BACKGROUND:
The Australian government is a signatory to the World Health Organization’s resolution to eliminate trachoma (1) and has made a commitment to do this. As the only developed country to still have endemic trachoma (2), one Australian jurisdiction, Western Australia, has reoriented it’s key focus from screening and antibiotic dissemination within the WHO’s SAFE (Surgery; Antibiotics; Facial Cleanliness; Environmental change) Strategy, to the preventive strategies of facial cleanliness and environmental change.

METHODS:
All cases of trachoma occur in Australia’s very remote communities. To enable the shift to the F and E strategies, a program to upskill First Nations Environmental Health Workers (EHWs) was created. This program provides mentoring to enable the EHWs to enter remote community houses, identify risk factors for trachoma that prevent the ability to wash (functional health hardware), complete emergency plumbing fixes whilst in the house, and provide hygiene yarns and resources to promote facial cleanliness.

RESULTS:
Data collected from house visits across 29 very remote Western Australian communities will be presented to demonstrate the challenges associated with ensuring functional health hardware in remote homes, the scope of plumbing fixes carried out, and efforts to promote facial cleanliness in remote communities. Advocacy attempts to improve maintenance programs to these communities will be discussed.

CONCLUSIONS:
Australian First Nation communities located in very remote areas face significant disadvantages and do not have equitable access to services or housing maintenance programs. This presentation will demonstrate an innovative, co-designed preventive program, often through the use of photographs, to show how the SAFE strategy was upended to provide a critically important and sustainable public health program to reduce and hopefully, eliminate preventable trachoma in Western Australia.