Guinea Worm Hunting

“Somebody Poisoned the Water Hole!”
by Julia Day

Mid-August, Sarah "Juicy" Zuger, Rachel Emmick and I set out on one of the greatest adventures that we've had to date: a twenty hour bus ride to Gao to get involved with the eradication of Guinea Worm in northern Mali. Back in the day guinea worm was quite widespread, reaching all the way to Europe. Interestingly enough, the snake on a stick symbol that is used today in the medical field originates from healers’ signs depicting place to come for guinea worm extraction. Today, guinea worm cases are decreasing as organizations, such as the Carter Center, fight to stop transmission. Mali is one of the few remaining countries in the world with guinea worm cases, mostly in the Douentza, Gao, and Kidal areas.

For those of you who have not yet read Where There is No Doctor from cover to cover, guinea worm is transmitted by ingesting drinking water contaminated by guinea worm eggs. When an infected person enters the water source, the worm pokes out of the wound it creates and sprays its eggs into the water. Water fleas, acting as the primary host, pick up the eggs. The eggs cause the fleas to become lethargic and float to the surface of the water hole. That way, when someone new comes to drink from that water source, they scoop the surface water, including the tiny fleas, and ingest the worm eggs. The worm takes around 9-12 months to develop. A painful sore or blister forms, usually on the lower part of the body, and the worm will poke out when it senses water to continue the lifecycle.

The Carter Center doctors and staff are working to eradicate guinea worm in Mali in three main ways: distributing cloth water filters that catch the infected flea, chemical treatment of contaminated water sources, and isolating current cases to ensure they do not contaminate water sources. Guinea worm can be easily avoided if everyone in the area follows one or more of the above guidelines. If infected people stay out of the water, or if everyone agrees to filter their water it will break the guinea worm lifecycle. But as an extra measure of safety, the Carter Center also puts a chemical called “Abate” in the water holes to kill the water fleas.

Treatment for someone hosting guinea worm is simple, yet painful and slow. Once the worm sticks out of the wound it should be tied to a string or a small stick and slowly pulled out. This process may happen quickly or over a week. The worm can be more than a meter long! It is important that this process happens slowly and thoroughly because serious infection may result if the worm is broken. Also, it is very painful for the patient if the worm is forced out more than it is willing to yield.

Though the days were long, it was the highlight of my Peace Corps career. I felt like I finally made it to that romanticized Africa you always see on TV. Expect to get up early to a huge breakfast of greasy spaghetti and a tabaski amount of “bush meat,” drive en brusse to the most remote villages (not even huts, just stick support structures with leather hide tarp) you’ve ever been in your life, see camels and milk them, hand out filters, poison water holes, hunt antelope and utards (giant birds) from a land rover, drink cow, goat, and camel milk daily, meet the most hard core and rustic people in the world, extract some guinea worm (if your lucky), see incredible sunsets, eat a dinner of greasy zamé and another tabaski amount of meat, and do some awesome star gazing. I highly recommend you all take advantage of this opportunity as, Inshallah, guinea worm will soon be extinct. It really is an opportunity of a lifetime.