Breaking the Guinea Worm Cycle

Health

Backgrounder

It is a painful affliction that is so common you may have suffered it yourself. Or your children have, or your neighbour. Chances are many people in your village have been crippled by the pain of this condition, and some of them never recovered completely. It is called Guinea worm, and it is probably as old as time.

Guinea worms grow in the body, and then, when they are ready to lay their eggs, they crawl through the skin. The pain is terrible, there is swelling, there are infections. But there is also hope. Guinea worm can be wiped out. All it takes is care and co operation.

Guinea worm is transmitted through contaminated drinking water or by standing in infected water. To get rid of it, you must do two things. The first is to filter your drinking water so you don’t swallow the worms that are already in it. The second is that you and your neighbours must prevent more of the worms from getting into the water you drink by not letting infected people stand in your water source.

It sounds simple, but it is difficult to keep up. And that is the catch. A Guinea worm takes up to a year to grow inside the body. That’s a long time for a whole village to be careful about its drinking water. And the worm is spread by an organism that is so tiny, it is easy to believe there is no danger at all. It is hard to stay watchful when you can’t see what you are fighting.

But if you understand what you are fighting when you know the problem isn’t magic, but just a nasty worm that is stopped by a simple filter and simple precautions you can save yourself, your family and your village much grief.

The Guinea worm doesn’t get into your body by itself. Instead, it travels inside an insect that you swallow by accident. That insect is a waterflea. The waterfleas live in open wells and ponds where people get their drinking water. In the wet season there is less chance that you’ll swallow a waterflea because they sink to the bottom of the well or pond and people skim their water from the top. But in the dry season people scoop up the waterfleas when they collect drinking water, and that’s when the guinea worm gets its chance to infect you. If you drink infected water, you’ll almost certainly get Guinea worm. But you won’t know for a year.

After it is in your stomach, the water flea dies, which frees the Guinea worm. During that year, the Guinea worm grows inside you. It starts out as something called a larva (like a tiny caterpillar), and slowly grows into a worm that can reach up to 120 centimetres long. Then it starts migrating through your body to get out and lay its eggs. At that point it looks like a fine wire running underneath the skin, usually in the leg or foot.

As the worm works its way through your skin, it creates a very painful blister, which then opens to form an open sore or ulcer. The worm comes out of your body through the sore. That happens very slowly, perhaps a centimetre a day. That means you suffer from the sore for a long time. And all during that time, if that ulcer touches water that people drink, the worm will lay its eggs in the water and the whole cycle starts again in somebody else. That means if you are infected and you walk in your drinking water, your family and your neighbours can become infected, too.

But you and the other people in your village can break that cycle. What a village must do to protect its members is to make sure that no one stands in water that people drink from. If no one stands in water that people drink from for a whole year, the Guinea worm will die out. The village will be free of it.

In the meantime, there is a simple way to protect yourself and your family. Filter your water before you drink it. To filter it, pour it through a fine cloth or wire mesh. The filter catches the waterfleas that carry the Guinea worm and as long as you don’t swallow the waterfleas, there is no way for the Guinea worm to get inside you.

People are the only host which is another way of saying that if the Guinea worm isn’t inside a person, it can’t lay more eggs. Birds, animals or fish won’t do. Only people.

But one of the biggest problems in stopping the Guinea worm is that people can’t believe such simple solutions work. They try medicines and other cures, and still they suffer. That makes Guinea worm seem powerful indeed.

And it is not surprising that we think that way, considering that so many people have suffered so much for so many generations. Something so terrible must be very powerful, people think. It must be magic.

But it’s not. The Guinea worm isn’t magic, it’s just tiny and sneaky. And the two solutions filtering drinking water and not standing in the source of your drinking water will wipe it out.

Magic? No. But wiping out this pestilence will probably feel like a miracle.

Acknowledgements

This script was prepared by Katie Gillmor Ellis, Toronto, Canada.

Thank you to Dr. Abera Abay, formerly a district public health manager in Ethiopia, and to Dr. Arthur Heywood, University of the Western Cape, Capetown, South Africa, for reviewing this script.

Information sources

Where does the guinea worm come from?, World Neighbors Filmstrip (Film #122), produced by World Neighbors in Action, International Headquarters, 4127 NW 122 St., Oklahoma City, OK 73120 8869, U.S.A.

“Children against the guinea worm” in Footsteps, No. 4, September 1990, published by Tear Fund, 100 Church Road, Teddington TW11 8QE, U.K.

“Traditional methods of treating guinea worm” in Waterlines, Vol. 4, No. 4, April 1986, published by Intermediate Technology Publications Ltd., 9 King St., London WC2E 8HW, U.K.

“Guinea worm” in The world of health radio information programme, April 1990, published by the World Health Organization, 1211 Geneva 27, Switzerland.