Importance of water in preventing blindness in indigenous populations: A pilot study exploring perceptions and knowledge of trachoma and facial hygiene of families in Chiapas, Mexico

Trachoma is a little known but serious disease that persists as the leading cause of preventable blindness in the world. Access to modern sanitation and adequate sources of water is crucial to preventing the spread of trachoma, particularly among indigenous communities that may lack the resources to implement complex surgical and antibiotic treatment programs. Facial hygiene has the potential to be among the most cost effective methods for reducing the risk of trachoma and preventing the progression of irreversible blindness in the population. A key element of proper facial hygiene is potable water, the lack of which tends to dominate resource-poor areas where trachoma thrives. Using structured interviews and through environmental assessment and day-long, in-depth observation, information was gathered concerning water availability and utilization, perceptions of facial hygiene and the role of water in hygienic practices, and knowledge and opinions of trachoma among indigenous families. In these communities, actual observed behaviors conflicted with interview findings. This study has implications for the success of future preventive efforts of the Trachoma Program in Chiapas, as well as those in similar regions. It is critical for public health nurses to understand the relationship dynamics of these indigenous families and communities, in order to apply this knowledge in the field to link cultural beliefs with disease prevention, and to influence local health policy initiatives to address the importance of clean water in these settings. Comprehensive observational studies should be conducted to expand knowledge of the basic cultural beliefs and hygiene routines of this population.