RHEUMY-eyed Chief Joseph Lokoi has lived through two civil wars in south Sudan, but the scars covering his body are not the relics of battle.
Each one marks the spot where a Guinea worm – a spaghetti-like waterborne parasite up to 1m long – pushed out of his skin.
After living inside its host for up to 14 months, the long worm, often known as the “fiery serpent”, releases chemicals to soften the flesh, making a blistering, pus-filled wound. It then pushes out so it can deposit around a million larvae.
“The pain is great,” said Lokoi, who lives in Sudan’s dry Eastern Equatoria State.
A Guinea worm emerges from the leg of a girl in Juba, southern Sudan, in this picture taken on June 21 last year. Burning pain sends many victims into the nearest available water for relief. For Lokoi’s Toposa tribe, this is often one of the small stagnant hand-dug rainwater ponds or shallow wells the whole community depends on.
The Guinea worm spews a cloud of larvae into the water on contact and dies. Unless it is boiled or filtered, the water is likely to infect those who drink it.
Sudan is home to four-fifths of the world’s cases of Guinea worm: a painful and soul-destroying yearly fixture that often afflicts people during the rainy season. But now, there is fresh hope the parasite can finally be eradicated.
The semi-autonomous southern government and the US Carter Center, an aid group set up by former US president Jimmy Carter, aim to eliminate Guinea worm from Sudan by next year as part of their goal of ridding the world of the disease by then.
This would be the first global eradication since smallpox was wiped out in 1977, and the first without vaccines or medicines.
“There is no silver bullet, no vaccine. If you can keep everyone who has Guinea worm out of the water for one year, then it’s gone,” said Steven Becknell, who heads south Sudan’s Carter Center office.
When the Carter Center first got involved with the disease in 1986, there were 3.5 million cases worldwide.
In 2006, only 25,217 cases were recorded and just over 20,000 of those were in Sudan, Africa’s largest country. Ghana recorded around 4,000 cases that year, and the parasite, also known as dracunculiasis, is also holding on in Mali, Nigeria and Niger. Since then, there has been dramatic improvement in Sudan, which registered only 5,815 cases in 2007.
The Carter Center distributes cloth filters and plastic drinking pipes with gauze at one end to block the larvae. Ponds are also treated with chemicals, and other agencies have drilled boreholes to provide clean drinking water.
Over 25,500 volunteers monitor around 22,000 villages, counting worms that pop out of the skin, and doing “case management”. This means stopping infected people from going into the water, and pulling worms out of victims’ bodies.
Volunteers use tools like a forked toothpick, which they roll between finger and thumb, twisting the worm around it. Often the worm is wrapped around the victim’s muscles, making the process extremely painful.
Eradicating the disease would bring both social and economic gains, as well as easing individuals’ suffering. The Carter Center estimates rice farmers in south-eastern Nigeria lost US$20mil (RM65mil) in one year because of outbreaks of Guinea worm which incapacitated workers.
The worm itself rarely kills, although secondary infections from the wound can be deadly. But the parasite drains energy and nutrients and hampers movement.
“People cannot cultivate, children cannot go to school,” said Makoy Samuel Yibi, director of the southern government-led project to eradicate the disease.
The disease affects men and women almost equally, especially those aged between 16 and 35 years, the most productive age group.
Guinea worms usually break out of the flesh in the legs or feet, but Lokoi has seen them growing in a person’s head and emerging out of sexual organs and eyes.
In the red dust of Eastern Equatoria State, Toposa Kumoliang, a mother of five, says not a year goes by without one of her children contracting Guinea worm.
“It makes my children restless and unable to play, helpless, it is very painful,” she said. – Reuters
Source: The Star Newspapers
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