high rate of trachoma in outback Indigenous communities was “a disgrace”, with up to half the children in some communities infected.

Taylor said Australia is the only developed country still to have this preventable disease and the nation was on track to be the last country in the world where the infection is endemic.

The advanced stage of trachoma is trichiasis and women are three times more likely to contract it than men. The condition not only causes severe pain it also makes it extremely uncomfortable for women to cook over smoky fires, collect water in bright sun, or farm in dusty fields. Thus women incapacitated with trichiasis become a burden on their families and communities where resources are scarce.

Professor Taylor’s survey of the Katherine region found one in 12 adults had in-turned eyelashes as a result of inflammatory trachoma as a child. These in-turned lashes rub the eye and cause blindness. “I expect one in six of the children are on the same escalator to trachoma as these older people”, Taylor said.

“The Aboriginal community is a non-written culture visually based so to have something that takes away their vision, particularly for elders, is devastating.” The infection, mainly spread through poor living conditions, affects communities found mainly in inland and remote Western Australian, South Australia and the Northern Territory. In coastal communities trachoma is less common because children's faces are kept cleaner by playing in water.

Up to now, “a lack of government commitment and targeted resources on the ground” have been the main impediments to eliminating the disease among Indigenous Australians, Taylor said.

Compared with Australia’s failure to eradicate trachoma Morocco had done so in 10 years.

In 2007 ABC Television reviewed the situation, introduced by Leigh Sales: “If you're old enough, you might remember the National Trachoma and Eye Health Program run in the outback in the 1970s by the legendary Professor Fred Hollows, who went on to become Australian of the Year. That program was meant to eliminate trachoma, the major cause of blindness among Indigenous Australians. But despite the enormous attention the work generated at the time, it faded after only a few years and now 30 years on, trachoma is still endemic among Aboriginal communities. Australia stands isolated as the only developed country in the world where trachoma is still a major public health problem.”

Reporter Murray McLaughlin reported on Minyerri, an Aboriginal community in the Northern Territory 200km southeast of Katherine where the 250-strong community was being screened for trachoma.