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Fighting Guinea Worm, a waterborne blight in Mali

In 2013, only 148 cases of guinea worm were reported worldwide – down from an estimated 3.5 million cases in the mid-1980s. As this UNICEF report from Mali in 2010 shows, it is one of many challenges in ensuring safe water, sanitation and hygiene.

By Heidi Good

GAO, Mali, 4 October 2010 – Guinea Worm, a painful parasitic disease, is endemic in northern Mali. Transmitted through contaminated water sources, the illness is just one of many challenges in ensuring safe water, sanitation and hygiene in the country.

VIDEO: UNICEF's Matthieu Crette reports on efforts to eradicate Guinea Worm in Mali.  Watch in RealPlayer


In stagnant ponds – which double as drinking water sources in many parts of the world – microscopic water fleas absorb Guinea Worm larvae. Humans then consume the contaminated water.

Over the period of about a year, the larvae develop into a worm that can measure up to one metre in length. Patients frequently use water sources to relieve the pain. Once the adult worm makes contact with the water, however, thousands of larvae are expelled, perpetuating the cycle of contamination.

UNICEF and its partners are working to eradicate Guinea Worm and promote improved water and sanitation throughout Mali. The project represents a major push to help the country meet the United Nations Millennium Development Goals targets related to child health as well as improved water and sanitation.

Among other goals, the MDGs, a set of internationally recognized targets for reducing poverty worldwide, call for countries to halve the number of people without access to safe water and sanitation by the year 2015.

Strides against infection

"One person carrying [Guinea] worm can contaminate 200 to 300 people,” said Hamadoun Dicko, who works for the local Administrative Agency for Health in Gao. “If a child infected with Guinea Worm is in charge of collecting all the water, it is certain that she will transmit it."

© UNICEF video
A boy carries water in Gao, Mali.

Treatment entails accelerating the expulsion of the worm, a process that may take several painful weeks while the worm emerges through a blister in the skin. It is then extracted, rolled out little by little, and bandaged to prevent breakage and infection.

In 1992, there were more than 16,000 cases of Guinea Worm in over 1,000 villages in Mali. Following the start of a national eradication programme by the Government of Mali, supported by UNICEF, the non-governmental Carter Center, the World Health Organization and other partners, the number of patients dropped to fewer than 200 in 2009, localized within 52 villages in the country’s northern region.

"The main problem is in the north,” said National Coordinator of the Eradication Program in Mali Dr. Gabriel Guindo. “Eradication in Gao, Timbuktou and Kidal is problematic, as there are security problems in these areas and implementing interventions is difficult given the scarcity of underground water."

Multiple strategies

Despite these challenges, the eradication of Guinea Worm is possible through a three-tiered strategy. It begins with an awareness-raising campaign aimed at behaviour change to encourage the use of filters when drawing pond water. When no filter is available, straining water through fabric can prevent the worm from getting into the family drinking container.

© UNICEF video
Health workers extract a Guinea Worm from a patient in Gao, Mali.

Next, patients receive treatment at containment centres, temporarily separating them from the local water pond in an effort to curb the spread of the parasite. Isolated patients receive medical treatment and about $4 per day as an incentive to receive the care while separated from their families.

UNICEF Mali is also working with local partners to increase the number of available wells, as access to safe drinking water is essential to curb the use of potentially contaminated ponds. 

Through these measures and the support of local behaviour change, UNICEF and its partners hope to eradicate Guinea Worm completely within the next two years.



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