Carter Center


NYTimes profiles a dragon slayer, Donald Hopkins, and his fight against guinea worm | 

A woman in Nigeria endures the painful extraction of Guinea worm
A woman in Nigeria endures the painful extraction of Guinea worm
Mike Urban,

The NY Times’ Don McNeil has done a great profile of a global health champion, Donald Hopkins – the man who has led the successful campaign to rid the world of one of nature’s most disturbing parasitic diseases.

Guinea worm. I’ve written about this disease many times, seen people afflicted with it and years ago met a woman who was Nigeria’s last case. Jimmy Carter, whose philanthropy the Carter Center has sponsored Hopkins’ work, was recently talking about guinea worm with comedian Jon Stewart on the Daily Show. This painful, debilitating disease used to afflict millions of people every year.

Thanks to Hopkins and the Carter Center, it’s today down to few hundred cases remaining in the Sudan.

Endangered species: Guinea worm | 

Mike Urban,

A woman in Nigeria endures the painful extraction of Guinea worm

A flurry of reports lately have celebrated the potential end of one of the world’s most horrific human parasites, the Guinea worm. Here’s the latest such from The Guardian:

Guinea worm disease is reaching the end of its days. The parasitic infection, which has sickened millions, mostly in Asia and Africa, is on the verge of being done in not by sophisticated medicine but by aggressive public health efforts in some of the poorest and most remote parts of the world.

I’ve reported on this disease for many years and seen people afflicted by it – including the last Nigerian known to have had the parasite. You become a host to Guinea worm from drinking contaminated water, which allows it to eat its way through your body over a year’s time – as it grows to several feet in length.

It doesn’t kill you, but its painful course through your body might make you wish were dead.

Some might think this an interesting but minor accomplishment given the other health needs of the developing world, but it’s more important than it appears. The elimination of Guinea worm from poor farming communities in Africa and Asia translates into more productive communities, not to mention the broader benefit of improved water quality. And it was largely done through educating people on a shoestring budget, mostly led by the Carter Center, rather than using some new vaccine or drug.

Guinea worm looks to be the second human disease, after smallpox, to get wiped off the planet (followed soon — or perhaps preceded — by polio, many hope). This is a great accomplishment. For those who aren’t so sure, those who want to preserve the balance of nature and respect all life, here’s a place for you — Save the Guinea Worm Foundation

Grace: Nigeria’s last case of guinea worm | 

After my first visit to Nigeria in 2001, when I saw more than my fair share of guinea worm infections, I returned to Nigeria for a book project I claimed to be working on. It was 2009 and I was a freelancer.

Since I was in the neighborhood, I asked the Carter Center if I could go meet the last person — a woman named Grace Otubo — to have guinea worm in Nigeria. After a long and frequently bumpy drive from Abuja, we arrived at the village of Ezza Nkwubor, outside of Enugu.

Based on the greeting I received, I think they must have assumed I was someone more important.

Here, in their own words, and song, they celebrate no longer having guinea worm to deal with. They still have health problems, emphasizing that they still need basic health services such as maternal and child care. They still deal with malaria and pneumonia. But they do have one thing to get up and dance about. I later decided I had to join in the dancing, but deleted that part from the video:

Nigeria’s last case of guinea worm | 

Mike Urban

Guinea worm emerging, Nigeria 2001

It’s hard for many of us, living inside the safe and comfortable bubble of existence offered by western civilization, to understand just how disruptive, tragic and dangerous it can be to simply get sick in a poor, rural African village.

It’s probably even harder to imagine living with the threat of a three-foot long worm eating its way through your body and then painfully emerging over a period of weeks as you sit — or lay, or writhe — there waiting for the “fiery serpent” or “little dragon” to be done with you.

Nigeria used to be planet-central for guinea worm, with hundreds of thousands of known cases every year (and probably many more unknown cases). This parasitic disease was painfully crippling farming communities, throwing people into poverty.

That doesn’t happen anymore.

Mike Urban

Nigerian woman undergoing guinea worm extraction

Thanks to decades of effort by the Carter Center, working in collaboration with many other organizations and given financial support by donors (including $93.5 million from the Gates Foundation), Nigerians no longer have to fear this threat.

Once afflicting millions worldwide, including the Middle East and the Soviet Union, guinea worm has been fought into just a few isolated corners of the world. There are less than two thousand cases, in four African countries, Sudan, Ethiopia, Mali and Chad.

Last night, at the U.W., some of us got a sneak preview of  a documentary film, “Foul Water: Fiery Serpent.” It describes the Carter Center’s ongoing effort to repeat this success story in Sudan — and also make guinea worm only the second human disease (after smallpox) to be eradicated from Earth.

I was in Nigeria last spring (doing research for a book on global health I keep threatening to write). I visited with Carter Center folks and also met Grace Otubo, then a sturdy 79-year-old woman and migrant farmer, in the eastern Nigerian village of Ezza Nwukbor.

Grace was Nigeria’s last known case of guinea worm.

Here’s my (very amateurish, sorry) video of the visit.