Guinea worm has formidable allies: poverty, a lack of clean water, and age-old superstitions.

Steps to prevent the spread of Guinea worm are straight-forward: keep people with an emerging worm from entering any water source, boil cooking and drinking water, and use nylon filters that strain out the fleas. Standing water can be treated with chemicals that kill the fleas. But the worm has formidable allies: poverty, a lack of clean water, and age-old superstitions.

“We went to a village where their only water source was in a giant crater, and there was an old woman at the bottom of the puddle with a Guinea worm hanging off her foot,” says Philip W. Downs, a Rollins School of Public Health graduate student who has traveled to Africa with Global 2000. “Some of our local workers in the village say, ‘The old people don’t listen to us, they say it’s sorcery or something else.’ ”

If workers see a Guinea worm emerging, they can demonstrate to the villagers what happens when the victim puts his foot in a bucket of water. “They’ll see the worm stiffen and shoot out a cloud of eggs,” Downs says. “Then a light comes on and people understand.”

Prevention workers and volunteers explain the process through drawings and plays they perform in the local dialect. They visit villages to check for new cases, bandage blisters, and distribute large, round water filters, one per household, that fit over the tops of containers.

The latest weapon in Global 2000’s arsenal is a pipe filter, a hard plastic straw with a nylon filter over one end that people can wear around their neck and sip drinking water through. The Carter Center and its partners–Health and Development International, Hydro Polymers of Norsk Hydro, and Norwegian Church Aid–have begun to blanket Sudan with nine million pipe filters .

Former President Jimmy Carter, who got involved in the eradication effort after he and his wife visited villages in Ghana and saw hundreds suffering from the disease, credits the nomadic Tuaregs in the northwest of Africa with the idea of the pipe filters.

“Filter cloths have always been available, but it is not easy to distribute them,” Carter told reporters recently. “And so what the Tuaregs did was cut small pieces of filter cloths and tie them on the end of a reed and they wore them around their neck.”

The personal filters, made with PVC pipe, are assembled in Nairobi by more than thirteen hundred local workers. The project costs about a million dollars, with two hundred thousand dollars coming from the Carter Center.

“All of the communities we visit greet us warmly,” says Christopher O. Duggar, student government president at Emory’s Rollins School of Public Health, who spent the summer in Niger, West Africa, with Global 2000. “It was not long ago when everyone accepted Guinea worm as a way of life. Today the cases are becoming more rare, and the villages are trying to help us finish this battle.”–M.J.L.