The gap in health between non-Indigenous and Indigenous Australians is widening. While non-Indigenous Australians can raise their champagne glasses to the second highest life expectancy in the world, Indigenous Australians are at risk of contracting trachoma, a contagious eye disease only common in developing countries with the exception of Australia.
Trachoma is a preventable condition which has been eradicated from almost all developed countries. In the past year, the developing nations of Morocco, Oman, Ghana and Iran have successfully eliminated trachoma; something Australia has failed at despite launching a national program to eradicate the disease 30 years ago.
The evils of trachoma
Trachoma is caused by a bacterium called Chlamydia trachomatis. The initial symptoms are stinging pain in the eye, photophobia (sensitivity to light) and swelling of the eyelids which is similar to the uncomfortable feeling of conjunctivitis. Repeated infections can cause scarring underneath the eyelid and in-turned eyelashes, which may rub against the cornea (the clear centre part of the eye). This can cause eye ulcers, scarring, vision loss and blindness. Six million people worldwide have lost their sight from trachoma. Many children are affected by trachoma but the consequences of scarring are not known until later in life. Blindness usually occurs between the ages of 40 and 50.
It’s common for young children to pass the disease by touching their eyes and then other children. The disease can also spread by contaminated materials such as towels and clothes, and some flies and gnats (small insects) can also transmit the disease.
A national survey on Indigenous eye health is being conducted by the Centre for Eye Research Australia at the University of Melbourne, led by ophthalmologist (eye doctor) Professor Hugh Taylor. The survey has found trachoma is still entrenched within outback Indigenous Australian communities. The survey aims to update 30-year-old data collected by the late Fred Hollows who won Australian of the Year for his work on trachoma. Previously it was thought that affected Indigenous Australian communities were mainly located inland in remote Western Australia, South Australia and Northern Territory but new research has reported a few cases in Queensland and the Torres Strait.
In 2008, 20 per cent of Indigenous children in the outback had the disease, and about 8 per cent of the Elders had in-turned eyelashes as a result of the disease, which could result in corneal scarring. Professor Taylor says the continuing high rate of trachoma is a ‘disgrace’ particularly when ‘it is a completely curable disease.’ In some communities, half of the children have trachoma infections.
Why is it such a big deal?
Trachoma is only seen in areas where living conditions and hygiene is poor. According to the World Health Organisation, trachoma spreads from one person to another especially where there are shortages of water, numerous flies and crowded living conditions. In communities where there is adequate housing, drainage and fresh water supplies, the infection never gets the chance to spread. The fact that trachoma does not affect non-Indigenous Australians, but continues to cause blindness in Indigenous communities shows the gap in the standard of living between the two populations.
Dr Katrina Roper from Centre for Disease Control says ‘trachoma is a reflection on their poverty, their lack of access to water and lack of basic hygiene capabilities.’ Within some communities it can be due to distance, remoteness and infrastructure. In addition, there is a lack of access to specialist eye health services by ophthalmologists and optometrists (health care professional specialising in eye health) in rural and remote areas.
Sarah Fox, Project Coordinator National Indigenous Eye Health Survey at the Centre for Eye Research Australia, says people in Indigenous communities are aware of trachoma and there is passion to eradicate the disease. She feels that now it is just about getting the resources to achieve the goal. ‘The main problem is once you identify someone with trachoma, you need to treat the individual and the household with antibiotics and then do a six month follow-up, which requires man power and sufficient funding,’ Fox says.
Frequently washing the face of an infected child can prevent the infection being spread to other children. If the disease is left untreated and the eyelashes become inverted, it can be reversed with a simple surgical procedure.
Professor Taylor says if the Australian government spends $20 million, active trachoma could be wiped out in Australia within three to five years. On the other hand, if the Federal Government does not reach into the hip pocket and fund a national prevention program, Australia is on track to becoming the last country in the world that still has communities infected with trachoma.
As a nation, we can’t turn a blind eye to the existence of a third world disease in a rich and prosperous society. We may be able to treat people with trachoma but if living conditions in Aboriginal communities don’t change, third world diseases will fester and more and more people in the community will become infected.
How do I know this?
Australian Indigenous Health Info Net www.healthinfonet.ecu.edu.au
Cooper, Dani (2007) ‘Trachoma programs fail Indigenous Australians,’ ABC News in Science, 19 December accessed at: www.abc.net.au/science/articles/2007/12/19/2114236.htm
‘Fight to eradicate trachoma rekindled’ ABC www.abc.net.au/7.30/content/2007/s2056073.htm
Fox, Sarah [Interviews with Jenelle Whittaker] 10 November 2008
Lavelle, Peter (2003) ‘Trachoma’, ABC Health & Wellbeing accessed at: www.abc.net.au/health/library/stories/2003/02/27/1831847.htm
‘Preventing Trachoma’ BBC www.bbc.co.uk/worldservice/specials/
1031_Trachoma/index.shtml
Shanahan, Leo (2008) ‘Life’s black and white divide’, The Age, June 25 pg 1
Taylor, Hugh [Interviews with Jenelle Whittaker] 12 November 2008
‘Trachoma’, Health Line www.healthline.com/adamcontent/trachoma
‘Turning a Blind Eye (Trachoma)’, Vibe Health, accessed at: www.vibe.com.au/vibe.asp?PageID=2010
University of Melbourne leads the charge to eradicate blinding eye disease, 22 May 2008, accessed at: http://uninews.unimelb.edu.au/view.php?articleID=5197
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© 2008. First published on actnow.com.au
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