This article is part of HuffPost’s Project Zero campaign, a yearlong series on neglected tropical diseases and efforts to fight them.
ASILONG, Kenya ― Before her eye troubles began, Selina Chepserum was a skilled harvester of termites. In the few days after the seasonal rains, she would stand at the bottom of massive termite mounds, catching the insects as they swarmed down the knobbled orange totems, across a stick lattice trap, and into her cup.
Chepserum could haul around 100 pounds of giant termites, stashed in twitching sacks. She would sell the bulk of them to add to her family’s small farming profits and use the rest to make protein-rich dishes that fed them during the dry months in this remote and arid part of northwestern Kenya.
Selina Chepserum nearly lost her sight to trachoma several years ago. Here, she stands in front of a termite mound, ready to harvest insects for food. (Photo: Hannah McNeish)
She prepared sugared termites, honeycombed termites, and a kind of salty termite pesto to add to the staple cornmeal, or ugali, dish. Chepserum peddled cups of raw insects for 20 Kenyan shillings (about 20 cents) to people living around her village of Asilong in West Pokot County.
But all this stopped about 10 years ago, when Chepserum’s eyelashes started growing into her eye, causing stabbing pain and destroying her vision as they scraped at her cornea.
“I felt something rubbing against my eye, and when I tried to get it out, I couldn’t,” said Chepserum, who estimates her age to be about 55.
The swelling, weeping and scarring of her eyes got so bad that Chepserum could no longer make out the face of the person sitting next to her, let alone collect bugs from the towering termite mounds dotting her land. She could neither kindle a cooking fire nor tend to her crops, chickens and goats.
“I felt so bad, like there was no need for me to be alive because I couldn’t do the smallest thing for myself,” Chepserum said.
She had contracted trachoma, a bacterial eye infection that blinds one person every 15 minutes. The leading infectious cause of blindness worldwide, trachoma affects over 100 million people in 57 countries. The diseaseis common in hot, dusty areas that lack clean water and is transmitted by human contact or by flies that pick up the discharge it causes in people’s eyes. Women, who tend to be caregivers and are therefore more at risk of coming into contact with trachoma, are twice as likely to go blind from it.
Africa is particularly blighted by the disease. In Kenya, trachoma is thought to be the second leading cause of blindness after cataracts ― but while cataracts affect mostly older people, trachoma also can strike the relatively young.
Though the disease causes irreversible blindness, it is fully preventable and treatable with antibiotics or, in more severe cases, surgery performed under local anesthetic.In areas like the one where Chepserum lives, however, surgery isn’t always available. Though awareness of the disease is growing, there may not be doctors in remote villages who can tell sufferers how to care for their trachoma.
Chepserum lives in an arid part of western Kenya, where she relies on basic subsistence farming. As her eyesight began to fail, she could no longer easily feed herself and her family (Photo: Zoe Flood)
Chepserum, who suffered for yearsbefore finding proper treatment, would spend her days waiting for children to come and assist her, or crying out for anyone to yank out her eyelashes and give her some relief from the pain. In the absence of proper medical care, she turned to a controversial folk remedy that involves someone yanking out the affected eyelashes.
When friends and family were not around, Chepserum would pay whoever she could find either 100 shillings (around $1) or a few pounds of corn to extract her eyelashes using their fingers and an ash-coated nail.
“It’s a painful process,” she noted. “They have to make sure that all the hair growing inside my eye comes out. But within a short time, maybe three days or a week, you feel them coming back.”
After a plucking session, Chepserum’s eyes would be full of discharge and so sensitive that she would have to cover her face with a scarf. But at least she could enjoy a brief sense of relief from the stabbing pains she knew would soon return.
Finally, in 2014, she got help from Michael Makari, a doctor from a hospital located an hour’s drive down dusty dirt tracks lined with thorn bushes. Makari roams the poor countryside treating people with trachoma. The Fred Hollows Foundation, an Australian charity, funds this work, allowing him to find patients like Chepserum.
“The bacteria first causes inflammation, and after that the lid will be scarred and turn inward, so the lashes keep scarring the cornea,” Makari explained.
He advised Chepserum to keep her face clean and recommended surgery to stop the damage to her cornea.
