Guinea Worm

Humans have known the searing pain of Guinea worm disease since ancient times, and the common treatment for the disease goes back centuries as well. It involves wrapping the worm around a stick or piece of gauze while gradually—but painfully—extracting it over several weeks. Emerging worms often cause secondary bacterial infection, and depending on where the worm is, there can be long-term paralysis.

On a human level, Guinea worm’s effects are painful and debilitating. On an economic level, they are disastrous. Infected children cannot attend school, and adults cannot farm or tend to their cattle. In Mali, Guinea worm is known as “the disease of the empty granary” because of the starvation it has caused.

Guinea worm disease is spread through water—more specifically, by the copepods that carry Guinea worm larvae. These tiny crustaceans—no more than a couple of millimeters long—thrive in the stagnant ponds and lakes that provide the only source of drinking water in many communities.

Filtering water through a simple mesh fabric, however, removes the copepods, rendering the water 100% Guinea worm free. Since the early 1990s, The Carter Center has worked closely with national health ministries to distribute millions of free filters, teach people how to use them properly and help residents understand the importance of water filtration. Although it hasn’t been easy, this low-tech intervention has prevented millions of cases of Guinea worm disease across sub-Saharan Africa and parts of Asia.

While the tools of Guinea worm eradication—a plastic tube or cloth filter—may seem simple, the process of eradication is anything but simple. It’s not enough to hand out filters or establish containment centers. People will only change their behavior if they understand the need for these interventions and are convinced of their value. That’s where education comes in.

Throughout sub-Saharan Africa, thousands of local volunteers have been trained not only to treat infection, but also to raise awareness and teach others about the disease. At the peak of the eradication effort, village volunteers were operating in more than 23,000 African villages. Because many people can’t read, workers get the message out in creative ways—through T-shirts, picture books, performances, radio broadcasts and visits from national leaders.

After decades of intense work, Guinea worm eradication is nearly complete. And yet the final push will be especially difficult. The last few cases will likely be found in some of the most remote and war-torn communities. But an eradication effort isn’t successful until it succeeds everywhere.

The remaining endemic areas are mostly insecure or conflict-ridden zones. Fighting in parts of South Sudan and northern Mali make it extremely difficult for health workers to move about freely and to provide necessary services. Refugees from war zones—in addition to the movements of nomadic populations—add to the challenges of tracking and containing new cases.

A more recent challenge is a large number of domesticated dogs in Chad contracting Guinea worm. In Chad’s fishing villages, dogs eat raw fish or fish guts carrying Guinea worm larvae and are infected, even though they are not the parasite’s natural host.

The global Guinea Worm Eradication Program has already prevented some 80 million cases of Guinea worm disease while educating and empowering people in thousands of communities. And by working closely with local and national health providers, the campaign has helped to strengthen the healthcare infrastructure in 21 African and Asian countries.

Where Guinea worm has been eliminated, adults can work without interruption and children attend school more regularly. Poverty has decreased, and productivity has gone up.