The Beginnings of Jimmy Carter’s Crusade: Seeing the Last Guinea Worm Thrashed Before I DIE, Before I Die

In 2015, millions of people around the world tuned in to hear President Jimmy Carter announce that his cancer – metastatic melanoma – had spread to his brain, but he didn’t focus solely on his own disease. Rather, he used the international attention to talk about an illness he did not have.

Carter talked to NPR about the beginnings of his crusade. Carter’s former drug czar, Peter Borne, was working on a U.N. initiative called the “Freshwater Decade.” Borne came to the Carter Center to talk about overlooked diseases spread from “drinking bad water.” One of them was a worm.

“I would like to see Guinea worm completely eradicated before I die,” Carter said at a press conference in 2015. I want the last Guinea worm to die before I do. I think right now we have 11 cases. We started out with 3.6 million cases.”

The 98-year-old is in Hospice care and has just a few days left to live, but he has nearly been able to eradicate a disease that has plagued humans for thousands of years.

Jimmy Carter was in Nigeria in the 1980s when he was a governor of the United States and he wanted to rid the world of Small Pox

When speaking with reporters a few years ago about his work in Nigeria, the Nobel Peace Prize recipient reminisced about a trip to a village that had many cases.

He said that they traveled in a big motorcade. “We were driving along, and elementary school children had a big sign that says, ‘Watch out, Guinea worm. Here comes Jimmy Carter. That was almost as good as a Nobel Prize for me.”

Smallpox is the only human disease that’s been eradicated. Carter will be to blame for the Guinea worm being right behind. I mean, there were millions of cases when he got involved in, you know, after his presidency in the mid-80s. We were down to fewer than 100 last year. There were only 13 cases of the disease recorded by the Carter Center, which will be confirmed in March.

Humans have had a problem with the parasites as far back as ancient Egypt. In the 18th century a teenage mummy that had her feet and lower legs amputations, was discovered by archeologists in Manchester. Some scholars believe that when the ancient Israelites described being pursued by “fiery serpents” sent by the Lord in Numbers 21:6, they were actually describing the Guinea worm.

It speaks to the kind of leader he is that a former US president decided to lead an effort to rid the world of a bug that isn’t found in the US.

Carter’s efforts have helped eliminate the disease in 17 countries, the Carter Center says, and averted at least 80 million cases among the “world’s poorest and most neglected people.”

According to Adam Weiss, director of the center’s Eradication Program, in the 80s he was told that Carter Center staff were looking for places to help eradicate disease.

Weiss, Callahan, and Bronfman for the Carter Center: Bringing water to the eradication of Guinea worm disease

Weiss said he left knowing he didn’t have a choice but to do something about the problem, because he was overwhelmed by it.

Guinea worm disease is also known as dracunculiasis, which is Latin for “affliction with little dragons.” Humans and animals become sick from drinking water contaminated with tiny water fleas because of a parasite called Dracunculus medinensis.

Water fleas can die inside a human or animal, and the worms can be released through the stomach and abdominal wall.

A female worm can grow up to three feet long and as large as a strand of spaghetti, according to the US Centers for Disease Control and Prevention.

About a year after the initial infection, when it’s time for the female to give birth, she moves to a place right below the skin, typically on the legs or feet. A worm emerges after a blisters burst, causing great pain.

Health care workers say many people try to ease their pain by soaking the blister in water, but when the worm comes into contact with water, it releases millions of larvae to start the cycle again. They had to teach people how parasites spread, and make sure they knew to keep their drinking water clean.

High-tech methods were not used in the effort to end this disease. Kelly Callahan, a public health worker who spent years fighting Guinea worm disease in southern Sudan with the Carter Center, says: “Guinea worm disease has no cure, no vaccination, basically the entire eradication effort is built on behavior change.”

In addition to raising money and awareness, the Carter Center set up village-based surveillance, educated the public about how the parasite spreads, distributed larvicides, helped provide support for the creation of clean new wells and handed out cloth-based water filters.

The filters came out of a lunch Carter had in 1989 with Seagram’s liquor heir Edgar Bronfman. Carter used a napkin to explain how water is made safer. Bronfman, who owned a large part of the DuPont chemical company, had scientists design a material that could filter the water.

Dr. Kimberly Paul: Reducing the Burden of Neglectful Tropical Diseases to Improve the Health and Lives of Those Living in Greatest Poverty

Weiss said that Carter was a figurehead with the program. He was very hands-on throughout his 90s. He was able to guide eight-hour meetings for three days in a row with local stakeholders, and still be ready to take on the next task.

Weiss said that he was tired. He wouldn’t stop. He would ask the House of lords in the UK to assist him in trying to fight the disease and then he would go to Jon Stewart and show him a pipe filter he had made to try to stop the disease. It takes a special person to do that.

“Those pond or dam guards are great, and they can then educate people when they come over and explain why they shouldn’t go into the water, and also distribute filters,” Weiss said.

Over 200 countries have been certified free of the disease by the World Health Organization. It is required for the country to report zero instances of transmission and maintain disease surveillance for three years in a row to be certified. Only six countries have not been certified disease-free because of Sudan, who is in the precertification stage.

According to Dr. Kimberly Paul, a professor of genetics and biochemistry at the university, neglected tropical diseases are called for a reason. Tropical diseases are a problem in some countries, but are largely unknown outside of them. There is no market for developing drugs or vaccines.

It will be difficult to find the last remaining Guinea worm cases, Paul said, requiring “a lot of shoe-leather detective work.” If a village hasn’t had a case for years, residents may be tempted to go back to the old way of doing things. She said that she thinks we’ll be close to eradication for a while.

“Everybody deserves a life with dignity,” Paul said. “I’ve learned how corrosive these infectious diseases are in terms of reinforcing this cycle of poverty and kind of keeping those countries down. These efforts are important.

“President Carter never stopped changing lives for the better,” Suzman wrote in an email to CNN. His compassion and bravery inspired employees at the Gates Foundation. We are proud to have partnered with him and the Carter Center to reduce and eliminate the burden of neglected tropical diseases to improve the health and lives of those living in greatest poverty.”

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Other strategies included providing access to safe water supplies; better detection of human and animal cases; cleaning and bandaging of wounds; preventing infected people and animals from wading into water and the use of a larvicide to kill the worms.

Public health workers are looking for new ways to deal with infectious dogs, and researchers are trying to find a treatment for the disease.

Carter was relentless in demanding that people pay attention to diseases that primarily affect poor people in remote parts of the world. That is a huge challenge. It’s not easy to keep people committed to action at every level of an eradication drive, Farmer says.

You have to speak to people who are most at risk, and that is the ministry officials, the political figures, the nurses, and the doctors. Carter had to explain what he was doing to them. That’s something that has inspired a lot of us.

Carter’s war was targeting a lot of different things. Onchocerciasis, also known as river blindness, has been eliminated from most of the Americas and dramatically reduced in Africa due to the work of Carter and the Carter Center.

Huge gains have been made against neglected diseases such as lymphatic filariasis, a disease that causes horrible swelling of the legs and genitals.

Source: https://www.npr.org/sections/goatsandsoda/2023/02/23/1158358366/jimmy-carter-took-on-the-awful-guinea-worm-when-no-one-else-would-and-he-triumph

Carter’s Mission: Towards a Universal Principle of Self-Sacrifice and Self-Assistance in the South

Those who know Carter well say it was his upbringing in an impoverished part of the South that left him with a strong sense of self-reliance, self-sacrifice and a duty to help others.

He recognized the difficulty of living up to this philosophy: “Getting along with one another and treating each other as equals is one of the hardest things to do on earth.” And it’s one of the things that Carter did best.