To fix the lashes, Makari said, a surgeon flips the affected lid inside out and stitches it in place so the lashes point in the right direction.
The Fred Hollows Foundation pays doctors about $30 a day to perform surgeries on patients. Otherwise, says Makari, sufferers would have to pay about $90 to cover the cost of the surgical tools and a weeklong hospital stay ― a cost that was well out of Chepserum’s budget.
During a recent follow-up, Makari checked Chepserum’s eyes as she sat in the shade of a tree outside her conical hut. He put in some eyedrops before declaring his satisfaction with her recovery and expressing relief that she is no longer having her lashes plucked.
Dr. Michael Makari applies eyedrops to Chepserum’s eyes during a follow-up visit. Makari has performed basic surgeries on trachoma sufferers in this remote area of Kenya, helping people like Chepserum to see again. (Photo: Zoe Flood)
“Sometimes if you walk around, you see the forceps hanging around for pulling the eyelashes,” he said.
Makari added that plucking hairs can worsen the condition, causing inward-growing lashes to eventually turn further inward.
Today, plucking is mostly practiced among older people, and education about treatment for this blinding disease is increasing in Kenya.
Africa overall is taking major steps forward in the fight against trachoma, which is remarkable given that the World Health Organization considers the disease to be severely underfunded and ignored.
Last year, over 200,000 people in 27 African countries received surgery for inward-facing lashes ― that’s 95 percent of the surgeries performed worldwide. In addition, more than 83 million in Africa were treated with antibiotics, accounting for 97 percent of all antibiotic treatments for the disease worldwide, per the WHO.
For Chepserum, the surgery saved one of her eyes, letting her return to her daily routines, for the most part. Her days of harboring a death wish are well behind her.
“The things I am happy about seeing are my children and grandchildren, and seeing how my farm is doing,” she said.
She’s also pleased that she can once again “look for food for the family,” she added, before going to fetch a cup and arranging twigs at the foot of a nearby termite mound to demonstrate how she will make her family protein-rich again.
Chepserum prepares to catch termites from a towering termite mound near her home. (Photo: Hannah McNeish)
Also on HuffPost
Lymphatic Filariasis
Lymphatic filariasis, more commonly known as elephantiasis, is a leading cause of disability worldwide, according to the U.S. Centers for Disease Control and Prevention. It affects over 120 million people globally and can cause severe swelling of body parts, including the legs and scrotum. While people are usually infected in childhood, the painful, disfiguring symptoms of the disease only show up later in life.
Onchocerciasis
Onchocerciasis, commonly known as river blindness, is an eye and skin disease that can cause severe itching and visual impairment ― including blindness. Around 18 million people are infected. Of those, over 6.5 million suffer from severe itching, and 270,000 are blind. The disease is caused by a parasitic worm, transmitted through bites from infected blackflies. The worm can live for up to 14 years in the human body, and each adult female worm can be more than 1.5 feet long.
Chagas
Chagas disease is a potentially life-threatening illness. In the first months after infection, symptoms are mild, including skin lesions and fever. But in its second, chronic phase, up to 1 in 3 patients develop cardiac disorders, which can lead to heart failure and sudden death. The disease is transmitted to humans by “kissing bugs,” which live in the walls or roof cracks of poorly constructed homes in rural areas, according to the World Health Organization. Of the estimated 6 million to 7 million people affected worldwide, most live in Latin America, but the disease has also spread to the United States. Around 300,000 people in the U.S. have Chagas disease, according to the Dallas Morning News.
Dengue
Dengue is a flu-like illness that can sometimes be lethal. In 2015, more than 2 million cases of dengue were reported in the Americas. In some Asian and Latin American countries, “severe” dengue is a leading cause of serious illness and death among children. Dengue is spread by the Aedes aegypti mosquitoes, the same type of insect that transmits Zika. To reduce the risk of bites, WHO recommends covering water containers, using insecticide, having window screens and wearing long sleeves.
Human African Trypanosomiasis
Human African trypanosomiasis, commonly known as sleeping sickness, is a chronic infection that affects the central nervous system. People can be infected for years without signs, but in the second stage, patients can suffer behavior changes, hallucinations and even slip into a coma and die. Many people affected live in remote, rural areas that don’t have easy access to quality health services. This makes diagnosis and treatment more difficult. WHO has identified sleeping sickness as a disease that could be eliminated worldwide by 2020 if the right resources are dedicated to it.
