Water woes hit Guinea worm fight in Ghana
DIARE, Ghana, Oct 25: Musah Issahaku could not know that the water he drank was teeming with Guinea worm larvae.
Now, a bandage on the 12-year-old's leg covers the tip of a white worm up to one metre long twisted deep into his flesh.
One worm has already been removed from his other leg and each day health workers extract an inch of the spaghetti-like creature, a process that can take up to two months.
''When the worm pulls itself around the muscle and they are pulling ... it is painful,'' Issahaku said. ''If God persists, then the worm will be pulled out either today or tomorrow.'' Guinea worm, also known as ''the fiery serpent'', is contracted by drinking water contaminated with microscopic water fleas carrying larvae. Once in the abdomen, worm larvae grow for around a year before emerging through an agonising blister.
Global efforts to eradicate the waterborne parasite have seen the number of cases fall from an estimated 3.5 million in 1986 to 10,674 reported cases last year, according to the Carter Center, an aid organisation set up by former US President Jimmy Carter.
It is now endemic in just nine countries, all of them in Africa: Sudan, Ghana, Mali, Niger, Nigeria, Togo, Ethiopia, Burkina Faso and Ivory Coast.
Many of the countries where the disease is found are also struggling with other humanitarian crises: Sudan's conflicts in its western Darfur region and until recently its oil-rich south, or Mali and Niger's crop failures and food shortages.
Yet Ghana, a peaceful and relatively prosperous West African state, had 3,981 reported cases in 2005, second only to Sudan, which saw 5,569 cases reported last year.
CLEAN WATER The main reason the incidence of Guinea worm remains stubbornly high in the former British colony is that many of those living in the country's north do not have access to safe drinking water, aid workers say.
''It seems there are some unique issues (in Ghana) with regards to standing water, where people are getting water and how it spreads,'' Ann Veneman, head of the UN children's fund UNICEF, said in an interview.
''A lot of people in very poor areas rely on ponds with still water and people drink that water.''
The stinging sensation caused in the boil or blister when the Guinea worm emerges sends many sufferers into water to try to cool their skin. But on contact with water, the worm spews out larvae, putting those who drink the water later at risk. Issahaku stays in a centre run by district health staff and partly funded by the Carter Center in his northern hometown of Diare, safe from the water in which he may be tempted to cool his infected limbs.
Many of the 9,000 people who live in Diare get their drinking water from a man-made dam banked by sand and full of rainwater, a common system of water collection throughout the region but a method that increases the risk of contamination.
A new mechanised borehole -- funded by UNICEF -- provides them with an alternative.
But the geology of northern Ghana makes digging boreholes difficult and a low success rate -- of between 20 to 30 per cent -- deters those who want to help, said Dr Andrew Seidu Korkor, the manager of the Ghana Guinea Worm Eradication Programme, which works with the Carter Center, UNICEF and the World Health Organisation.
Filtering drinking water or stopping people with hanging worms entering the water would help eradicate the disease.
''Educating people not to step into rainwater (behind the dam) is one of the biggest challenges ... We should try to find ways of making (dam) water potable,'' Korkor said.
''As far as Guinea worm is concerned, transmission occurs when people step into water. It might eliminate Guinea worm if you take water from the source and put it into a tank, then they can't step into it.'' As the debate continues on how to tackle the region's clean water problems, the social and economic costs of the disease remain high.
The Carter Center estimates rice farmers in southeastern Nigeria lost million in one year because of outbreaks of Guinea worm which incapacitated workers.
Last year, one elderly man had 80 worms surgically removed in a village in Ghana's Brong Ahafo region so devastated by the disease that the government had to send in food aid. Children are also kept out of school to care for adults with the disease.
So far this year, there have been 2,500 cases but progress is being made, Korkor said.
''What people fail to recognise we have gone from 180,000 cases in 1989 to 4,000 last year ... No matter how long it takes, we are going to eradicate Guinea worm,'' he said.