ABOUT THE SPEAKER
Caroline Harper - Advocate for visually impaired people
At Sightsavers, an international NGO, Caroline Harper leads efforts to eliminate avoidable blindness around the world and fight for equal rights.

Why you should listen

Dr. Caroline Harper's ultimate goal is to see herself out of a job. She runs Sightsavers, an organization with global offices that strives to eliminate avoidable blindness and ensure that people with disabilities have equal rights. Up to 75 percent of sight loss can be cured or prevented, and her team hopes to achieve their goals so spectacularly that the organization is no longer needed. 

Harper worked in the gas industry until 2002, before co-founding a management business that specialized on turnaround sales of energy companies. But during what she describes as a mid-life gap year, she visited a number of developing countries and felt drawn to international development. "My own family has a lot of blindness, so the mission of Sightsavers really resonated for me," she said. "I have now been its CEO for 13 years, and every year something more incredible happens. The best moments are when I visit some of the countries where we work, sit with people in their communities and realize that what we do has a massive impact. I am so lucky."

Harper is a Commander of the Order of the British Empire (CBE) for her work to protect the sight of people in developing countries. Sightsavers works with a range of partners and is supported by organizations such as The Queen Elizabeth Diamond Jubilee Trust and UK aid through the UK government's Department for International Development.

More profile about the speaker
Caroline Harper | Speaker | TED.com
TED2018

Caroline Harper: What if we eliminated one of the world's oldest diseases?

Filmed:
1,399,900 views

Thousands of years ago, ancient Nubians drew pictures on tomb walls of a terrible disease that turns the eyelids inside out and causes blindness. This disease, trachoma, is still a scourge in many parts of the world today -- but it's also completely preventable, says Caroline Harper. Armed with data from a global mapping project, Harper's organization Sightsavers has a plan: to focus on countries where funding gaps stand in the way of eliminating the disease and ramp up efforts where the need is most severe. Learn more about their goal of consigning trachoma to the history books -- and how you can help. (This ambitious idea is part of The Audacious Project, TED's initiative to inspire and fund global change.)
- Advocate for visually impaired people
At Sightsavers, an international NGO, Caroline Harper leads efforts to eliminate avoidable blindness around the world and fight for equal rights. Full bio

Double-click the English transcript below to play the video.

