President Carter Prepares to Slay the Guinea Worm: Hoelterhoff

By Manuela Hoelterhoff

Photographer: Emily Howard Staub/The Carter Center via Bloomberg

While sending his herd, a young man wears ash on his face for decoration and to keep away flies. He also wears a pipe... Read More

President Jimmy Carter saw his first Guinea worm poking from the nipple of a sick woman in a small village in Ghana about 30 years ago. Many wells and millions of filters later, he may also see his last.
Carter, 90, told the story as he opened “Countdown to Zero: Defeating Disease” at the American Museum of Natural History in New York.
The sight, he recalled, was so horrifying that a member of his entourage paid for a well on the spot.
Having spent 12 months growing inside you, the Guinea worm is reluctant to leave and also quite long: typically two to three feet. Its painful extraction takes three to four weeks.
Photographs in the exhibition of afflicted villagers sitting under a tree wearily wrapping a skinny white worm around a spindle makes you glad Carter lost the White House in 1980 to focus on water filtration.
Initiatives by his innovative Carter Center in Atlanta have
dramatically reduced Guinea worm sufferers from an estimated 3.5 million in 1986 to just 126 people who are stuck in places like South Sudan where warlords enjoy killing people more than worms and bugs.
When wiped out completely, Guinea worm will become only the second human disease ever eradicated, after smallpox.
“Countdown to Zero” surveys other diseases that could be vanquished for the price of a few rocket launchers: malaria, elephantiasis, river blindness and polio.
Yes, polio, so easy to thwart these days with a few drops of vaccine, has returned to torment Syria and its refugees.
I spoke with Carter on the phone while he was resting up for an evening event at the museum.

Sacred Ponds

Hoelterhoff: Where do you think the last worm might be extracted and will you celebrate?
Carter: We will have a great celebration, but right now we can’t predict anything because conflict continues and we don’t know how this will interfere with us. Still, if I would guess, it will probably be in either Chad or South Sudan.
Hoelterhoff: Some of these very isolated villages regard their ponds as sacred. Were you ever in danger?
Carter: The danger was there in other aspects of our work, like monitoring elections and negotiating peace agreements. What we often faced was rejection, so we had to go back to a community several times to convince people their ponds were permeated by fleas that contained the Guinea worm egg. When we put them under a magnifying glass and they saw the bugs, they would become convinced.
Other times, we had opposition from witch doctors who treated Guinea worm and didn’t want to see their patients disappear.

20,000 Years

Hoelterhoff: How did they treat it?
Carter: The same way it’s been treated for 20,000 years, by wrapping the worm around a little stick.
But they considered themselves uniquely qualified to give that treatment to people along with incantations and prayers and sometimes dances. They would convince the people that they didn’t get this by drinking contaminated water, but by the confluence of planets or a curse placed on the family. They had all kinds of reasons without knowing themselves what caused it.
Hoelterhoff: What was the most difficult place you visited?
Carter: I remember being in southern Sudan in broiling temperatures over 100 degrees during the terrible civil war.

Latrine Liberation

Hoelterhoff: You’ve also launched various hygienic initiatives. How’s the latrine building coming along?
Carter: I’ve become famous for latrines! When we first started out in Ethiopia, we thought we’d have 5,000 a year, but it caught the attention of the women’s liberation movement. They couldn’t relieve themselves during the day, unlike men. So they began insisting their husbands and sons dig the holes to build the latrines. We taught them how to do it very inexpensively. The first year we had 87,000 latrines built. Now we passed the 3-million mark.
“Countdown to Zero,” a collaboration with the Carter Center in Atlanta is on view through July.