Affliction with Little Dragons

Jimmy Carter on the cover of Africa TodayHave you heard the good news? For those of us who may have lost hope– expect the worst from humanity– no end to war, pollution and the like– the world has been handed an inspiring example in the form of the eradication of everyone’s favorite parasite, the guinea worm. In a recent article in the New England Journal of Medicine, Michele Barry, M.D. explains how the guinea worm, or dracunculiasis (Latin for “afflication with little dragons”) has been virtually eradicated world-wide through an unprecedented global public health effort spearheaded by Jimmy Carter, among others:

The World Health Organization (WHO) has now certified 180 countries as free of guinea worm disease, and all countries where the disease was endemic have signed a WHO Geneva declaration pledging to wipe out the parasite by 2009. Whereas massive funding is funneled into campaigns to eradicate poliovirus, to control malaria and tuberculosis, and to prevent the spread of human immunodeficiency virus, guinea worm disease is about to be eradicated without any drug therapy or vaccine. Its demise will be proof that people can be persuaded to change their behavior through innovative health education.

Life Cycle of the Guinea WormI first got to know of the affliction of little dragons from a wonderful little handbook for traveling hypochondriacs, Where There Is No Doctor (more intriguingly, there now seem to be similar titles for situations in which one might find one’s self without a dentist or psychiatrist). For those of you who are not familiar with our friend the guinea worm, it is a very special parasite whose larvae, when ingested through contaminated water (in the stomachs of tiny water fleas), hatch within the flesh of their host and then burrow outward, becoming very long, disgusting white slippery worms. People with these worms hanging out of their legs then go and fetch water from a step well or pond, and the worms immediately toss a few eggs into the well, thus contaminating the water for future users. The only way to remove the worm is to slowly draw it out over a period of months using twigs and bits of string. Needless to say, the guinea worm is an excellent candidate for global eradication.

But the eradication plan has been no ordinary one:

drawing of guinea worm

When the eradication program encounters an impasse, those involved often deploy unusual tactics. At a 1989 lunch with Edgar Bronfman, the Seagram’s liquor heir, President Carter explained the technique of filtering copepods out of water, demonstrating with a damask napkin. Bronfman, who held a major stake in the DuPont chemical company, had DuPont scientists develop the tough fine mesh that is now used to filter water. In Uganda, the eradication program has employed elderly men as “pond caretakers” to guard ponds against contamination by worms emerging from people. When infected people are identified at a pond, the caretakers assist them with water gathering, preventing contamination of the water, and distribute nylon filters for ongoing prevention. Cash rewards are sometimes offered to those who report cases or to infected villagers who agree to be quarantined while the worm is emerging; often such persons receive free care and food during that period.

little boys in Sudan using special pipe filters to drink water possibly contaminated by guinea wormBut most heart-warming of all have been the efforts in international diplomacy that have managed to effect guinea worm cease-fires in war-torn areas, in which civil war factions have agreed to temporary moratoria on killing each other so that international public health officials will have the opportunity to kill the guinea worms in their country:

Faced with one of the most imposing barriers to eradication of guinea worm — the civil war in southern Sudan — Carter negotiated a 4-month “guinea worm ceasefire” in 1995, which also allowed public health officials to kick-start Sudan’s onchocerciasis control program.

Author: lapata

Daisy Rockwell paints under the takhallus, or alias, Lapata (pronounced ‘láh-putt-áh’), which is Urdu for “missing,” or “absconded,” as in “my luggage is missing,” or “the bandits have absconded.”

5 thoughts on “Affliction with Little Dragons”

  1. I know people are happy to be rid of a worm like this, one that can cause this much damage. I must say that I see things differently. I see this situation as a great loss. An animal that we could still learn things about has been swiped off the face of the planet. Try to think of it like a child that was stuck into a world where nothing seemed to go right for him, but he didnt know. The child would be totally innocent in his own mind, but to others, the child could do no right. The people would kill this child, one that was given life and no more, because they feared the things he did to society. People have a hard time thinking of this matter from a perspective like mine because they are given the results on the human population that the worm has caused. Guinea worms helped keep the animal population in check. And now, the scale has been tipped by humans yet again. Was eradication really necessary? I have read books in which the world is a dead place. The books were depressing, and in each and every one of them, humans were the cause of it. Our population is growing out of control, and we have just exterminated another thing that was part of the great web that is the planet. Everything in Nature has a cause and effect. This will lead to issues. This is not something we should have done.

    Please email me with any comments to my post.

  2. Whatever your personal feelings are for Carter, set them aside for a moment and consider the misery this parasite has caused mankind. However difficult life and survival are in some parts of the world, it is made worse by a neccessity for clean water in any place where the only sources are contaminated by a bad parasite and it is impossible to avoid it. Jimmy Carter sees problems and uses his resources to take initiatives to solve them, using his influence for the good of everyone regardless of race, creed, nationality, politics, or need. His is the kind of leadership one expects of an American naval officer. Consider not what you think is the quality of this person: consider the quality of the deed and the outcome and the service. Dr. Dave Gowan, biologist, Crawfordville, FL USA

  3. This is excellent news. I did know about the guinea worm, but had no idea these efforts were underway. This should be on a lead story in all theworld’s media.


  4. I confess that I started reading this post with some glee. Oh goodie, I said – high on snark, as is my wont – this will be all about Jimmy Carter personally de-worming all of Africa and finally deserving that silly Nobel Peace Prize [Can the Swedes be trusted with anything?]

    But no. This post is all about some yucky worm -and Carter never even touching the water-injested larvae which hatch and require 3 months of twig and stick action.

    On a more emotional note, I request that some global fund to distribute “Where There Is No Dentist” outside all such establishments

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