00:13
I'd like you to imagine,
just for a moment,
0
1380
3238
00:16
that your eyelashes grew inwards
instead of outwards,
1
4642
5054
00:21
so that every time you blinked,
2
9720
2301
00:24
they would scrape
the front of your eyeballs,
3
12045
3096
00:27
damaging the corneas,
4
15165
1777
00:28
so that slowly and painfully,
you went blind.
5
16966
3720
00:33
Well, that's what happens
to a person who has trachoma.
6
21307
3810
00:37
Now, this little boy here, Pamelo,
from Zambia, he has trachoma.
7
25607
5169
00:42
And if we don't do anything,
he's going to go blind.
8
30800
3443
00:46
Trachoma is a curious disease.
9
34700
2192
00:48
It's a bacterial infection
that's passed from person to person
10
36916
4160
00:53
and by flies.
11
41100
1421
00:55
The repeated infection
will scar your eyelids
12
43057
3814
00:58
so that they contract
and they turn inside out.
13
46895
4318
01:03
It particularly affects women,
14
51879
1912
01:05
because they have
the contact with children.
15
53815
2356
01:08
So what you'll often see
in places like Ethiopia
16
56569
3524
01:12
are girls who have tweezers
like this around their necks,
17
60117
4728
01:16
and they use them
to pluck out their eyelashes.
18
64869
3117
01:20
But of course, that only gives them
temporary respite,
19
68482
2644
01:23
because they just grow back
more vicious than before.
20
71150
3559
01:27
There are around two million
people in the world
21
75538
4078
01:31
who are blind or visually impaired
because of trachoma.
22
79640
3063
01:35
And we believe there may be
as many as 200 million people
23
83283
4342
01:39
who are at risk.
24
87649
1150
01:41
Now, it's a very old disease.
25
89418
2285
01:44
What you can see is a photo
of a wall of a tomb in Northern Sudan.
26
92188
5108
01:49
A colleague and I were traveling
in a very remote village,
27
97855
2972
01:52
and we asked an old man
to take us down into a little tomb.
28
100851
3537
01:56
Now, on the wall, we saw two eyes.
29
104955
2850
01:59
One is crying,
30
107829
1316
02:01
and you can see
there are tweezers next to it.
31
109169
2588
02:04
Simon said to me, "My God,
do you think that's trachoma?"
32
112127
3515
02:08
So we sent this picture
to the British Museum,
33
116103
3066
02:11
and they confirmed that, yes,
this is trachoma.
34
119523
2931
02:14
So, thousands of years ago,
35
122879
2285
02:17
the ancient Nubians
were painting pictures of trachoma
36
125188
3826
02:21
on the walls of their tomb.
37
129038
1864
02:22
And the tragedy is
38
130926
2000
02:24
that disease is still rampant
in that area today.
39
132950
3322
02:28
And the crazy thing is,
we know how to stop it.
40
136980
3549
02:33
And what's great is that the trachoma
community have all come together
41
141171
4877
02:38
to pool their efforts.
42
146072
1765
02:40
We don't compete; we collaborate.
43
148157
3142
02:43
I have to tell you,
that's not always the case
44
151712
2204
02:45
in my experience in the NGO world.
45
153940
2614
02:50
We've created something
46
158149
1823
02:51
called the International Coalition
for Trachoma Control.
47
159996
3797
02:56
And together, we've developed
a strategy to fight it.
48
164298
3924
03:00
This strategy is called the SAFE strategy,
49
168719
2945
03:03
and it's been approved
by the World Health Organization.
50
171688
3333
03:07
The "S" stands for "surgery."
51
175434
2364
03:10
It's very straightforward procedure
52
178292
2031
03:12
to turn the eyelids back the right way.
53
180347
2363
03:15
We train nurses to do it,
54
183141
2000
03:17
and they use local anesthetics.
55
185165
2047
03:19
And as you can see, you can do it
in somebody's front porch, if need be.
56
187236
4555
03:24
Then "A" stands for "antibiotics."
57
192688
2769
03:27
These are donated by Pfizer,
58
195982
2778
03:30
who also pay for those drugs
to be transported to the port in-country.
59
198784
4960
03:35
From there, they're taken to the villages,
60
203768
3286
03:39
where hundreds of thousands
of community volunteers
61
207078
4817
03:43
will distribute those drugs to the people.
62
211919
3032
03:47
Now, we train those volunteers,
63
215696
2437
03:50
and we also help the ministries
with all that complex logistics.
64
218157
4064
03:54
And every one of those volunteers
has a pole like this.
65
222819
4837
04:00
It's called a "dose pole."
66
228526
1734
04:02
This one's from Cameroon.
67
230606
1666
04:04
And you can see it's marked
different colors,
68
232759
2430
04:07
and you can tell how many pills
you should give somebody,
69
235213
3570
04:10
based on how tall they are.
70
238807
1800
04:14
"F" stands for "face washing."
71
242442
2439
04:17
Now, we used to have trachoma
in the UK and in the US.
72
245498
3698
04:21
In fact, President Carter,
73
249220
1992
04:23
he talks about how trachoma
was a real problem in Georgia
74
251236
3817
04:27
when he was a little boy.
75
255077
1525
04:29
And in the UK, the famous
eye hospital, Moorfields,
76
257046
3983
04:33
was originally a trachoma hospital.
77
261053
2267
04:36
What we do is teach kids like this
how important it is to wash their faces.
78
264039
5847
04:42
And finally, "E" stands for "environment,"
79
270976
3000
04:46
where we help the communities
build latrines,
80
274000
2880
04:48
and we teach them to separate
their animals from their living quarters
81
276904
3849
04:52
in order to reduce the fly population.
82
280777
2600
04:56
So we know how to tackle the disease.
83
284190
3277
04:59
But we need to know where it is.
84
287491
2269
05:01
And we do,
85
289784
1374
05:03
because a few years ago,
Sightsavers led an incredible program
86
291182
4603
05:07
called the Global Trachoma
Mapping Project.
87
295809
2872
05:11
It took us three years,
