Carter's Life After the White House

Oct. 7, 20087 — -- Since his White House tenure, former President Carter has established a legacy as an elder statesman and diplomat. Carter, who has had more success since vacating the nation's highest post, has spent much of his time traveling abroad and bringing attention to international issues.

His post-presidency activities have included dealing with more than 70 nations and leading peacekeeping efforts in countries like Ethiopia, North Korea and Bosnia.

In his new book, "Beyond the White House," Carter discusses some of the world's most pressing issues as he sees them. The book is structured by section, with each detailing a specific nation or issue. The memoir is highly personal and the 39th president tries to provide insight into international development practices and high-level diplomatic negotiation, and other issues.

Read an excerpt of the book below.

Trachoma is the leading cause of preventable blindness in the world, but it is still known as one of the "neglected" diseases. It is caused by infection and can be treated, but 7 million people have been stricken blind by trachoma. An additional 500 million, usually the poorest and most forgotten in communities that are already struggling for survival, are at risk. In African countries, these are often areas where lymphatic filariasis, Guinea worm, schistosomiasis, and onchocerciasis are also endemic.

I knew about cases of trachoma as a boy, and I often had conjunctivitis, or sore eyes. As is the case now in our targeted areas of Africa, flies were everywhere, breeding in the excrement from both animals and humans. Our barn lot was nearby, and chickens, ducks, and geese ran freely in the yard. Screened doors and windows helped, but we also had to put a piece of gauze on top of any open pot or pitcher to keep the flies out of our milk or food. Fortunately, my mother was a nurse and a stickler for cleanliness, and our family had the only outdoor privy in the community. Trachoma was considered a threat to America in those early years, so doctors at Ellis Island used buttonhooks to examine the undersides of immigrants' eyelids and shipped those with trachoma back to their home countries.

Trachoma is caused by filthy and infected eyes, beginning as conjunctivitis and ultimately causing the upper eyelids to turn inward. Every blink drags the eyelashes across the corneas, causing pain like a thorn in the eye and then permanent blindness. The disease can be transmitted by contact with an infected person, by hands, a towel, or a garment, or carried by flies that have come in contact with discharge from infected eyes. Transmission is enhanced by an intimate relationship between mother and child or within a family or close-knit community.

Rosalynn and I had noticed during our visits to Masai and Dinka villages that, when seen from a distance, children appeared to be wearing eyeglasses, but when we approached them it was clear that rings of flies were sucking moisture from their eyes. The children rarely brushed the flies away and had never been taught to wash their faces.

In 1997, at the request of the Conrad N. Hilton Foundation, The Carter Center decided to make a major effort to help control trachoma in Ghana, Mali, Niger, and Nigeria, countries where the average annual income ranges from $100 to $370. We knew that trachoma only deepened the despair and poverty in these communities.

We began learning about the disease and raising funds to support the new program. Having been a district governor of Lions Clubs International during the mid-1960s, I knew that protecting eyesight was the organization's major benevolent project. I went to their Chicago headquarters to relay our plans, and they pledged a total of $16 million for five years, permitting an expansion of our program to Ethiopia and Sudan. The Hilton Foundation promised $13.6 million for a total of ten years.

The first cases of trachoma that we saw were in Mali, where Rosalynn, our Carter Center team, and I were joined by Jim Ervin, president of Lions Clubs International, and the leaders of Lions Clubs in the country. Through an interpreter, we talked to a blind grandmother who said she was thirty years old. She was holding in her arms a little boy, about the same age as Amy's son, our youngest grandchild. Someone said, "The flies cluster shoulder to shoulder around an infected eye." With proper treatment, the grandson would never be blind. Along with the other organizations involved in the International Trachoma Initiative, we use the acronym SAFE as a guide to treatment: S=surgery, A=antibiotic, F=face cleaning, and E=environment.

Before surgery, victims carry crude tweezers, with which they pluck out all their eyelashes, but the hairs grow back even sharper. We are able to train nurses or physician's assistants to perform the simple surgery, a fifteen-minute procedure, to restore the eyelids to their normal position. On surgery day, hundreds of people desperate for relief stream into eyelid surgery camps run by the government and paid for by The Carter Center. We prefer a month of training, which costs six hundred dollars per worker, plus eight hundred dollars for two surgical instrument kits each. The materials for each operation cost about ten dollars.