Area Pump Minders are volunteers who are trained to repair boreholes in their communities. In 2022, we collaborated with the local government to fund William’s training in borehole maintenance. Today, we’re proud to employ many of the Area Pump Minders we’ve previously trained to assess the dysfunctional water points, source materials and carry out the repairs. After several weeks of work on the Chisamba borehole, William had the hand pump working and water flowing freely again.

The effects of a broken hand pump can be devastating to the local community. In Chisamba, teenaged girls had to walk long distances to fetch water for their families, missing school and facing risks of gender-based violence along the way. Without clean water, the community was vulnerable to infectious diseases like cholera and trachoma – an eye infection that can cause blindness if left untreated.

For one local grandmother, seeing the water flow has brought a renewed sense of hope for her grandchildren, who had been walking up to three kilometres each day to fetch water.

The work we do goes far beyond just creating access to safe, clean water. The borehole becomes a focal point for community interaction and allows people raise extra income by growing vegetables and selling the produce – strengthening both livelihoods and resilience within the community.

Story written with files from Program Manager Tony Kazembe.

Learn more about the ripple effects of clean water by watching our video about boreholes in Zambia’s Sinazongwe District.

The post Volunteer brings borehole back to life appeared first on Operation Eyesight.

Clean water.

When communities have access to abundant clean water, they can wash their hands and faces regularly, do laundry more often, and prevent the otherwise relentless transmission of the disease. That’s why we are working hard with communities and partner organizations to make sure that the people in our project areas have access to a local, sustainable clean water source.

The prevalence and effects of trachoma

There’s been a lot of good news in the eradication of trachoma in recent years. In 2023 alone, Benin, Iraq and Mali each received certification from the World Health Organization (WHO) for eliminating trachoma as a public health problem. Also, the number of people at risk of getting the infection fell from 125 million in 2022 to 115.7 million in 2023, a significant reduction.²

But the hard work must go on.

Ethiopia has some of the highest rates of trachoma worldwide, with the prevalence in the Amhara Region estimated to be nearly 63 per cent. In that country, trachoma is the second leading cause of blindness overall.³

Trachoma continues to infect people in 42 countries and has caused blindness or visual impairment in roughly 1.9 million people. It remains the leading infectious cause of blindness worldwide. And the effect on the workforce in these countries is huge. According to a recent paper by the WHO, the loss of productivity due to trachoma costs somewhere between US $3-8 billion each year.⁴

To people like Stephen, in Narok County, Kenya, having trachoma meant not being able to support his family. The father of four, who works as a motorcycle courier, struggled with the infection for years. He tried eye drops, eyeglasses and several surgeries before the trichiasis in his right eye, caused by repeat trachoma infections, was fully resolved.

Since undergoing a successful final surgery at one of our partner hospitals, the young man now acts as an eye health ambassador in his community, making sure people know what the infection is, the role of hygiene in stopping its spread, and how to get it treated.

How an infection leads to blindness

Years of repeat infection from trachoma causes scarring to the eyelid. This scarring can be so severe that the eyelid turns inward, causing the eyelashes to rub against the eyeball. This leads to severe pain, light intolerance and scarring of the cornea.

If left untreated, the damage to the cornea can cause vision impairment, usually between the ages of 30 to 40 years⁵, although it can happen in children as well. Trachoma causes 1.4 per cent of blindness globally.⁶

Women become blind from trachoma four times as often as men. This is likely due to frequent infections they get while caring for small children, who often pass trachoma on to others.

How we’re working to eliminating trachoma

At Operation Eyesight, we follow the WHO’s SAFE strategy for controlling and preventing trachoma. SAFE stands for:

S: Surgery to treat trichiasis (the painful late stage of the disease)
A: Antibiotics to eliminate infection
F: Face washing and hygiene education
E: Environmental improvement including wells and latrines

The foundation for the strategy is environmental improvement, namely – providing access to clean water. Over the decades, we’ve worked with communities to rehabilitate and drill hundreds of boreholes. In recent years, most of our work with water has been concentrated in Zambia and Kenya, but we are also getting involved in more water projects in Ethiopia as we expand our programs there.

