Pipe filters may wipe out Guinea worm

Emily Howard is coordinator for health programs at the Carter Center

The Carter Center, along with its partners—Health and Development International (HDI), Hydro Polymers of Norsk Hydro and Norwegian Church Aid (NCA)—is blanketing Sudan with more than 9 million pipe filters—one for every man, woman and child in the country at risk of Guinea worm disease.

“The Sudan Guinea Worm Pipe Filter Project is a positive story coming out of Africa, and unfortunately there are not enough of these,” said President Jimmy Carter. “We are grateful for this opportunity to aggressively attack Guinea worm in Sudan. We also are encouraged by the eagerness of all interested parties to participate in the fight to eradicate this debilitating disease.”

Guinea worm disease cripples victims, leaving them unable to work, attend school, care for children or harvest crops. Eradicating, or at the very least reducing the incidence of Guinea worm in a country improves the quality of life for all its people. The Carter Center leads the global eradication effort against Guinea worm and has reduced worldwide incidence of the disease by 98 percent, from 2.1 million cases in 1986 to fewer than 75,000 in 2000.

The situation in Sudan represents the greatest challenge to Guinea worm eradication: 73 percent of all reported cases are Sudanese. In 2000, the Sudan Guinea Worm Eradication Program (SGWEP) reported more than 54,000 new cases of Guinea worm disease (the actual number of cases in Sudan is unknown) from 3,386 villages. The regions with the highest incidence of disease are in the south Sudanese territories. Since November 2000, 10 northern states have reported zero indigenous cases.

Use of pipe filters prevents individuals from consuming contaminated water, thus interrupting disease transmission. The pipe filters are an adaptation of the household nylon filter cloth, which is placed over jars to strain water. Nomads came to hold a piece of cloth over the end of a reed, while they drank through it like a straw.

An adaptation of that idea has been found to be effective in response to circumstances in Sudan: the continued internal conflict and its adverse effects on the population; the number of displaced and nomadic persons; the difficulties of accessing safe drinking water and delivering household filters to every endemic home; and the high rate of Guinea worm disease.

“An effort of this magnitude would not be possible without the strong collaboration and continued support of our partners from the community to the international level,” said Donald Hopkins, associate executive director of the Carter Center’s health programs.

The SGWEP was established through a unique collaboration, which also made the Sudan pipe filter project possible. HDI, NCA, Hydro Polymers and the Carter Center have joined forces with more than 39 implementing agencies; 16 working groups, consisting of more than 1,300 people in Nairobi and Kenya; and many supporting industries. Together these groups are working produce, assemble and distribute the pipe filters throughout Sudan before the rainy season begins and disease transmission peaks. More than 9.25 million pipe filters have been produced; 8.25 million of these have been distributed in the most endemic areas of Sudan.

“The massive pipe filter project has the potential to greatly reduce the number of new cases in Sudan in 2002,” Hopkins said. “However, we must remain aware that the continued conflict leaves many parts of the country inaccessible or difficult to reach, making the prevalence of disease and the actual number of Guinea worm cases unknown.”

“We believe the pipe filter project is the quickest and most effective solution at this time to eradicate Guinea worm disease in Sudan, given the constraints of the environment and the costs associated with providing clean water,” said Mikkel Storm, public affairs manager for Hydro Polymers. “This solution gives the Sudanese people a better quality of life without Guinea worm disease.”