88
299158
2305
05:13
but we went through 29 countries,
89
301487
3353
05:16
and we taught local health workers
to go district by district,
90
304864
5048
05:21
and they examined the eyelids
of over two and a half million people.
91
309936
5023
05:27
And they used Android phones
in order to download the data.
92
315380
3917
05:31
And from that, we were able to build a map
93
319776
2777
05:34
that showed us where the disease was.
94
322577
2524
05:37
Now, this is a very high-level map
95
325125
2422
05:39
that shows you which countries
had a problem with trachoma.
96
327571
3785
05:43
And you may ask me,
"Well, does this strategy actually work?"
97
331380
3831
05:47
Yes, it does.
98
335634
1190
05:49
This map shows you the progress
that we've made to date.
99
337426
3353
05:52
The green countries believe
they've already eliminated trachoma,
100
340803
4072
05:56
and they have either been through
or are in the process of
101
344899
2984
05:59
having that validated by the WHO.
102
347907
2711
06:02
Countries in yellow
have the money they need,
103
350642
2627
06:05
they have the resources
to eliminate trachoma.
104
353293
3270
06:08
And some of them are really nearly there.
105
356937
2477
06:11
But the red countries,
they don't have enough funding.
106
359795
3079
06:14
They cannot eliminate trachoma
unless they get more.
107
362898
3365
06:18
And we're quite concerned, though,
that the progress to date may stall.
108
366721
4386
06:23
So when we were talking
to the Audacious ideas guys,
109
371857
4777
06:28
we asked ourselves:
110
376658
1786
06:30
If we really, really pushed ourselves
over the next four or five years
111
378468
4468
06:34
and we had the money,
112
382960
1833
06:36
what do we think we could achieve?
113
384817
2047
06:39
Well, we believe
that we can eliminate trachoma
114
387523
4849
06:44
in 12 African countries
115
392396
2420
06:47
and across the Americas
116
395245
3176
06:50
and all across the Pacific.
117
398445
2252
06:53
And we can make significant progress
118
401150
3022
06:56
in two countries which have
the highest burden of the disease,
119
404196
3795
07:00
which is Ethiopia and Nigeria.
120
408015
2770
07:03
And in doing all of that,
121
411237
2072
07:05
we can leverage more than two
billion dollars' worth of donated drugs.
122
413333
5682
07:11
(Applause)
123
419039
6214
07:17
Now, this map here shows you
the impact that we'll have --
124
425277
2776
07:20
look how many countries are going green.
125
428077
2318
07:22
And there, you can see progress
in Ethiopia and Nigeria.
126
430419
3048
07:25
Now, yes, there are some countries
that are still red.
127
433491
2921
07:28
These are mainly countries
which are in conflict --
128
436436
2801
07:31
places like Yemen, South Sudan --
where it's very difficult to work.
129
439261
3789
07:35
So, we have the team,
the strategy and the map.
130
443555
4785
07:40
And we also have the relationships
with the governments
131
448364
4072
07:44
so that we can make sure
that our program is coordinated
132
452460
3902
07:48
with other disease-control programs,
133
456386
2287
07:50
so that we can be efficient.
134
458697
1867
07:53
Wouldn't it be amazing
if we could do this?
135
461449
4231
07:57
We'd have trachoma on the run.
136
465704
2254
07:59
We would be on the home straight
137
467982
2335
08:02
to eliminate this disease
from the whole world.
138
470341
3374
08:06
But before I finish,
I just want to share with you
139
474800
2913
08:09
some words from
the founder of Sightsavers,
140
477737
2503
08:12
a guy called Sir John Wilson.
141
480264
2283
08:14
Now, he was blinded at the age of 12.
142
482571
2393
08:16
And he said,
143
484988
1297
08:18
"People don't go blind by the million.
144
486309
2600
08:21
They go blind one by one."
145
489468
2698
08:24
And in the excitement of being able to say
146
492658
2544
08:27
we've got rid of trachoma
for the whole country,
147
495226
3424
08:30
let's not forget that, actually,
this is a devastating disease
148
498674
4619
08:35
that destroys the lives
of individual people.
149
503317
3038
08:39
People like Twiba.
150
507156
1501
08:40
Now, I met Twiba last year in Tanzania.
151
508681
2600
08:43
She had had trachoma
for as long as she could remember.
152
511618
3245
08:46
And a couple of months before I met her,
she'd had the operation.
153
514887
3406
08:50
It's no exaggeration to say
154
518660
2474
08:53
that this had totally
transformed her life.
155
521158
3293
08:57
We'd saved the sight that she had left,
and she was free of pain.
156
525198
3983
09:01
She could sleep.
157
529515
1532
09:03
She could work, she could socialize.
158
531071
2158
09:05
And she said to me,
159
533848
1300
09:08
"I have my life back."
160
536222
1888
09:10
And it was impossible
not to be moved by her story.
161
538587
3466
09:14
But there are so many Twibas.
162
542445
2317
09:16
I want to find all the Twibas,
163
544786
2540
09:19
and I don't want anyone
to go blind in agony anymore.
164
547350
3272
09:23
Now, you know, there are so many
intractable problems in this world.
165
551138
5165
09:29
But this is not one of them.
166
557333
1720
09:31
This is something that we can solve.
167
559602
2952
09:34
And we can ensure
168
562983
1500
09:36
that kids like this can grow up
free from the fear of trachoma.
169
564507
5268
09:42
So, for the sake of kids like this,
170
570261
3365
09:45
and for the sake of people like Twiba,
171
573650
2387
09:48
let's get rid of trachoma.
172
576849
2503
09:52
Do you think we can?
173
580391
2111
09:55
Well, yeah, if we really, really want to.
174
583010
2667
09:58
Yes, we can.
175
586121
1486
10:00
So thank you.
176
588060
1167
10:01
(Applause)
177
589251
5507

