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The primary aim of the work reported here is to determine whether a low cost teaching approach which had been successfully used in one region of Tanzania (Tanga) could be introduced to other teachers in a different region by teachers, rather than outside experts. A second aim is to determine whether changes occurred in children's knowledge and behaviour and a third aim is to determine if the work was sustained.

The study was carried out in ten randomly selected schools in the Dodoma region, where there is a high prevalence rate of trachoma, with the teachers being taught active methods by colleagues from Tanga. Local staff from Helen Keller International had an input in teaching about trachoma itself. Data in the form of environmental, educational and clinical observations and were collected at the beginning, the end and during the programme and information on children's knowledge was obtained at the beginning and the end.

The results were encouraging in showing that teachers were effective in passing on their skills to other teachers, who in turn were enthusiastic in putting their new knowledge into practice. Equally encouraging was the way in which children's behaviour changed as well as their knowledge. A follow up four years later showed that the work has continued in all ten schools and has and spread to 27 others. Teaching on trachoma will be included in the new national curriculum for primary schools.

It is suggested that teachers should be considered as a significant part of any community based trachoma programme.