Lessons learned in the implementation of programmes to eliminate trachoma within conflict zones

Eliminating trachoma as a public health problem requires inclusive actions for all people living in endemic areas.

In places where there is armed conflict, the strategy for approaching populations and implementing activities requires special precautions to be taken, but above all a situational analysis on a case-by-case basis. Not all contexts are the same. Indeed, when a group of people in general decide to take up arms and entrench themselves, it is to conquer or destabilise power. Various reasons may be given, including social injustice, corruption, oppression, dictatorship, poor distribution of national wealth and nepotism on the part of those in power; in short, bad governance. Alternatively, they may have less obvious motives, such as the exploitation of natural resources for themselves or for the benefit of other groups or powers to whom they give allegiance.¹ These two categories of people, fairly well organised and structured, with different aspirations, will behave in different ways to the communities and health workers in the field.¹