Preventing blindness in South Sudan - in pictures

Trachoma, a neglected tropical disease, and the primary cause of preventable blindness worldwide, is common in villages such as Kalakalak in Unity State (pictured here) and across large parts of South Sudan. Up to 80 percent of children are infected in some communities. Flies, attracted by cow dung in Sudan's nomadic communities, are the primary cause of the bacterial infection and it is also spread through direct contact with infected hands and clothes. It occurs most commonly in overcrowded conditions where access to clean water and basic health care is restricted. In this village in Unity State, many children were found to show symptoms of trachoma.

Four-year-old Nyatini Muut Tora receives preventative trachoma antibiotics from Malaria Consortium Community Drug Distributors in Kotna, Unity State, South Sudan. Nyantini’s family knows of the risks and problems associated with trachoma because one of her father's wives suffers from blindness due to multiple infections. Children are most affected by active infection. The disease usually first occurs in childhood but its resulting blindness does not become apparent until adulthood. The disease progresses over time and is often referred to as the “quiet disease.”

Left untreated, the eyelids become in-turned and scrape the eyeball. The resultant scarring of the cornea leads to a rapid decline in vision which can be reversed through a simple surgical procedure which reverses in-turned eyelashes. If left un-treated however, repeated trachoma infections result in entropion, a painful form of permanent blindness. 59 year old Nyanjanmut Gok from Kotna, Unity State, South Sudan suffers from blindness associated with trachoma.

In 2011, with support from USAID, Malaria Consortium conducted mass drug administration campaigns with the aim of reducing trachoma infection in entire communities in South Sudan. Community drug distributors (CCDs) were trained by Malaria Consortium to conduct censuses of villages to ensure that everyone was recorded for treatment. Hundreds of CDDs were trained in the country to administer drugs to treat the disease. Here, two CDDs arrive on donated bicycles for a treatment day in Kueryiek, Unity State, South Sudan.

School children look on as a Malaria Consortium Child Survival Officer, Andrew Dak Duoth, distributes preventive trachoma antibiotics to two community drug distributors (in red), in Ngop, Unity State, ready for them to start work. Children, because of their outdoors play habits and low immunity to the disease, are the most susceptible to infection, but the blinding effects are often not felt until adulthood.

Community drug distributors use coloured poles to measure the height of people being treated. This method enables them to determine the correct dosage of drugs appropriate for each person. The number on the coloured section of the pole indicates the dosage of antibiotics that the person should receive. Malaria Consortium Community Drug Distributor Simon Nguany Madit gives preventative antibiotics for trachoma to 14 year old Nyayait Kueth in Kalakalak village, Unity State.

Mary Nyekuich Jak helps her youngest daughter, 9 month old Nyalok Ruop Ring, stand against the Malaria Consortium dosage pole, as she waits to receive preventative trachoma antibiotics from Community Drug Distributors in Kotna, Unity State, South Sudan. This child needs 4ml of the antibiotic treatment for Trachoma.

Mary Nyekuich Jak helps her youngest daughter, 9 month old Nyalok Ruop Ring, stand against the Malaria Consortium dosage pole, with her 6 year old Nyamam Beliw Ruop Ring on the other side. Globally, the World Health Organisation reported that in 2011 an estimated 325 million people were living in trachoma-endemic areas and therefore at risk of contracting the disease.

Having been measured, this 8 year old is drinks the correct dosage of preventive antibiotic for trachoma as another child looks on, waiting to receive her antibiotic dosage. Children, often playing outdoors, are particularly susceptible to trachoma infection.

With the help of the child’s mother, Malaria Consortium Community Drug Distributor administers the preventative antibiotic for trachoma to three-month old Wuor Majak's eyes in Kalakalak village, Unity State, South Sudan. If left untreated, trachoma can keep families in a continual cycle of poverty with the disease and its long-term effects are transferred from one generation to the next. Across the world, trachoma leads to an estimated $2.9 billion in lost productivity every year.

Malaria Consortium Community Drug Distributors give preventative antibiotics for trachoma to 50 year old Nyadar Cheichor and her family in Kalakalak village, Unity State, South Sudan. Malaria Consortium is treating entire communities for the infectious eye disease trachoma, as part of the Neglected Tropical Disease Control Program. Trachoma is endemic in Unity State, spread primarily by flies and direct contact with infected hands or clothes. Left untreated, repeated trachoma infections result in entropion painful form of permanent blindness where the eyelid turns inward, causing eyelashes to scratch the cornea. Children are the most susceptible to infection, but the blinding effects are often not felt until adulthood. 7 July 2010.

Malaria Consortium Community Drug Distributor Nyadiu Kwany discusses trachoma symptoms and prevention with Nyacethe Deng Tong and her children, in Ngop, Unity State, South Sudan. Basic information on how to prevent transmission of the disease – for example through washing children's faces and effective disposal of human and animal waste – is critical if transmission is to be reduced.

Children in Kotna, Unity State, Southern Sudan received preventative trachoma antibiotics from Malaria Consortium Community Drug Distributors. Repeated mass administration of antibiotics, such as the one carried out by Malaria Consortium in 2011, will reduce the prevalence of infection and make a major contribution towards the elimination of trachoma from South Sudan. This project was made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents of this slideshow are the responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government. For more information about the USAID NTD Control Program, click here or click here. To find out more about the UK NTD coalition, please visit www.ntd-coalition.org.