The 'ngisipet' and trachoma prevention: solving the latrine problem in nomadic tribes.

There is a global commitment to eliminate trachoma by 2020.1 Many different governmental and non-governmental agencies, in conjunction with industry, are working hard to achieve this aim. It relies on implementing the whole SAFE strategy: surgical treatment for trichiasis (S), widespread distribution of antibiotics (A), face-washing with other hygiene measures (F), and environmental improvement (E). A clean, reliable water supply is vital to this process. Equally important is changing the defecation habits of many tribal people, as this will decrease the number of flies that carry the disease. It is thought that the principal carrier of trachoma, Musca sorbens, lays its eggs mostly on human faeces lying exposed on soil and not on excreta of other species or on human faeces in latrines.2 The World Health Organization recommendation is to use either latrines or what is referred to as ‘ventilation-improved pits’.3 However, for nomadic tribes, these present various disadvantages, the most obvious being: