27 July 2003

Eradicating Guinea Worm Disease

In 1986, Guinea Worm Disease infected an estimated 3.5 million people living in rural agricultural communities in 16 African countries, parts of India, Pakistan, and Yemen. The disease is extremely painful and debilitating, contracted by drinking water containing larvae of the parasite Dracunculus medinensis. The disease has plagued humanity for thousands of years. Today, after a decade’s campaign of education and the design and distribution of a special fabric, the disease has been virtually eliminated.

CaudecousDracunculus medinensis has been traced to calcified worms in the stomachs of Egyptian mummies during the first millenium. Records of infection and treatment have been found dating back to 1530 BC. The Guinea worm is believed to be the ‘fiery serpent’ mentioned in the Bible, that infected the Hebrews during their exodus from Egypt. The medical symbol ‘Caduceus’ is believed to represent two coiled Guinea worms.” [source]

A Sanskrit poem from the 14th century B.C. includes the plea, “Let not the sinuous worm strike me nor wound my foot.” [source]

“Victims must endure the worm’s painful emergence for as long as three months, and are usually incapacitated not only by the pain but by fever, fatigue, and nausea as well. To speed things along, people carefully wind the worm around a stick as it emerges [as depcted in the ‘Caduceus’], being careful not to pull too hard. If the worm breaks, it will retract into the body, causing severe inflammation. Over half of all worm-emergence sites become infected, and the worst cases can result in permanent crippling or even death from tetanus.” [source]

There is no preventive or curative drug. However, the disease is relatively easy to prevent — drinking contaminated water is the only way to acquire the disease.

“Measures to prevent [Guinea Worm Disease] are community-based and inexpensive. Control methods include health education, providing safe drinking water, using filters to remove infected copepods from drinking water, boiling water or treating it with small doses of temephos, a colorless, odorless chemical that, kills copepods but is harmless to people.” [source]

EMT Logo“The cycle of transmission can easily be broken by filtering drinking water and preventing infected people from entering drinking water sources. [The worm] has no reservoir other than humans. When the worm’s one-year life cycle is broken for two years, the disease is permanently eliminated from the area. This is the only disease that can be eradicated by providing clean drinking water....

Water contaminated with guinea worm is safe for drinking (as far as this disease is concerned) if the water is filtered through a tightly woven cloth.

Inexpensive, effective cloth is available in most local African markets, and 1 million square meters of special synthetic fabric, for more rapid water filtration, has been donated by DuPont, with additional synthetic cloth donated by the Danish government and others.

Agricultural and school projects, along with company advertising, can teach people about guinea worm and how to protect themselves. Farmers who drink from ponds during the day should have a filter with them.” [source]

The filter must always be used with the same side up, usually marked with a printed symbol or instructions.

Since 1986, local, national, and international campaigns have had dramatic success. The disease has been virtually eliminated.

“The Carter Center joined the fight against Guinea worm in 1986, when it helped Ghana and Pakistan launch their eradication programs. Since then, it has spearheaded the World Health Organization’s global eradication effort, aimed at making Guinea worm only the second disease, after smallpox, to be wiped out completely. Under the leadership of the Carters and Dr. Donald Hopkins, the Carter Center has raised money, provided technical expertise, forged partnerships, and mustered the political will necessary to achieve this ambitious goal. They have distributed portable filters and initiated education programs to help break the cycle of the worm.

Transmission has been stopped in seven countries, and Asia is now free of the disease. In 2001, fewer than 65,000 cases remained in thirteen African countries, a 98 percent reduction since the beginning of the effort. Experts are confident that total eradication is just around the corner.

In 2001, it was estimated that 80 percent of the remaining cases were in the Sudan, where civil war has prevented a major eradication effort. That same year, courageous Carter Center volunteers distributed 8.5 million pipe filters, enough for every man, woman and child in the endemic areas of the Sudan. These hard plastic straws with nylon filters at one end can be carried around the neck and allow nomadic peoples to strain their water before drinking.” [source]

At the request of President Carter in 1990, DuPont developed a nylon monofilament filtration fabric to filter water infested with the Guinea worm parasite. The fabric is manufactured by Precision Fabrics:

“This fabric was unique. It had never been produced in this country. It is woven using a very fine monofilament nylon yarn. The fabric is washed, stabilized and finished to control the pore size of the fabric. It is precision slit into 12-inch wide rolls for export to the countries plagued by the disease. The fabric is then used in villages to filter water sources.”

DuPont and Precision Fabrics donated millions of square yards of the fabric from 1990 to 1997. Other countries have also produced similar fabric filters.


The Guinea Worm Filter is my suggestion to “100 ‘Cubes of Good Ideas’”, an exhibition of “objects that change people’s lives.” Design for the World is organizing the exhibition, which takes place during the Universal Forum of Cultures in Barcelona in the summer of 2004.

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