▲Back to top

ABOUT THE SPEAKER
Caroline Harper - Advocate for visually impaired people
At Sightsavers, an international NGO, Caroline Harper leads efforts to eliminate avoidable blindness around the world and fight for equal rights.

Why you should listen

Dr. Caroline Harper's ultimate goal is to see herself out of a job. She runs Sightsavers, an organization with global offices that strives to eliminate avoidable blindness and ensure that people with disabilities have equal rights. Up to 75 percent of sight loss can be cured or prevented, and her team hopes to achieve their goals so spectacularly that the organization is no longer needed. 

Harper worked in the gas industry until 2002, before co-founding a management business that specialized on turnaround sales of energy companies. But during what she describes as a mid-life gap year, she visited a number of developing countries and felt drawn to international development. "My own family has a lot of blindness, so the mission of Sightsavers really resonated for me," she said. "I have now been its CEO for 13 years, and every year something more incredible happens. The best moments are when I visit some of the countries where we work, sit with people in their communities and realize that what we do has a massive impact. I am so lucky."

Harper is a Commander of the Order of the British Empire (CBE) for her work to protect the sight of people in developing countries. Sightsavers works with a range of partners and is supported by organizations such as The Queen Elizabeth Diamond Jubilee Trust and UK aid through the UK government's Department for International Development.

More profile about the speaker
Caroline Harper | Speaker | TED.com