In Nigeria, health officials and donor organizations are expressing concern over the high rate of Guinea worm infestation. They say the disease plagues almost half of Nigeria’s 36 states. Officials are calling on the government to prevent the spread of the illness by ensuring clean drinking water.
Health officials say the lack of clean water leads most rural dwellers to use infected streams and ponds for cooking and drinking water. As a result, they become exposed to the organism that transmits Guinea worm. The disease is usually associated with a painful and swollen blister that develops into an ulcer on the lower part of the patient’s leg. The infection is spread when people drink standing water containing a small water flea -- or cyclops -- that is infected with the tiny larvae of the guinea worm. Once water touches the swollen ulcer, the female worm under the blister discharges her larvae – which infects the drinking water.
Mynepalli Sridhar heads the department of Epidemiology, Medical Statistics and Environmental Health at the University College Hospital in Ibadan.
He says, "Guinea worm has been a problem for so many years. Look at the Nigerian program motivated by American funding. It was fairly under control for a long time (then) but that kind of control is only temporary unless the state and federal government takes care of safe water supplies."
There have been several campaigns against the disease by the government and donor agencies like Rotary International, UNICEF and the World Health Organization. But health experts say infection rates remain high. Some blame the problem on inadequate funding.
But others, like Noel Ihebuzor, attribute the problem to financial mismanagement. Mr. Ihebuzor is the assistant country representative of UNICEF southwest.
He says, "The money is going in and is not well utilized. If it were well utilized it will achieve more. Why is it not well utilized? It could be greed. It could be corruption. It could be a failure of transparency. It could just be total sloppiness and inefficiency. But whatever it is, it needs to be addressed. And unless it is addressed… you could keep throwing money at a problem and you never solve the problem."
Meanwhile the Oyo state government plans to provide clean water for infected communities by building new boreholes. They’re expected to benefit several communities along the border with Ogun state communities – including Ibarapa and Igugun.
Some doubt that the new initiatives will help. They say past efforts have been spoiled not only by mismanagement – but also by local superstitions. Kayode Obembe runs a private specialist hospital in Ibadan.
He says, "A lot of rumors and taboos surround guinea worm infestation. By and large it is still thought that it could even be as a result of evil forces and other manifestations from evil spirits."
But, Professor Sridhar of the University College Hospital says winning the war against guinea worm is possible and needs everyone’s commitment. He says some people don’t try to find safe drinking water -- they drink from any source. Professor Sridhar says part of a winning strategy would be educating the public about the importance of boiling and filtering drinking water. He says this can be done with an aggressive radio and television campaign. Meanwhile UNICEF has obtained about 500 thousand US dollars from the Bill and Melinda Gates Foundation to help fight guinea worm in Nigeria. The organization’s country representative – Ezio Murzi – says it will provide technical assistance.