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For Dr Melissa Stoneham the importance of having access to education and hygiene resources is the key to help end trachoma in regional WA.

Melissa, who heads up The Environmental Health Trachoma Project (#endingtrachoma) run by the Public Health Advocacy Institute, has been working in the fields of public and environmental health for more than 30 years.

Funded by the Australian Government, the Ending Trachoma project helps to improve and expand trachoma control and health promotion initiatives in communities with endemic trachoma.

Melissa and research officer Scott MacKenzie have been visiting remote communities across WA for several years to reduce cases of the disease.

“Australia is the only developed country with endemic trachoma and almost all cases occur in Aboriginal people in remote communities,” Melissa said.

“It is the leading cause of blindness globally with risk factors including the inability to wash face, hands and to a lesser degree clothes, as well as sharing clothes and towels.”

Melissa said the disease is strongly associated with non-functional health hardware and poor hygiene in people’s homes and can be prevented through better health education and promotion. “In WA, we have trachoma in the Goldfields, Pilbara, Kimberley and Midwest,” she said.

“Our project works across all four regions, and we aim to reduce the risk factors for trachoma within people’s homes.

“To achieve this, we train and mentor Aboriginal Environmental Health Workers (EHW, based in remote communities to enter people’s houses, identify risk factors for trachoma, and where possible fix minor plumbing such as blocked drains, replacing shower heads or taps.”

The team also provides soap, coloured towels, light bulbs, mirrors at child height and other hygiene resources. They also “yarn” about the six steps to stopping germs, the importance of hand and face washing and what communities and individuals can do to prevent trachoma and other diseases.

“We also provide training and support to the EHWs to offer appropriate responses for environmental health clinical referrals which come from clinics or hospitals,” she said.

“Our final strategy is to develop culturally appropriate and fun resources to support the ‘six steps’ message. We regularly work with the school students in community to develop videos about stopping germs.”

Melissa said the disease was completely preventable.

“Trachoma easily spreads from one person to another through infected eye and nose secretions,” she said.

“But it can be prevented by reducing risk factors such as poor hygiene, litter, dust and overcrowding.

“Providing health education and promotion around the importance of washing face and hands to prevent trachoma in schools is a good strategy but if the kids go home and can’t use the bathroom because there is no shower head or tap handle, then the messages are lost.

“Focusing on providing minor plumbing fixes in the house, providing access to washing machines and dryers and providing hygiene resources and products as part of a whole of house assessment is equally important.”

The team works with Mawarnkarra Health Service as part of their Healthy Homes Program.

“We recently loaned them a portable washer dryer trailer to integrate into their Healthy Homes Program. “This trailer has two washer dryer combo units, a BBQ and a wash hand basin.

“The equipment can steam, meaning that disease carriers like the scabies mite will be killed in the wash.

“This is a free service for community members.”

With funding for the Environmental Health Trachoma Project set to end in July 2025, Melissa said it was important to continue to focus on the home.

“This is critical to prevent trachoma so additional funding to keep the project running longer would be great,” she said.

“We would also like better connections with the teams that address other diseases related to the home such as rheumatic heart disease, skin sores and otitis media so we can share expertise, ideas and funding.”

The project so far has delivered:
• 1,500 individual healthy homes assessments
• 1,800 issues affecting people’s ability to wash identified and fixed
• 2,800 issues referred to housing
• 5,500 bars of soap allocated
• 2,500 coloured towels distributed
• 1,200 light bulbs fitted
• 500 hygiene kits donated

Acknowledgement of Country