In early August the Pacific Elimination of Trachoma Program (PacET) team surveyed 20 clusters of trachoma in the Northern Division of Fiji, on the island of Vanua Levu. Trachoma is the result of infection of the eye with Chlamydia trachomatis. Infection spreads from person to person, especially where there are shortages of water, many flies, and crowded living conditions. Infection often begins during infancy or childhood and can become chronic. If left untreated, the infection eventually causes the eyelid to turn inwards, which in turn causes the eyelashes to rub on the eyeball, resulting in intense pain and scarring the eye. This ultimately leads to irreversible blindness, most commonly between 30 and 40 years of age.
The PacET team was headed by the National Trachoma Coordinator and made up of a local Ophthalmologist, eye health nurses, and public and village community nurses. We were based in the main township of Labasa, but surveyed a number of areas on the island. The terrain outside of the main township of Labasa in the North is a mix of village communities and houses in the sugar cane belts. The team worked tirelessly to screen children between the ages of one to nine starting their survey walk at 9am and finishing at 6pm. In some areas of the North, the survey team screened children who had active trachoma, especially in the older age group.
Formal analysis of the data commenced in October for all divisions surveyed in Fiji and will be presented to key stakeholders to inform implementation of the second stage of PacET.
One of the first survey areas about 40kms out from the main township Labasa. This village was identified by the local public health nurse as lacking in basic facilities and a proper rubbish disposal area.
Dr Vara screens an eight-year-old for active trachoma.
A nine-year-old child screened for trachoma. Trachoma follicles (TF) were detected.
Children from the community school arriving for their screening and educational talk on Trachoma. The talk is based on the SAFE strategy and features components F and E. The SAFE Strategy is an innovative public health approach designed to treat and prevent trachoma. Endorsed by the World Health Organization, the components of SAFE are: S for Surgery for in-turned eyelids; A for Antibiotics to treat and prevent active infection; F for Facial cleanliness to prevent disease transmission; and E for Environmental change to increase access to water and sanitation.
The team conducting surveys in one of the clusters in the sugar cane belt. With houses quite spread out, this meant a lot of walking around with equipment.
Pacific Elimination of Trachoma Program (PacET) data forms.
At each village we entered there was the ceremonial sevusevu, which is an official Fijian ceremony for meeting and greeting visitors by the Chief or the head person of the village. The sevusevu is a ritual which allowed the survey team to ask permission and show appreciation for screening kids in the village. Kava is usually offered to drink in a sevusevu.
All photos courtesy of the Fiji Ministry of Health and the PacET Project.