Guinea worms used to inflict burning pain on millions of people in Africa and South Asia every year. They would grow up to 3 feet long while living inside a person’s body, then burst out of their foot or other sensitive areas of their anatomy, such as their eyeball or their penis. But only 13 human cases of Guinea worm disease were reported worldwide last year, reports the Carter Center.
The Carter Center began working to eradicate Guinea worm disease after former President Jimmy Carter visited “a tiny village in Ghana.” He
stumbled across a crying woman who appeared to be cradling a baby to her right breast. He stepped forward to talk to her – but he reeled back when he realized a 3ft-long worm was inching its way out of her nipple, at the centre of an engorged, purpling breast. It was one of 11 guinea worms taking a month or more to crawl out of the young woman’s body that summer. One was burrowing out from her vagina. The woman couldn’t speak; she could only howl.
She was living through a guinea worm infestation. One survivor, Hyacinth Igelle, says: “The pain is like if you stab somebody. It is like fire. You feel it even in your heart.” After seeing some victims, the journalist Nicholas Kristof called it “torture by worms”. The worm’s head causes a blister that often develops deadly tetanus; if the victims survive, they can starve because they have not been able to farm their fields for months. Many scholars now believe that when the Old Testament Israelites were afflicted by “fiery serpents” in their flesh, they were meeting this worm for the first time.
The eradication program’s director says the final phase of the effort to eradicate the disease will be “the most difficult,” because it will require working in very remote, dangerous areas.
The 13 remaining Guinea worm infections occurred in four countries in sub-Saharan Africa that experience periodic civil wars or violence, making it difficult for anti-guinea worm campaigners to work in affected areas. Six cases were reported in Chad, which is known as the “Dead Heart of Africa” for its remoteness and backwardness, and which has experienced periodic civil wars and ethnic conflicts. Five Guinea worm cases were reported in violence-wracked South Sudan, which was in a state of civil war for most of its brief existence as a country, and is still so dangerous that the U.S. State Department tells Americans, “Do not travel to South Sudan due to crime, kidnapping, and armed conflict.” One case was reported in the Central African Republic, which has been in a bloody civil war since 2012. The State Department has issued a travel advisory saying “Do not travel to the Central African Republic (CAR) due to … crime, civil unrest, and kidnapping.” One case was reported in Ethiopia, where portions of the country are hard to access due to ethnic conflict or insurgencies.
When former President Jimmy Carter began working to eradicate Guinea Worm disease in 1986, it infected 3.5 million people.
Guinea worm affects some of the world’s poorest people and can be prevented by training people to filter water before drinking or bathing in it. Those who drink unclean water can ingest parasites that can grow as long as 3 feet. The worm incubates in humans for up to a year before painfully emerging, typically through the feet or other sensitive parts of the body.
The populations where Guinea worm still exists are mostly in areas plagued by armed conflict or banditry, which can make it dangerous for staff and volunteers to go from house to house in educate residents and provide technical assistance. “If we take our foot off of the gas in terms of trying to accelerate getting to zero and providing support to those communities, there’s no question that you’re going to see a surge in Guinea worm. We’re continuing to make progress, even if it is not as fast as we all want it to be, but that progress continues,” says Adam Weiss, director of The Carter Center’s Guinea Worm Eradication Program. “We are truly in the midst of that last mile and experiencing firsthand that it is going to be a very long and arduous last mile.”
Guinea worm is expected to be the second human disease to be wiped out, after smallpox.
