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Visions of Health: Carters Work to End Scourge in Ethiopia

By Claudia Feldman

Former first couple's nonprofit brings them to
poor nation struggling with blinding disease


Copyright 2005, Houston Chronicle
Originally published Sept. 16, 2005. Posted with permission

MOSEBO, ETHIOPIA - A motorcade of white SUVs chugged up a rocky road Thursday, and when the trucks came to a stop, former President Carter and wife Rosalynn stepped out.

While cows and goats ambled past and adults lined up to pump hands, the Carters were drawn irresistibly to village children. As the Carter Center entourage milled around, the children sang songs about trachoma, the preventable blinding disease that haunts Ethiopia.

In the national language, Amharic, they sang: "It's not too late. Closed eyes can be opened. We will see the light."

Rosalynn Carter stared at one child in particular, a 3-year-old beauty in a bright-green dress, then whispered to her husband, "She's covered in flies." She was. The black winged insects landed on the child's mouth, her eyebrows and her eyes. Almost certainly she has the early stages of the disease. The infection is caused by certain strains of the bacterium Chlamydia trachomatis, and it's transmitted by human contact and flies.

Both Carters, drawn to problems they think they can solve, have worked through their nonprofit organization - the Carter Center - since 2001 to control trachoma, found throughout the world but concentrated in Africa. Their other efforts have meant that guinea worm disease is close to eradication worldwide and river blindness is on the verge of eradication in Latin America.

They hope their work will serve as a model to others tackling the life-threatening diseases rampant on the often forgotten continent - HIV, AIDS and malaria.

The former president, who turns 81 in two weeks, still travels the world to monitor elections, negotiate peace and promote public health programs. He was in this African nation to check on progress in the fight against trachoma.

Millions of Ethiopians, particularly those living in rural areas, are malnourished, starving. Middle-aged villagers can't read or write. Many sleep on animal skins on the floor of one-room mud huts. Goats, chickens, even cows may sleep in the huts, too. In the villages, running water is unheard-of. Latrines are a luxury.

The flies that help spread trachoma breed in feces, and there are flies everywhere.

In the nation of 72 million people, about 10 million have active cases of trachoma. The disease has several stages, each one progressively worse.

Carter says roughly 1 million Ethiopians have the last stage, trichiasis. In those worst-case scenarios, scarring inside the upper eyelids causes the skin to contract, which means the eyelashes turn inward and scrape against the cornea. It's painful and, in time, blinding.


Latrine construction

The Carters headed up the hill, keen on visiting three new latrines - a sanitation issue key to preventing trachoma - built by local villagers. He noticed their bare, callused feet. He said he used to go barefoot when he was young. And his nearest bathroom was a latrine.

He and Rosalynn checked out the neat construction sites - they are 8- or 9-foot holes surrounded by mud walls and twigs. In the Amhara region, which includes Mosebo, almost 220,000 latrines have been constructed by the villagers.

One woman proud of her latrine was Tazie Shiferaw.

She couldn't tell the strangers how old she is. Maybe 50, she said. She has seven children, many grandchildren. For 25 years, she said, she suffered with trachoma, then trichiasis. It was difficult to endure the itching, the constant pain. She felt guilty that she was limited in what she could do at home. She tried to cook, but the smoke from the open fire got in her eyes and exacerbated the pain.

"I had no alternative," she said through a translator. "My children and husband didn't help."

Neither did neighbors. She was looked upon as an embarrassment, an object to ridicule.

Able to cook again

In February 2003, she finally had vision-saving surgery. She still has blurring, but she can see, she can cook, she can work in the fields again, if with difficulty.

She is barefoot. She owns only three outfits. She is illiterate. But these days, she is bolder, more outspoken than she used to be. She tells friends with vision problems to go to the clinic and get help. She tells them they need to build their own latrines. They need to wash their hands and faces and teach their children to do the same.

And then, she says, they will enjoy life again.

She does.

Through a translator she said, "I live every day as if it is my birthday," she said.

After the latrines, the Carters were the guest stars at a program attended by up to 500 people. Villagers showered him with presents. They named their new primary school after him. They dressed him in a native costume.

