Home' Trinidad and Tobago Guardian : June 9th 2016 Contents B26
body & soul
Guardian www.guardian.co.tt Thursday, June 9, 2016
Guinea worm is going down. Way down.
From more than three million cases of Guinea
worm disease a year in the 1980s, the world tally in
2016 stands at just two confirmed cases. Both are
in Chad and are believed to have been contained
before they had a chance to spread. There are also
two suspected cases, one in Chad and one in Ethiopia.
If Guinea worm is pushed into extinction, then
Guinea worm disease would be just the second human
disease to be eradicated after smallpox.
It's not a fatal condition but it's pretty horrible.
There's a good reason the Guinea worm's nickname
is "fiery serpent."
Guinea worm larvae live in fresh water. When
people drink from contaminated ponds and other
bodies of stagnant water, they can become infected
with the parasite. The larvae turn into worms that
can grow to be up to three feet long. After about a
year, the worm creates a blister, typically on the legs
or feet, for its slow and painful exit.
When the worm first erupts, the person suffers a
burning sensation and often seeks comfort by sub-
merging the wound in a lake or a stream. The worm
takes this opportunity to release a cloud of tens of
thousands of larvae into the water. Other people end
up drinking that larvae-laden water, which starts the
cycle all over again.
There's no medication to kill the worms. The only
treatment is to slowly pull or cut the worm out of
the infected person's body.
Ringo Naah Sulley, the district director of Asante
Akim South District Health Services, worked on
Guinea worm eradication campaigns in Ghana in the
late 1990s and early 2000s. He recalls how people
used to extract the worms in his home village in
"They have to put a knife in fire until it's red hot,"
"Then they would incise it [the blister]. Usually
the pus would open and the Guinea worm emerged.
Sometimes the Guinea worm is even cut into pieces."
The other common extraction method was to twist
the worm around a small stick to slowly reel it out.
"It wasn't just a minor parasite. It was serious,"
Sulley says. "In one person about three or four worms
could appear on any part of the body. You have to
extract one after the other until you get all the parasites
Often the wounds from incising the blisters or
yanking out the worms became infected.
Sulley is now with the health department in the
Asante Akim South District in central Ghana. He
says back in the 1990s in some remote villages, half
the residents had Guinea worm. One of the reasons
it spread so quickly is that people didn't realise how
the worm spread.
David Agyemang, who is the now programme
manager for Sightsavers' Ghana office, used to worked
on Ghana's national Guinea worm eradication pro-
"Guinea worm has no cure," he says. "So everything
was about getting people to change their behaviour.
Getting people to do the right things."
In the short term that means stopping people who
had a worm dangling from their foot or leg from
entering bodies of water for that momentary relief.
The longer-term solution is to get people access to
clean drinking water.
Agyemang says education was the key in the drive
against Guinea worm in Ghana, which eliminated
the disease in 2010. In Ghana, as soon as people
learned how the worms spread, most would stay out
of the rivers and lakes, says Agyemang---even if their
leg felt like it was on fire.
But to completely stop the cycle of transmission,
you can't just rely on people doing the "right thing."
Communities posted guards at watering holes and
new laws were put into place.
Public health officials stress that anti-Guinea worm
measures should not be imposed by outsiders. That's
the perspective from the Carter Center in Atlanta,
which has been almost obsessively devoted to elim-
inating Guinea worm.
The last days of Guinea Worm
Medical worker Abaare Hussein extracts a Guinea worm from a child's leg in
Savelugu Village in northern Ghana in 2007. PHOTO: WES POPE
"The key thing is to engage the community," says
Donald Hopkins, who's been working on the centre's
eradication programme for decades. He adds that
it's crucial is to explain to the community that this
parasite is coming from their drinking water and
convince them that they have the power to stop it.
Prior to the global eradication effort, which began
in earnest in the 1990s, Guinea worm was spread all
across the mid-section of Africa, parts of the Middle
East and South Asia. (NPR)
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