Pakistan

Current Status: Transmission stopped, 1993
Certification of Dracunculiasis Elimination: 1997

Current Guinea worm case reports >

At the personal urging of former President Carter and through the help of The Carter Center and the U.S. Centers for Disease Control and Prevention, Pakistan became one of the first nations to establish a Guinea Worm Eradication Program in 1986. A nationwide survey conducted the following year estimated 2,400 cases in 408 villages in the North West Frontier, Punjab, and Sindh provinces. Within seven years, Pakistan had stopped Guinea worm disease transmission.

In Pakistan, volunteer community health workers were recruited and trained to detect, record, and report cases. The volunteers distributed nylon water filters and conducted health education on their use and care; and they also provided first aid care to individuals with emerging Guinea worms.

In the endemic areas of the North West Frontier province, where brackish water from underground sources was undrinkable, residents used household cisterns to harvest rainwater throughout the residential compound. These cisterns extended below ground level, and the water supply easily was contaminated by residents infected with Guinea worm.

In 1991, a cash reward system was implemented to induce people to report Guinea worm cases and follow case containment procedures. The program also established a national registry of potential cases and ensured that program staff promptly investigated all claims of cases of the disease.

In 1993, Pakistan made history by becoming the first Carter Center-assisted nation to stop transmission of Guinea worm disease.

Pakistan was honored at a special ceremony at The Carter Center in Atlanta in 2000 for having stopped Guinea worm disease transmission.

The World Health Organization certified Pakistan free of Guinea worm disease in 1997.

The Carter Center and an independent partner, the Task Force for Child Survival and Development, worked in the 1980s in Pakistan to reduce the incidence of neonatal tetanus or lockjaw. Caused by a toxin called Clostridium tetani, maternal and neonatal tetanus is contracted during birthing procedures and is a primary cause of infant death during the first seven days of life in many countries.

The Carter Center, in collaboration with government and local health professionals, studied the beliefs and practices of midwives, who are birth attendants and child care providers, to improve the education of mothers about the need for immunization. Studies also evaluated birthing techniques that might affect the risks of neonatal tetanus, such as unclean surgical instruments or the failure of midwives to wash their hands before performing deliveries.

The Carter Center also worked to improve collaboration among local ministry of health child survival staff and midwives to avoid or eliminate unsafe birthing and neonatal care practices, to establish antiseptic delivery methods, and to refer pregnant women and mothers with past histories of neonatal tetanus for immunizations to prevent contracting the disease again.