Since leaving the White House, Jimmy Carter has redefined the role of ex-President, using his status to help broker peace and fight disease worldwide. The stubbornness and sense of moral purpose that disabled Carter during his presidency has served him well in these post-presidential crusades.
The Carter Center was established in 1982 with the mandate of resolving political conflict and combating disease. The near-total eradication of Guinea Worm Disease is its most successful health effort.
Outside of the Carter Center, Jimmy Carter conducts diplomatic missions as an elder statesman. While his approach is not always popular, at times drawing criticism from both Republicans and Democrats, Carter demonstrates the potential of a meaningful post-presidential career.
In 2002 the Nobel committee recognized his efforts at Camp David and the accomplishments of his post-presidency by awarding him the Nobel Peace Prize.
Guinea worm is an ancient affliction. An Egyptian medical text from the 15th century B.C. mentions it, and scientists found a calcified worm in the mummy of a 13-year-old girl who lived in Egypt around 1000 B.C. A Sanskrit poem from the 14th century B.C. includes the plea, "Let not the sinuous worm strike me nor wound my foot."
The disease was once present in many parts of the world, including the Americas. But it slowly disappeared as drinking water supplies were improved, showing that Guinea worm is one of the most easily preventable of all parasitic diseases.By 2001, it had become a disease of the world's forgotten people,the poorest of the poor, in 13 African countries.
The economic impact of Guinea worm is huge. The disease coincides with harvest and planting seasons, when the demand for labor is highest and workers need to consume large amounts of water, leading to re-infection. One study in southeastern Nigeria showed that rice farmers lost the equivalent of $20 million per year because they couldn't work. The same study put the school absenteeism rate over 60 percent, either because the children suffered from Guinea worm or had to labor for family members who did.
Every year, during the dry season, villagers in Sub-Saharan Africa fall victim to the Dracunculiasis parasite lurking in the muddy watering holes they visit each day. Guinea worm larvae are eaten by tiny water fleas called Cyclops, which are then ingested by humans as they drink the contaminated water.
Guinea worm larvae move to their victims' abdominal tissues, where they grow and mate. The male worms die after mating, but the females make their way to other parts of the body, usually the legs and feet.
About 12 months after initial infection, the flat white worm, now as long as two or three feet, begins to emerge through the skin, emitting toxins that cause burning blisters. As victims try to ease their pain by submerging their skin in water, the blisters rupture -- releasing hundreds of thousands of new larvae, contaminating the water source, and beginning the terrible cycle all over again.
Victims must endure the worm's painful emergence for as long as three months, and are usually incapacitated not only by the pain but by fever, fatigue, and nausea as well. To speed things along, people carefully wind the worm around a stick as it emerges, being careful not to pull too hard. If the worm breaks, it will retract into the body, causing severe inflammation. Over half of all worm-emergence sites become infected, and the worst cases can result in permanent crippling or even death from tetanus.
There is no vaccine or cure for Guinea worm disease once a person has been infected. The only way to prevent the disease is to disrupt the transmission cycle of the worm. The way to do this is to protect the water supply. Victims must avoid infecting water, and people must filter or treat their water before drinking.
The Carter Center joined the fight against Guinea worm in 1986,when it helped Ghana and Pakistan launch their eradication programs.Since then, it has spearheaded the World Health Organization's global eradication effort, aimed at making Guinea worm only the second disease, after smallpox, to be wiped out completely.Under the leadership of the Carters and Dr. Donald Hopkins, the Carter Center has raised money, provided technical expertise, forged partnerships, and mustered the political will necessary to achieve this ambitious goal. They have distributed portable filters and initiated education programs to help break the cycle of the worm.
They're getting close. Transmission has been stopped in seven countries, and Asia is now free of the disease.
In 2001, fewer than 65,000 cases remained in 13 African countries,a 98 percent reduction since the beginning of the effort.Experts are confident that total eradication is just around the corner.
In 2001, it was estimated that 80 percent of the remaining cases were in the Sudan,where civil war has prevented a major eradication effort.That same year, courageous Carter Center volunteers distributed 8.5 million pipe filters, enough for every man, woman and child in the endemic areas of the Sudan.These hard plastic straws with nylon filters at one end can be carried around the neck and allow nomadic peoples to strain their water before drinking.
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