Leishmaniasis
There are several forms of leishmaniasis, including visceral, which can be fatal, with symptoms including fever and weight loss; and cutaneous, the most common form, which causes skin lesions, leaving lifelong scars and disability. The disease, spread by sandflies, affects some of the poorest people on earth, according to WHO, and is associated with malnutrition and poor housing. Around 1 million new cases occur annually, causing 20,000 to 30,000 deaths. Leishmaniasis is climate-sensitive, affected by changes in rainfall, temperature and humidity ― which means it could be exacerbated by global warming.
Trachoma
Trachoma is an eye disease, which if untreated, can cause irreversible blindness. It causes visual impairment or blindness in 1.9 million people, per WHO. The disease is present in poor, rural areas of 42 countries in Africa, Latin America, Asia and the Middle East ― but Africa is the most affected.
Rabies
Rabies is almost always fatal once symptoms show up. Initial symptoms are fever and tingling around the wound. As the virus spreads, people with “furious” rabies become hyperactive and die by cardiac arrest; people with “paralytic” rabies become paralyzed, fall into a coma and die. Transmitted by pet dogs, rabies causes tens of thousands of deaths every year. The disease is present on all continents except Antarctica ― but more than 95 percent of human deaths due to it occur in Asia and Africa. It is a neglected disease primarily affecting poor populations, where vaccines are not readily available.
Leprosy
Leprosy is a chronic disease, which when untreated can cause permanent damage to the skin, nerves, limbs and eyes. There were 176,176 cases at the end of 2015, according to WHO. While the stigma associated with the disease means people are less likely to seek treatment, leprosy is curable, and treatment early on can avoid disability. Leprosy was eliminated as a public health problem in 2000 ― meaning there is now less than one case for every 10,000 people worldwide.
Schistosomiasis
Schistosomiasis is a chronic disease that causes gradual damage to internal organs. Symptoms include blood in urine, and in severe cases, kidney or liver failure, and even bladder cancer. Around 20,000 people die from it each year. Transmitted by parasites in infested water, the disease largely affects poor, rural communities in Africa that lack access to safe drinking water and sanitation. “[People] get it as kids bathing in water,” Sandrine Martin, a staff member for the nonprofit Malaria Consortium in Mozambique, told HuffPost. “But the symptoms, like blood in the urine, only develop later ― and then people tend to hide it because it’s in the genital area.”
Chikungunya
Chikungunya is a disease that causes fever and severe joint pain, according to WHO. While it is rarely fatal, it can be debilitating. Since 2004, it has infected more than 2 million people in Asia and Africa. There is no cure for the disease, which is transmitted to humans by infected mosquitoes. The name comes from a word in the Kimakonde language, spoken in some areas of Mozambique and Tanzania, that means “to become contorted” ― a nod to the hunched-over position of people who are affected with joint pain.
Echinoccosis
Echinoccosis is a parasitic disease that leads to cysts in the liver and lungs. While it can be life-threatening if untreated, even people who receive treatment often have a reduced quality of life, according to WHO. Found in every continent except Antarctica, the disease is acquired by consuming food or water contaminated with tapeworm eggs, or through direct contact with animals who carry it, such as domestic dogs or sheep.
Foodborne Trematodiases
Foodborne trematodiases can cause severe liver and lung disease, and on rare occasions death. Most prevalent in East Asia and South America, the disease is caused by worms that people get by eating raw fish, shellfish or vegetables that have been infected with larvae. While early, light infections can be asymptomatic, chronic infections are severe.More than 56 million people were infected with foodborne trematodes, and over 7,000 people died in 2005, the year of WHO’s most recent global estimate.
Buruli Ulcer
Buruli ulcer is a skin infection caused by bacteria that often starts as a painless swelling, but without treatment, it can lead to permanent disfigurement and disability. In 2014, 2,200 new cases were reported, with most patients under age 15. The exact mode of transmission is still unknown. The majority of cases, if detected early enough, can be cured with antibiotics.
