Carter's Life After the White House

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.

In September 2000, Jim Ervin went with me to the headquarters of Pfizer Inc, the world's largest pharmaceutical company, where we met with corporate leaders and I spoke to several hundred of there assembled employees about trachoma. I described the SAFE program and emphasized that their antibiotic Zithromax had proven to be most effective against the infection. I described how Merck had been contributing free Mectizan for the treatment of onchocerciasis, and their CEO, William Steere, offered to provide Zithromax whenever we could set up an effective system in a country for its use. Subsequently, Pfizer has expanded this commitment so that it now includes more than 135 million treatments. This is an invaluable contribution in fifteen of the fifty-five countries where trachoma is endemic.

Children can be taught by parents, teachers, or health workers to keep their faces clean, and the plethora of flies can be reduced by maintaining a sanitary environment using methods that are taken for granted in the developed world.

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