Believed to be "the fiery serpent" described in the Bible, the Guinea worm has plagued mankind since ancient Egyptian times. Now it's close to becoming the second disease in the world to be eradicated, after smallpox, health officials say.
The Guinea worm's last stronghold is in conflict-marred southern Sudan, a region of 9 million people where about 85 percent of the world's 3,000 remaining cases of the disease are found. The world's public health powers, including the World Health Organization and the Carter Center, have focused efforts there.
If that work is successful in Sudan, Guinea worm would be the first disease to be eradicated without a vaccine or medication, a remarkable achievement, according to experts. After a full year with no new cases, Sudan will be monitored for three more years. At the end of the fourth year with no new infections, the World Health Organization would declare the disease vanquished. Optimists foresee official eradication by 2015.
But that hinges on nonbiological factors.
Sudan holds its national election April 11-13. The country has remained divided along north-south lines for more than two decades and faces the potential of more political upheaval next year in a national referendum on whether southern Sudan should be an independent country.
"If there began, for whatever reason, a resumption of war and real insecurity, you start having mass movements of people," said Dr. Donald Hopkins, a former director of the U.S. Centers for Disease Control and Prevention.
Sudan borders nine countries. Eruption of violence could interrupt surveillance efforts and people infected with Guinea worm could migrate and unwittingly spread the disease, perhaps reinfesting countries that have been able to get rid of it.
"For all those reasons, there's a lot at stake," said Hopkins, vice president of Health Programs of the Carter Center. "It's in the world's interest to try to help try to keep a lid on the violence there."
There were a lot of very striking insights that I got from this article. One of which is that it is possible for a disease to be eradicated without a vaccine or medication. We have deemed vaccines to be the ultimate weapon against sickness, however because of this, we have taken for granted other means of eliminating disease. The Guinea worm can by controlled not by grand technological advancements, but by a change in behavior.
The Guinea Worms Life Cycle
The Guinea worm's life cycle starts when a person consumes water that contains larvae. The larvae mature in the stomach and eventually blisters will form on the person's skin as the fully grown worms try to escape from their hosts. The pain experienced when these worms break out is excruciating and is soothed by submerging the erupting blister in water, thus contaminating more of Sudan's water.
Health workers have the hard task of convincing Sudanese people to filter or chemically treat their water before consuming it. You would think that this would be a very simple and sensible change in lifestyle, but the Sudanese have been drinking unfiltered water for their entire lives and it takes time to educate them about the Guinea worm and how it is preventable.
This ongoing effort is further exacerbated by the political instability that plagues Sudan. War and violence is not an unfamiliar occurrence in this country and as such, health workers are continually exposed to physical and psychological threats. Aside from this, it will be much more difficult to track cases of Guinea worm if people start to migrate because of the instability. Carriers of the disease might spread the illness to countries which have already eradicated it.
This highlights how politics and health are very much inter-related. Instability in one could bring damaging effects to the other and vice versa.
Seeing the concepts we discussed in class applied to a real disease situation, such as Sudan's war on the Guinea worm, brings everything into perspective for me. At the end of the day it's about the real lives being lost to a preventable disease.