Amid war and devastation in South Sudan came glimmers of hope Wednesday as the world’s newest nation announced a milestone step toward eradicating a debilitating disease.
South Sudan has gone 15 consecutive months without a single reported case of Guinea worm, a major victory for the country that once had the most cases of the painful parasite.
Riek Gai Kok, South Sudan’s heath minister, called it a “massive achievement.”
“Having known the suffering it inflicts on people, one is very happy today,” he said at the Carter Center in Atlanta. Former President Jimmy Carter’s organization has led global efforts in eradicating Guinea worm.
“Future generations will read it in the books as part of the history,” Kok said. “We have restored dignity to our people.”
Guinea worm is set to become only the second human disease in history to be eradicated, after smallpox was vanquished in 1980. But unlike smallpox, Guinea worm is a parasitic disease and cannot be treated with vaccines. It requires enormous lifestyle changes, education and diligence.
Given those challenges and the unrest South Sudan has seen since it gained independence in 2011, the Guinea worm announcement is monumental.
Civil war in South Sudan has led to a failed state on the brink of collapse, a humanitarian crisis and famine. Under those dire conditions, health workers forged ahead to stop Guinea worm, which is transmitted through unclean water. Those efforts, Kok said, have made the Carter Center a household name in South Sudan.
“This is a great day for South Sudan, Africa and all of humanity,” said Dr. Donald Hopkins, the Carter Center’s eradication expert.
Hopkins has been at the helm of the Guinea worm effort since 1986, when 3.5 million people in 21 countries suffered from the painful ailment. In 2017, that number dropped to only 30 human cases reported in Chad and Ethiopia.
The World Health Organization will monitor South Sudan for the next three years before it certifies the nation as free of Guinea worm.
It has been Carter’s personal mission to rid the world of the “fiery serpent.” Even when he told the world he was battling a brain tumor in 2015, he expressed this wish: “I hope Guinea worm dies before I do.”
Carter has been declared cancer-free, and the world is closer to realizing the former president’s dream.
Guinea worm is not generally a killer and has never made headlines like malaria or polio. But it is a crippling disease that can destroy the lives of people already living in vulnerable conditions.
Humans usually contract the disease by consuming water tainted with Guinea worm larvae. Inside the body, the larvae mate, and female worms grow for a year. After the incubation period, milky white female worms pierce the skin and burst out of the human body in search of a water source to deposit their millions of larvae. The process creates festering blisters that are excruciatingly painful.
It can take weeks, even months, for the worm to fully emerge. There is no treatment except to wrap the worm around a stick to facilitate its removal. People have no option but to suffer through the process. If the worm is broken, its larvae goes into skin tissue.
Men and women are unable to work for months; children miss school.
“It will be very difficult for the family to support itself,” Kok said.
Guinea worm sufferers are often tempted to seek relief for the burning sensations by immersing in water. But that just helps reinvigorate the disease, as water triggers the female worm to release her larvae and begin a new cycle of infection. That’s one reason eradication has been a challenge, Hopkins said.
The Carter Center has been working with health officials in nations where the disease is endemic to distribute water filters and train people on clean habits. Hopkins thanked South Sudanese health officials for their political will; without it, Guinea worm would still be thriving.
Carter congratulated South Sudan on its achievement.
“The people and government of South Sudan have achieved a great milestone in the worldwide effort to eradicate Guinea worm disease,” said the former president, who negotiated a 1995 ceasefire that allowed health workers to start disease intervention campaigns.
“South Sudan’s success shows that people can collaborate for the common good,” Carter said in a statement. “We are within reach of a world free of Guinea worm disease.”