Yaws
Yaws is a chronic, disfiguring childhood infectious disease. Affecting skin, bone and cartilage, the symptoms show up weeks to months after infection and include yellow lesions and bone swelling. More than 250,000 cases of yaws were reported from 2010 to 2013, WHO told HuffPost. A lack of clean water and soap for bathing contributes to its spread. Only 13 countries are known to still have cases of yaws, including Ghana, Papua New Guinea and Solomon Islands.
Soil-Transmitted Helminth
Soil-transmitted helminth infections are among the most common infections worldwide and affect the poorest communities. People are infected by worms transmitted by human feces contaminating soil in areas with poor sanitation. People with light infections usually have no symptoms. Heavier infections can cause diarrhea, abdominal pain, general weakness and impaired cognitive development. Depending on the number of worms, it can lead to death. Up to 2 billion people are infected worldwide, according to WHO. But because infections can be light, not all patients suffer, WHO’s Ashok Moo told HuffPost.
Taeniasis
Taeniasis is an intestinal infection caused by tapeworms, which mostly causes mild symptoms, such as abdominal pain, nausea, diarrhea or constipation. But if larvae infect the brain, causing neurocysticercosis, the disease can cause epileptic seizures and can be fatal. People get it by eating raw or undercooked infected pork. The ingested tapeworm eggs develop into larvae and migrate through the body. Taeniasis is underreported worldwide because it is hard to diagnose in areas with little access to health services, according to the CDC.
Guinea Worm
Guinea worm is a crippling disease that it is close to being eradicated. There were only 22 human cases reported in 2015, according to WHO ― down from around 3.5 million cases in 21 countries in the mid-1980s. The disease is usually transmitted when people with limited access to quality drinking water swallow stagnant water contaminated with parasites. About a year after infection, a painful blister forms ― most of the time on the lower leg ― and one or more worms emerge, along with a burning sensation. It is rarely fatal, but can debilitate infected people for weeks. The Carter Center, founded by former President Jimmy Carter and his wife, has been instrumental in efforts to eradicate the disease.
Clark set the Indiana Fever’s franchise record for turnovers (10), shot 5-of-15 from the floor and struggled with the Connecticut Sun’s physical defense.
Gottlieb's repeatedly courted controversy in his media role and will reportedly continue to host his nationally syndicated radio show while coaching Green Bay.
All five of these hitters were drafted highly in fantasy baseball leagues. So far, they have not lived up to their ADPs — and that's an understatement. Scott Pianowski analyzes.
In one scenario, Dallas makes Prescott the highest paid player in NFL history. In another, the Cowboys decline that commitment, at which point another team will make him the top paid player in NFL history.
Budgeting apps can help you keep track of your finances, stick to a spending plan and reach your money goals. These are the best budget-tracking apps available right now.
A year ago, Usyk would have been at least a 2-1 underdog in this fight. But with these little hints of Fury on the decline all while Usyk has continued his steady march toward heavyweight domination, those odds have shifted.
![Schistosomiasis is a chronic disease that causes gradual damage to internal organs. Symptoms include <a href="http://www.who.int/mediacentre/factsheets/fs115/en/" target="_blank">blood in urine</a>, and in severe cases, kidney or liver failure, and even bladder cancer. Around 20,000 people die from it each year. Transmitted by parasites in infested water, the disease largely affects poor, rural communities in Africa that lack access to safe drinking water and sanitation. “[People] get it as kids bathing in water,” Sandrine Martin, a staff member for the nonprofit <a href="http://www.malariaconsortium.org/pages/who_we_are.htm" target="_blank" data-saferedirecturl="https://www.google.com/url?hl=en&q=http://www.malariaconsortium.org/pages/who_we_are.htm&source=gmail&ust=1480609103751000&usg=AFQjCNG03VPF1XL5zli4__XAjDWpDmBOvw">Malaria Consortium</a> in Mozambique, told HuffPost. “But the symptoms, like blood in the urine, only develop later ― and then people tend to hide it because it’s in the genital area.”](https://s.yimg.com/ny/api/res/1.2/9f9As.sw0iNn_ENR93iBhA--/YXBwaWQ9aGlnaGxhbmRlcjt3PTk2MA--/https://img.huffingtonpost.com/asset/5845a09e1700002500e7dd42.jpg)
