by Lauren Caldwell
This article, from AllAfrica.com, was originally published June 25, 2009, on America.gov.
Washington, D.C. - Guinea worm disease, which has crippled millions in Africa and Asia, is nearly vanquished in Ghana, thanks to the efforts of the Carter Center, which has been working with health workers in that country over the last 20 years.
People contract the disease by drinking water contaminated with Guinea worm larvae. The larvae grow in the body for about a year, reaching as much as a meter in length before exiting the skin through blistering sores. The only method of treatment is extraction of the worm, centimeter by centimeter, over several weeks. Victims feel excruciating pain; some are left crippled.
Communities suffer because victims cannot farm, attend school or care for their families. Often, the disease is spread when victims cool their wounds in water. When an emerging worm comes in contact with water, it releases thousands of eggs. Without education and treatment, the cycle of the disease continues.
When the Carter Center began its campaign in 1986, there were about 3.5 million cases of Guinea worm in 20 countries. Now, there are fewer than 5,000 cases in six countries - Sudan, Ghana, Mali, Ethiopia, Nigeria and Niger - and Guinea worm is likely to become the first disease to be eliminated without vaccines or medicines.
Ghana, the first nation targeted by the Carter Center's Guinea Worm Eradication Program in 1987, had 180,000 cases at that time. It had just 501 cases in 2008. With the effort of local volunteers and simple methods like water filtration and health education, the number of cases continues to drop.
Beginning the Campaign
The Carter Center is a nonprofit, nongovernmental organization established in 1982 by former U.S. President Jimmy Carter and his wife, Rosalynn. Its mission is "to wage peace, fight disease and build hope," said Donald Hopkins, a health expert at the center.
Before joining the Carter Center, Hopkins had lobbied heavily, with little success, for a program to eradicate Guinea worm disease. By presenting images of Guinea worm disease and describing how it could be prevented, Hopkins easily convinced former President Carter that the center could overcome the disease.
"The thought that goes through anyone's mind is, 'Why? Why is this preventable disease still there and causing this indescribable suffering?'" Carter said in a May 2007 interview with the Chicago Tribune newspaper.
When the Carter Center began its work in Ghana, the country was "economically in the doldrums," Hopkins said. "There was Guinea worm all over the place, especially in the north. It was horrific, painful, and severely impeding agricultural productivity."
The center partnered with Ghana's Ministry of Health to educate local volunteers about the disease. At first, efforts focused on digging wells for clean water, but that was expensive and did not prevent existing cases from spreading. Center officials focused on providing fine mesh filters to villagers so they could clean their own water. Volunteers also distributed chemicals to kill Guinea worm larvae and taught victims not to enter water, to prevent putting healthy neighbors at risk.
By 1994, these methods resulted in a 95 percent decrease in the number of cases. Ethnic fighting later that year threatened the eradication program, but now it is back on track.
"Ghana is closer than it's ever been" to a clean slate, Hopkins said. "After 12 years of stagnation, now they're having dramatic reductions again."
The Carter Center has not been alone in its efforts. Many U.S. organizations and government agencies work to eradicate Guinea worm disease, including the U.S. Centers for Disease Control and Prevention, the U.S. Agency for International Development and the Peace Corps. The United Nations Children's Fund, other organizations and several foreign governments have contributed as well.
Local Leaders
The responsibility for permanently ridding Ghana of the disease, said Andrew Seidu-Korkor, director of Ghana's Guinea Worm Eradication Program, lies mainly with one group: Ghanaian volunteers.
"To be effective, they need to be trained and supervised regularly, and this is where the [Ghanaian] health workers have played a significant role."
Village volunteers are supervised by Ghana's Ministry of Health and Carter Center technical assistants, who are mostly Ghanaians. They detect and manage cases, as well as educate communities about the disease.
Volunteers go door to door treating victims and teaching people to protect the water supply. Sometimes, volunteers distribute T-shirts with slogans like "Stop Guinea Worm Now, Ask Me How."
Famous Ghanaians are helping. Sheriff Ghale, a reggae artist from northern Ghana, encourages villagers with lyrics that translate into "Filter your water to prevent Guinea worm." Miss Ghana 2005, Lamisi Mbillah, has visited dozens of villages and raised thousands of dollars to bring attention to the disease.
"The fight against Guinea worm is unusual because it creates positive change in people's lives at the grass roots, that you can see immediately," Hopkins said. The Guinea Worm Eradication Program not only prevents disease, he said, it improves Ghana's economy, allows children to attend school and gives villagers a can-do mindset.
After eradicating Guinea worm, young volunteers will "take this experience and go on to do other great things," Hopkins predicted.
All photos: The Carter Center
Sadia, seated in the lap of Lamisi Mbillah, Miss World Beauty With a Purpose 2006, learns to not drink unfiltered water to avoid contracting Guinea worm disease. The former Miss Ghana is a spokeswoman for the program in Ghana.
In this group photo with President Carter (near center in first row of standees), Sadia, who was chosen the program's "Most Valuable Player," takes a central spot on the lap of Carter Center consultant Corey Farrell, who heads operations at the Savelugu Containment Center.
Learn more about the Carter Center's Guinea Worm Eradication Program >
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Sadia's Story (2007) >>
Sadia's Story Revisited: Triumph Over Guinea Worm (2008) > >
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