Along with drilling and rehabilitation, we work with local governments to make sure people can fix the boreholes when they break down. In Zambia, that means financing the training of volunteers called Area Pump Minders (APMs) to do routine maintenance and repair of boreholes. The program helps ensure that there is a system for repair work, with locally-available toolkits and spare parts, and that monitoring of the water supply is happening at the village level. In addition to helping their communities, some of the APMs go on to find paid work repairing privately-owned boreholes. Over the last two years, we’ve seen several women join the traditionally all-male teams, and we hope to recruit more in future.

The community involvement doesn’t stop there. We also work with volunteers to form WASH committees who help educate other people, especially children, in Water, Sanitation and Hygiene. In Ethiopia, we are working with partners to train teachers in WASH so they can pass on their knowledge to thousands of students. Our work in Ethiopia has also involved fixing up latrines and providing menstrual supplies, both of which can help keep teenaged girls in school longer.

Antibiotics also go a long way to preventing and treating existing cases of trachoma. We work with local governments and partner organizations to provide these antibiotics to areas with high prevalence of trachoma. Earlier this year, we collaborated with partners in a Mass Drug Administration project in Kenya’s Narok County. Despite wet road conditions that made it challenging for crews to access all the communities, the project managed to administer the antibiotic azithromycin to more than 215,000 people!

Throughout the process, our trained community health volunteers work tirelessly to provide education on the importance of facial cleanliness and environmental improvements in stopping the spread of trachoma.

Finally, with help from our generous donors, our partner hospitals can offer surgeries free of charge to people with advanced stages of trichiasis to alleviate the pain and prevent further loss of sight.

The ripple effects of clean water

We’re involved in clean water projects as a means of preventing trachoma, but the effects of providing clean water to communities are countless. The installation and maintenance of boreholes prevents dozens of waterborne diseases that sicken and threaten the lives of many, and that keep whole communities trapped in the cycle of poverty. Sustainable boreholes help people grow gardens full of fresh vegetables, allow them to raise livestock and improve the quality of life for everyone around them.

The effects of access to clean water are especially beneficial to women and girls. Here’s why:

Education and economic opportunities: In many communities, women and girls are responsible for fetching water, a task that can be extremely time consuming and physically demanding. This can prevent girls from attending school and women from pursuing income-generating activities. When clean water is locally available, girls are more likely to complete their schooling, and women have more time for activities that empower them economically.

Reduced gender-based violence: Providing access to clean water within communities reduces the need for women and girls to travel long distances for water, decreasing their vulnerability to the violence and harassment that they risk when collecting water.

Hygiene and menstrual health: Clean water is essential for maintaining proper hygiene, including menstrual sanitation. When women have access to clean water and sanitation facilities, it positively affects their overall health and dignity.

Community development: Women are often key contributors to the well-being of their communities. When they have access to clean water, they can actively take part in and lead initiatives that enhance the overall living conditions in their communities.

In 2023, we partnered on two new boreholes at schools in Ethiopia’s Amhara Region. In Zambia, we repaired 25 boreholes in the Mkushi District, trained 20 new Area Pump Minders and set up more WASH committees.

You can help us continue our water projects in 2024 by making a donation today. Thank you for your support!

1. https://my.clevelandclinic.org/health/diseases/25148-trachoma
   ↩︎
2. https://www.trachomacoalition.org/news-blogs/who-reports-continued-progress-towards-trachoma-elimination ↩︎
3. https://www.who.int/news-room/fact-sheets/detail/trachoma#:~:text=It%20is%20a%20public%20health,at%20risk%20of%20trachoma%20blindness ↩︎
4. https://www.who.int/news-room/fact-sheets/detail/trachoma#:~:text=It%20is%20a%20public%20health,at%20risk%20of%20trachoma%20blindness ↩︎
5. https://www.who.int/health-topics/trachoma#tab=tab_2 ↩︎
6. https://www.who.int/news-room/fact-sheets/detail/trachoma ↩︎

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The oldest of five children, Thandiwe in Zambia has always looked after her younger siblings. When the village borehole broke down, she had to fetch water from the river, and her family couldn’t wash as often. Thandiwe noticed some of her siblings had itchy, red eyes. Soon, she developed the same eye condition. Her left eye swelled and her eyelid turned inward, causing unbearable pain as her eyelashes scratched her cornea. With no money or access to a doctor, her eye became worse and worse until she lost vision in it entirely.

