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developing countries treatment eye pain disfigurement antibiotics community phobia crowded inflammation inequality visual impairment behavioral change families urban vulnerable people itching facial cleanliness economic burden eye infections women family isolation facewashing schools preventable socioeconomic blindness impoverished face vision loss screening women and children healthcare access challenges impact assessment facilities access itchy neglect community health workers health development trichiasis interventions sanitation inadequate sanitation disability accessibility eyelid trachomatous trichiasis infrastructure outreach corneal health education global hygiene risk trachoma humiliation water scarcity discrimination intervention resources stigma poverty diagnosis scarring who eyelid surgery awareness vision impairment redness flies remote cycloplegia infection control surgery prevention trachomatous progress public health campaigns elimination face-washing impact ngos risk factors support cornea empowerment endemic ngo world health organization eyes suffering sight improvement fly control rural hygiene promotion eye care hope public health impairment corneal scarring children complications low-income bacterial social barriers eyelids prevalence healthcare behavior epidemic program inclusion water vision neglected face washing conjunctiva eye drops campaigns advocacy ulcer partnerships global health trachiasis eyelashes access to clean water neglected tropical disease education training eye