Disease of the forgotten people

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By Mónica I. Feliú Mójer / Special for El Nuevo Día endi.com *Photo Credit: The Carter Center/E. Staub Country: Nigeria 2004 Imagine that a worm, a meter long and as thin as spaghetti, emerges from your skin, having to extract it several inches daily by three weeks. It is not science fiction, but the agony endured by around 11,000 people in nine African countries, where dracunculiasis or Guinea Worm Disease, caused by the parasitic nematode Dracunculus medinensis, still exists. Dracunculiasis, is a millenarian disease that tortured 3.5 million people in Africa and Asia. Since 1986, the Carter Center, founded by the ex- American president and Nobel laureate Jimmy Carter, fights against this terrible disease. And directing these efforts is one of ours, boricua epidemiologist, Ernesto Ruiz Tiben. “I had seen clinical pictures of the parasite, but it is necessary to see the faces behind the statistics, to really sympathize with the misery of these people”, said Ruiz Tiben. After retiring in 1998 as a commissioned officer of the Centers for Disease Control and Prevention of Diseases of the United States (CDC) , Ruiz Tiben works as the technical director for Guinea Worm Eradication Program, experience that he describes a very special. Thanks to the technical and financial assistance provided by the Eradication Program, nowadays, Asia and eight African countries are dracunculiasis-free, and the number of cases has been reduced in more than 99%. The eradication challenge In theory, the worm’s complicated life cycle is easy to break, therefore eradicating the disease. Unfortunately, the inequality of resources, the lack of infrastructure, potable water, and education, summed to economical, political and cultural barriers, causes the terrible dracunculiasis to afflict the poorest communities of equatorial Africa. Dracunculiasis is not fatal, but highly crippling. The only form to get rid of the worm is coiling it in a stick, extracting it manually without breaking it a few inches a day for several weeks; added to complications that can arise, it can incapacitate the patients an average of 8-9 weeks. For that reason the goal of the Eradication Program is to make of dracunculiasis the first parasitic disease to be eliminated in the history of the humanity. In spite of the resistance showed by some groups of the population, Ruiz Tiben stated that “human beings are human beings in Puerto Rico and Africa”. The pain and the empathy are human feelings that transcend national and cultural barriers, causing the Carter Center’s message to gain followers between the most incredulous. Although the fight against the dracunculiasis "sometimes it's like dragging a dead elephant through a swamp by its tail," Ruiz Tiben comments that “we never thought that we were going to fail. There are moments at which we do not see the light at the end of the tunnel, but we are approaching our goal of eradication, and the motivation its still there”. In Carter Center they feel “morally committed to using their knowledge to get this weight of the shoulders of the poorest among the poor”. Even with the difficulties and the years that this titanic task has taken, Dr. Ruiz Tiben and the Carter Center hope to make history by eradicating dracunculiasis in or before 2009. And victory is around the corner. The author is associated investigator to Massachusetts Institute of Technology and is member of the Council for the Advance in Puerto Rico of Investigation and Scientific Innovation (CAPRI; www.cienciapr.org)


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