South Sudan winning against Guinea worm, says Jimmy Carter

TEREKEKA, South Sudan (AP) — War-torn South Sudan "should serve as an example" for other countries in the progress it is making in eradicating Guinea worm, said former United States President Jimmy Carter.

Speaking to the Associated Press, Carter praised the world's youngest nation for making steady progress in ridding itself of the debilitating parasite despite the "tremendous problems."

Contracted and spread by drinking infected water, Guinea worm affects some of the world's most vulnerable people.

In 2006, when the Guinea worm program launched in South Sudan, the country had more than 20,500 cases in over 3,000 endemic villages. At the time it was one of nine affected countries. Today, it remains one of three still tackling the disease, with Chad and Ethiopia.

This year South Sudan reported zero cases. If this continues, the country will be on track to becoming certified Guinea worm free in the next couple of years.

This feat is being touted as one of the few successes to emerge from the young nation, while it battles a 4-year civil war, starvation and grave human rights atrocities being committed against its own people.

Jimmy Carter has been at the helm of the international campaign to eradicate Guinea worm for more than 30 years. From 1986, when there were an estimated 3.5 million people infected annually in 21 countries in Africa and Asia, the number has dwindled to 10 confirmed cases all of which are in Chad.

Unlike other diseases which are controlled by medicines or vaccines, Guinea worm can be eradicated by educating people how to filter and drink clean water.

An excruciating affliction, the meter-long worm is asymptomatic and incubates in people for up to a year before painfully emerging, often through extremely sensitive parts of the body.

"It was more painful than giving birth," said Rejina Bodi, tracing the stump of her deformed toe with her finger. "Childbirth ends but this pain persists."

In 2009, the 48-year-old mother of six was one of South Sudan's most severe Guinea worm cases. Seated on a mat outside her small hut in the rural village of Terekeka, Bodi yanks down her shirt to expose her chest and frantically point to the many scars covering her narrow frame.

Eight years ago more than 10 worms were pulled out from her breasts, legs, feet and arms over a seven month period. Three worms forced their way out of one hole in her small toe, leaving it misshapen and a permanent reminder of the agony she endured.

"It's a disease of those who basically have nothing," says Makoy Samuel Yibi, director for South Sudan's Guinea worm eradication program.

Due to its low literacy rates and remote location, Yibi says Terekeka was one of the worst hit areas.

He attributes the success of South Sudan's Guinea worm project to more than 17,000 community volunteers who go door-to-door providing preventative information and acting as surveillance systems in some of the most hard to reach areas across the country.

"The worst thing is a missed case," said Yibi. Due the mass displacement of people since the onset of the war, his team is working closer with neighboring countries to increase cross border surveillance.

Looking back, Jimmy Carter said this local network is something he wished he had implemented sooner.

"At the beginning we underestimated the importance of local leaders," said Carter, who admitted that he initially thought Guinea worm would be eradicated within five to 10 years of launching the campaign.

Much of South Sudan's success is due to the large strides taken before the war erupted in 2013, although experts say the conflict hasn't greatly harmed the program's progress. Between 2006 and 2012 the country's cases reduced by 93 percent.

Globally, the Guinea worm program is entering the final stretch, however, according to the World Health Organization, the last remaining cases can be the most difficult to control as they usually occur in remote and often inaccessible areas. Guinea worm has been on the verge of being eradicated for a few years.

Although fighting between President Salva Kiir's government forces and troops loyal to former Vice President Riek Machar show no signs of ending, those battling Guinea worm refuse to let the war stand in their way.

"We're pretty stubborn," said Carter. "We don't ever give up."

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AP journalist Maria Cheng in London contributed to this report.