Photo courtesy of South Sudan’s Ministry of Health.
One Ministry of Health Team Ending Preventable Blindness
Bior Bol Bior and Yak Yak Bol
Following nearly three decades of global efforts, 23 countries have eliminated the blinding disease trachoma using the World Health Organization’s SAFE strategy for trachoma control (The SAFE strategy includes Surgery, Antibiotics, Facial cleanliness, and Environmental improvement interventions). South Sudan hopes to join that list and Ministry of Health staffers are working hard to make that happen.
“I grew up in a trachoma-endemic region. During my childhood, I saw eye infections, but nobody knew it was trachoma,” said Bior Bol Bior, South Sudan’s Ministry of Health Trachoma Coordinator. “Now we know trachoma is the number one infectious cause of blindness in the world. When the trachoma program started, people were given education about what causes trachoma and started to understand.”
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Trachoma MDA activities in South Sudan. Photo courtesy of South Sudan’s Ministry of Health.
More than 4 million South Sudanese are at risk for trachoma. A preventable and treatable disease, trachoma is a painful eye infection caused by bacteria. It can be spread through hands, clothes, bedding or hard surfaces and by flies, especially in areas with limited access to clean water and sanitation.
Before South Sudan’s independence in 2011, some trachoma surveys to assess the prevalence of trachoma were completed as early as 1999. In 2007, a trachoma control program was formally launched in South Sudan. In 2024, South Sudan completed its nationwide baseline trachoma prevalence mapping, a 25-year-long effort to understand where to implement the SAFE strategy for eliminating trachoma.
The mapping confirmed that 40 of the 80 counties in South Sudan were trachoma endemic, primarily along the eastern side of the Nile River. This data enabled the country to focus its efforts in these areas. Bior and partners have facilitated large-scale community treatment programs (known as mass drug administrations, MDAs), surgeries to correct damage caused by trachoma, and water, sanitation, and hygiene activities. As a result of their efforts, six counties have now successfully reduced the prevalence of trachoma below levels that would cause a threat to public health.
The South Sudan Ministry of Health has worked to strengthen community engagement and education efforts, informing communities that blindness from trachoma is preventable and what resources are available to them. One approach is by working through Boma Health Workers – trusted and trained community members who support a number of health interventions.
Photo courtesy of South Sudan’s Ministry of Health.
“We have the Boma Health Initiative where the health workers are trained about trachoma,” said Yak Yak Bol, South Sudan’s National Coordinator for Preventive Chemotherapy & Neglected Tropical Disease, who oversees the financing and resource mobilization to combat trachoma and four other neglected tropical diseases: onchocerciasis, schistosomiasis, soil-transmitted helminths, and lymphatic filariasis. “They are part of the community and go to homes and villages to teach community members about the cause of trachoma and how to prevent it.”
The government has also embraced an integrated campaign strategy to reach nomadic populations, like cattle herders, fishers and hunters, who are sometimes missed during community treatment campaigns. The program followed the migration patterns of nomadic groups and conducted treatment campaigns simultaneously with cattle vaccinations. The health workers collaborated with cattle camp leadership to mobilize communities and also expanded outreach to hunting barracks and internally displaced people (IDP) camps to ensure equitable access. Additionally, they led focus group discussions to address gender-based barriers in treatment uptake.
Their efforts are paying off, with increased awareness about trachoma prevention and treatment; improved vision for people who received surgery; the establishment of surgery centers in highly endemic areas; and school-based trachoma education programs.
Trachoma MDA activities in South Sudan. Photo courtesy of South Sudan’s Ministry of Health
The Task Force for Global Health’s International Trachoma Initiative works with the South Sudan Ministry of Health to support trachoma MDAs through azithromycin donation. Since 2001, 13.4 million treatments of azithromycin have been donated. In 2024 alone, South Sudan distributed more than 1.5 million treatments through 22 MDAs across 19 counties, the country’s largest effort to date.
South Sudan’s health ministry partners with The Task Force for Global Health’s International Trachoma Initiative, Pfizer, ARISE/END Fund, Amref, The Carter Center, CBM and Sightsavers to ensure future generations in South Sudan do not have to endure the pain, suffering, and preventable blindness caused by trachoma.