The crowded courtyard at Chuahit Health Clinic in North Gondar, Ethiopia, is full of people - elders talking, mothers swaying side to side to soothe their infants, health workers hurrying back and forth between offices. Suddenly, a small corner of the clinic erupts in laughter.
Centayo Fengte, 65, seems like an unlikely cause of the outburst. He sits on a bench, a lone man, joking or perhaps flirting, with several female patients in a coveted spot of shade. Fengte and the women all have either one or both eyes bandaged. Just the day before they received free eye surgery, supported by Lions Clubs International Foundation and The Carter Center, to prevent blindness from trachoma.
Fengte hopes his children will be free from caring for him now that he has received treatment for his trichiasis. "I hope my eye will be normal again and that I can go back to farming," he says. "Thanks to this, I will live long now."
At the urging of family and friends, Centayo Fengte, 65, walked 12 miles and waited in line for two days to receive free surgery to correct his trichiasis, the painful advanced stage of trachoma that causes eye damage and can lead to permanent blindness. "I decided that things couldn't get any worse for me. It was better to try to live instead. I made up my mind to get the surgery."
Fengte sits on a bench in the shade of the Chuahit Health Clinic, the lone man among a large number of women waiting for their post-operation checkups. Women are nearly twice as likely as men to experience trichiasis, the painful, blinding condition caused by repeated trachoma infections.
A crowd of patients waits in the courtyard of the Chuahit Helath Clinic for eye examinations to determine if they need surgery to prevent blindness from trachoma. (All photos: Carter Center/P. Rohe)
After repeated infections, trachoma scars the inner eyelid, causing it to turn inward and the eyelashes to scrape the cornea with every blink, a condition known as trichiasis. Light, dust from roads and fields, and smoke from cooking fires exacerbate the condition.
Women are nearly twice as likely as men to suffer from blinding trachoma. This is believed to be because women are traditional caretakers of children, the main carriers of the infection. Fengte is one of the few men in the clinic.
A widower with three children, Fengte knew something was wrong with his eye two years ago, but he avoided seeking help, even as his condition became increasingly painful and debilitating.
A female neighbor recognized Fengte's problem and urged him to seek treatment. She said she had been afraid to have surgery, but afterward was glad she did. Fengte wasn't convinced.
"My child also told me to get the surgery, but I was too fearful," Fengte says.
Then, one day, Fengte could no longer care for his crops, and his son took on the burden. Soon, his oldest daughter began bringing him food. Eventually, Fengte admitted grimly, his youngest child quit school to help him around their home.
"My condition made things so difficult for me that I thought I might as well be dead," Fengte said with a self-effacing smile, a bit embarrassed to talk about his previous suffering. "Then a man came to my village calling for people to attend the clinic if they thought they had trachoma, and I decided that things couldn't get any worse for me. It was better to try to live instead. I made up my mind to get the surgery."
With only a small, plastic bag of bread and his walking stick, Fengte traveled 12 miles by foot from his village, Desanez, to the clinic. He stayed with a cousin who lived nearby, and each morning, returned to the clinic, dreading the long wait behind a backlog of patients. After two days, his right eye finally was treated.
The Carter Center works with the Ethiopian government, local communities in Amhara Region, and partners, including the Lions Clubs International Foundation and others, to provide free surgeries to patients like Fengte. Surgery is a vital component of the SAFE strategy to fight trachoma - a series of interventions endorsed by the World Health Organization that include Surgery, Antibiotics, Face and hand hygiene, and Environmental sanitation.
To date, nearly 230 surgeries like Fengte's have taken place in the region, and Trachoma Control Program Director Paul Emerson says the Center is training and equipping additional surgeons to operate the backlog of thousands of cases.
"Every patient who is better able to care for his or her family and to feel useful in their community after surgery is a success for us," says Dr. Emerson. "But we're not satisfied if even one more person needlessly becomes blind from this debilitating disease. We do not have to tolerate trachoma's devastation. Trachoma is not an acceptable fact of life for Ethiopia."
At the clinic, Fengte waits for his bandage to be removed and his eye to be checked one final time before returning home. He seems relaxed, even carefree. When asked what he hopes for the future, Fengte shyly shrugs his shoulders.
"I hope my eye will be normal again and that I can go back to farming," he says. "Thanks to this, I will live long now."
Read more about the Carter Center's Trachoma Control Program >
Amhara Region, Ethiopia is thought to be the most trachoma-endemic region of the most trachoma-endemic country in the world. The Carter Center has been working in Amhara Region for more than a decade to help local communities adopt their own efforts to fight trachoma.
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