He, in turn, gave hugs and kisses. He made a speech saying the new school touched his heart. While staff flitted around him and made sure he stayed on schedule, they couldn't keep him from demonstrating his old-school manners and charm. There were at least a dozen in his entourage. The one who seemed to thrive on the crowds as Carter did was John Moores, who recently was named chairman of the board of trustees for the Carter Center.

Moores says he loves being around Carter and seeing how people around the world are drawn to him. The former Houstonian talks with a slow, Texas drawl. He was kidding around with some little boys, and as he left them he said, "Bueno."

Both Carter and Moores talk incessantly about plans for trachoma control. They include training and education, and the Lions Club International has donated $3.5 million toward that effort in Ethiopia.

Helpful antibiotics

Antibiotics offer another line of attack. Pfizer Inc. has pledged to make a long-term donation of Zithromax, Pfizer's brand of azithromycin.

Thus far, the drug company has donated 1.3 million doses, valued at more than $20 million.

Both men were energized by the progress they saw in Mosebo.

And then, their time was up. As if someone had blown a whistle, Carter and his entourage headed for their SUVs and chugged down the pitted road.

They will be back, Carter said.

Yengussie Tebeje, 55, talks about her struggles with the blinding disease trachoma.
Houston Chronicle: Steve Campbell

Yengussie Tebeje, 55, talks about her struggles with the blinding disease trachoma. The disease is caused by certain strains of the bacterium, Chlamydia trachomatis, and is transmitted by human contact and flies.

Kebitu Halie, grandaughter of Yengussie Tebeje, has trachoma like most of her family in the village of Mosebo.
Houston Chronicle: Steve Campbell

Kebitu Halie, grandaughter of Yengussie Tebeje, has trachoma like most of her family in the village of Mosebo. Trachoma is a preventable blinding disease that is haunting Ethiopia.


Former first lady Rosalynn Carter, philanthropist John Moores and former President Jimmy Carter watch as Sefeleg Balew, 10, demonstrates washing her hands after using the family's latrine in the village of Mosebo.
Houston Chronicle: Steve Campbell

Former first lady Rosalynn Carter, philanthropist John Moores and former President Jimmy Carter watch as Sefeleg Balew, 10, demonstrates washing her hands after using the family's latrine in the village of Mosebo. Her father, Balew Desalegn, watches from the left. Personal and environmental cleanliness are key to controlling trachoma.


Former President Jimmy Carter gives a 'thumbs up' to a villager who has had an operation to repair damage to his eyes caused by trachoma.
Houston Chronicle: Steve Campbell

Former President Jimmy Carter gives a 'thumbs up' to a villager who has had an operation to repair damage to his eyes caused by trachoma. Carter was visiting the village of Mosebo, Ethiopia, with his wife, Rosalynn, philanthropist John Moores, a delegation from the Carter Center in Atlanta, and health care officials from Ethiopia.


Mulat Zerihuh, coordinator of the Carter Center trachoma program in the Amhara region of Ethiopa, examines the inner eyelid of Kebitu Halie.
Houston Chronicle: Steve Campbell

Mulat Zerihuh, coordinator of the Carter Center trachoma program in the Amhara region of Ethiopa, examines the inner eyelid of Kebitu Halie. The redness is symptomatic of the disease.


Former President Jimmy Carter and wife Rosalynn inspect a latrine in the village of Mosebo in Ethiopia.
Houston Chronicle: Steve Campbell

Former President Jimmy Carter and wife Rosalynn inspect a latrine in the village of Mosebo in Ethiopia. Personal and environmental cleanliness are key to controlling trachoma.


Muche Semachu washes his hands, another way to keep clean and prevent trachoma, which is spread by human contact and flies.
Houston Chronicle: Steve Campbell

Muche Semachu washes his hands, another way to keep clean and prevent trachoma, which is spread by human contact and flies.

mosebo

TRACHOMA: THE BLINDING OF AFRICA

  • Gallery:
  • What it is: Trachoma is a blinding disease, caused by Chlamydia trachomatis bacteria and transmitted by human contact and flies.
  • Its treatment: Antibiotics, such as Pfizer's Zithromax, attack the disease.
  • Its prevention: Simple sanitation is the best preventative latrines and hand washing.
  • Its scope: The disease can be found worldwide but is concentrated in Africa. In Ethiopia alone, 10 million people are afflicted.

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