Priya in Nepal can’t remember when she first started having trouble seeing, but her vision kept deteriorating until one day she fell and injured herself while climbing the steep trail leading from the village to her house. Figuring that blindness was an inevitable part of old age, she stayed at home, unable to visit friends and grandchildren. Eventually she couldn’t even reach the outhouse without assistance. She felt like a burden to her family.

Mary, in Kenya, loved school from her very first day in the classroom and dreamed of becoming a teacher someday. After she turned 13, she started having trouble reading the chalk board. She had to copy notes from her friends and couldn’t do her homework in the dim light at her house. Her grades began to slip. She asked her parents to take her to an eye doctor, but money was too tight because they were saving to send her brother to college. By age 15, Mary quit school and decided to get married, her hopes of teaching now crushed.

None of these characters are real, but they represent the millions of women and girls around the world who are living with avoidable vision loss and blindness. We hear stories like these every day.

The prevalence of vision loss is higher among women and girls than it is for men and boys; 55 per cent of people experiencing vision loss are female. And while there are some biological factors at play, the reasons for these discrepancies are largely social.

Why women and girls experience more vision impairment

Women live on average longer than men, and many conditions that rob people of their sight are associated with old age. This includes cataract, presbyopia, glaucoma and age-related macular degeneration. According to estimates, two-thirds of cataract blindness globally occurs in women.

Traditional gender roles are another factor, especially in some regions.

Women and girls are two to four times more likely than men and boys to get trachoma – the leading infectious cause of blindness worldwide. Trachoma is caused by bacteria that spreads through contact on hands and clothing. Small children are especially susceptible, and in turn, they often pass it on to their caretakers. Women and girls may also get infected from household cleaning and doing laundry.

Obstacles to eye health care access

The barriers to health care for women and girls vary widely from region to region, but there are trends that we can observe across the countries where we work. These include:

• Cost and lack of financial decision-making capacity: Men often control the family finances. Women are less likely to work outside the home, meaning that the men and boys in their family who earn an income are often prioritized for spending on treatment.
• Limited healthcare infrastructure: In some regions, particularly in rural areas, inadequate healthcare infrastructure makes it difficult for women and girls to access eye care. The cost or lack of public transportation to the nearest facilities can exacerbate this problem for many women and girls, as can the social taboos and safety risks presented by travelling alone.
• Family responsibilities: Running a household and taking care of family members, duties that often fall on women, can make it challenging for women to take the time they need to get eye care.
• Lack of information: Unequal access to education for women and girls contributes to lower literacy rates and educational levels, which make it more difficult for women to learn about a specific eye condition or find out where they can get it treated.
• Cultural stigmas: Cultural norms and stigmas surrounding health issues, particularly eye health, can dissuade women from getting help. These cultural barriers may result in delayed or avoided medical attention.
• Lack of female healthcare professionals: A shortage of female healthcare professionals in the eye care sector can create discomfort for women and girls, potentially discouraging them from seeking assistance.

Addressing these diverse challenges is crucial for breaking down the barriers that prevent women and girls from accessing essential eye health care services.

Working toward gender equality

Our approach, called the “Hospital-Based Community Eye Health Program Model,” is designed to address inequalities to accessing eye health care, starting at the village level.

Most of the community health workers trained by Operation Eyesight’s partner hospitals are women, which gives them the opportunity to become trusted leaders in their communities and helps them contribute to family finances. They also bring eye health screenings to people’s doorsteps, meaning that women and girls don’t need to travel to get primary eye care and referrals.

Additionally, we work with our partner hospitals to establish vision centres closer to the communities where we work, making it easier for everyone to access diagnosis and treatment. Our partner hospitals also provide safe transportation for patients – usually by bus – to the hospital so that they can get their surgeries without worrying about how they’ll get there.

Finally, by providing surgeries, eyeglasses and other treatments free of charge – or at a highly subsidized rate – we can decrease some of the financial barriers women and girls face. We strive to provide quality eye care services to everyone – regardless of gender, age, ability to pay or other personal circumstances.

