In Kaluwapur, a farming village a few miles north of Geta, Bilando Rana, 63, who is not related to Mr. Rana, had her eyelids re-inverted five years ago at one of the “eye camps” the hospital set up in a local schoolhouse.

“For about three months, I couldn’t work in the fields or cook food for the children because of the pain,” she said. “I knew it was something our healer couldn’t fix.”

Instead of fighting traditional healers, Mr. Raman said, the program has offered them training in recognizing the signs of trachoma in the hopes that they will refer people to the camps or clinics.

Nepalis have even accepted outhouses, a significant accomplishment because rural people often have difficulty breaking their most personal habits.

Twenty years ago, Mr. Raman said, he worked for a charity that built 50 houses, all with latrines, for flood victims. A year later, he said, 47 of the latrines were being used to store firewood or shelter goats.

Ms. Rana said her family dug an outhouse eight years ago after local officials encouraged everyone in her village to do so.

Encouragement includes both carrots and sticks, Mr. Raman said. Local leaders can earn fancy certificates declaring their villages “open-defecation-free.” But they may also be threatened with the loss of services like road repair if latrines are not built.