Reaching trichiasis patients

Yuol is a 40-year-old subsistence farmer in a small remote village in South Sudan. He has been suffering from trichiasis for the past 5 years. He has pain in his eyes and has noticed a gradual reduction in his vision. Yuol cannot provide for his family now. His wife and children have to farm the land and collect water and the children now stay at home instead of attending school. Yuol has not sought trichiasis surgery before now because he has been unaware of this treatment and no one in the village has had it. He is depressed and resigned to his fate of living in pain and with loss of vision.

Local health workers in South Sudan have mapped the district and know it is endemic for trachoma. Planning a trichiasis surgery service for this community is a key activity to eliminate trachoma. An important element of the planning will be to ensure that the services provided are available, accessible and acceptable to Yuol and similar patients in the area.

Planning a trichiasis intervention

Trachomatous trichasis (TT) prevalence data from trachoma mapping provides invaluable information on the magnitude of the problem in a given district. Trachoma action plans use this data to establish targets for the minimum number of TT interventions required to reach the elimination threshold.

To achieve this required surgical output, trachoma programme managers need to design and implement a range of activities:

• Establish a team or teams with accredited training in trichiasis surgery
• Acquire and maintain appropriate surgical instruments, medicines and other consumables
• Find and inform people with trichiasis about the surgery
• Organise transport and locations to enable the team to carry out surgeries close to where patients live
• Manage and follow up with patients, recording their details and progress
• Report back to programme partners

As you watch this video, consider what are the possible barriers for Yuol to accept or access trichiasis services?