Clean water for gender equality

In a village in Zambia’s Mkushi District, a group of men and women stand over a water borehole, tools scattered at their feet. Two of the women turn a pipe with wrenches, their faces furrowed in concentration.

These men and women are Area Pump Minders in training – volunteers who fix and maintain water pumps in their communities. The pump minders are just one of our strategies for keeping communities supplied with a reliable source of clean water. As well as rehabilitating boreholes, we also work with communities to drill new ones, and provide training in WASH – which stands for Water, Sanitation and Hygiene.

While traditionally the pump minder volunteers were all men, we’re seeing more women join the teams. Between 2022 and 2023, we trained half a dozen women in borehole maintenance and repair in Zambia, placing the skills to keep the water flowing in the hands of those who need it most.

Clean water means that families can wash hands, faces and clothing regularly, which prevents the spread of trachoma – lessening the chance of vision loss and blindness, particularly among women. And there are countless other ripple effects for women and girls when they have access to clean water. It helps with the maintenance of menstrual hygiene, impacting health, dignity and overall quality of life. And, as women and girls are usually tasked with hauling water for their families, having a nearby borehole can help keep girls in school and give women more time to pursue economic activities to support their families.

Dismantling gender-related eye health myths in the foothills of the Himalayas

In the villages of the Udhampur block in northern India, vision problems are often seen as a sign of bad luck. A girl wearing glasses might be told she’ll never have a good marriage, and a baby’s bad eyesight might be blamed on past life sins. A girl with a squint could be seen as a curse for the whole family.

Those are some of the beliefs a recent pilot project took aim at.

Created in partnership with NorQuest College and the Rotary Eye & ENT Hospital, the project provided services through a “Mobile Vision Centre” – a four-wheel-drive van staffed with an eye health team comprised mostly of women. The van roamed the area’s rugged roads, bringing primary eye care and education to people’s doorsteps.

More than 27,000 people received training pertaining to eye health myths during the project duration. A before-and-after survey that checked people’s attitudes and beliefs regarding eye health for girls and women showed dramatic differences after the intervention. With that success in mind, our teams are looking to implement strategies from the project throughout our programs.

Read our new Global Strategy to find out how we plan to continue providing essential eye health care to women and girls and other underserved groups. Donate today to help us bring quality eye health care to more women and girls.

The post Gender inequalities in vision loss appeared first on Operation Eyesight.

It’s one of five schools across Ethiopia’s state of Amhara where the attendance rate for girls decreases each year due to inaccessibility of clean water and bathroom facilities. 

“Students had to walk for more than 15 minutes to get water from surrounding households. Many would not return to classes after that,” says the school’s principal, Yingesu Meshobiaw. “In the past, when girls felt that their period was setting in, they used to jump over fences and go home for lack of facilities.”

In 2022, in partnership with Partners in Education Ethiopia and the Peter Gilgan Foundation, we launched a Water, Sanitation and Hygiene (WASH) program at Abichikili and four other primary and secondary schools in the state, bringing locally-accessible water to more than 9,000 students. 

The project has also helped improve school attendance, particularly among girls, who make up more than half of the student population. Before the project, upwards of 10 students were absent from class for a full week each month, often falling behind in class. 

“Water access is vital for everyone. Water sources on school grounds allow for community gardens, which promote a different kind of learning and responsibility of nutrition – for students and adults alike,” Yingesu adds.  

Local access to fresh water allows people to wash their hands, faces and clothing, prevention transmission of diseases, including blinding trachoma, which is a key cause of vision loss and blindness across sub-Saharan Africa.

Our teams took a variety of approaches to bring water to the schools, including drilling boreholes to access groundwater, digging trenches and installing water supply lines, and setting up storage tanks, faucets and appropriate drainage.  

Faculty and community members received training to maintain their water infrastructure and test water quality. Twenty-one female teachers also received menstrual hygiene training including how to create reusable sanitary pads using local materials. 

“Having a water supply line has changed our school for the better,” Yingesu says. “Girls started using the facility the day it opened, and attendance rates have increased tremendously.”

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