Rogue village continues to spread guinea worm

The government of Mali has launched a new campaign to eradicate guinea worm, focussing on a rogue village near the southern border with Burkina Faso, which inadvertently is exporting the water-borne parasite throughout West Africa. The problem is that the 2,000 inhabitants of Niagassadiou in the Mopti region of south central Mali drink polluted water from local wells without filtering the liquid in order to remove the guinea worm larvae. These eventually grow into metre-long parasites inside their body. The villagers believe they are simply cursed with the illness that leaves its victims incapacitated for up to three months at a time as the mature worm emerges through a painful blister. All efforts so far to persuade the villagers to use the filters that health workers give away freely have failed. Because the inhabitants of Niagassadiou are extremely poor, many of them leave home after each harvest to seek work elsewhere in Mali, across the border in Burkina Faso and even as far away as Saudi Arabia. Wherever they go, they take the guinea worm with them. Last year 11 cases of guinea worm in Burkina Faso and four in other parts of Mali were traced back to Niagassadiou. Doctor Issa Degoga, the national coordinator of Mali's campaign to eradicate guinea worm said the problem is that "they export this illness to other parts of the country - Timbuktu, Gao, Kidal, Bamako - and abroad too - especially to Burkina Faso." Since 1988 the infection has been virtually eradicated from 67 other nearby villages where it was once endemic, but in Niagassadiou it remains rife. Last year, the village accounted for 23 of the 24 cases of guinea worm registered in the surrounding district. Health workers have so far concentrated their campaign to eradicate guinea worm on a drive to persuade the inhabitants of Niagassadiou to filter their drinking water. But Fanta Ongoiba, a woman who walks two kilometres every day to fetch water from a large shallow well used by farm animals as well as people, says the real answer is to provide the community with clean drinking water in the first place. "How do you expect us not to get guinea-worm if we don't even have access to proper drinking water?" she said. An IRIN correspondent visiting Niagassadiou found that all three boreholes capable of providing clean water to this community of widely dispersed hamlets had been out of action for the past three years. A new campaign by the Malian government and its NGO partners to eradicate guinea worm nationwide was launched in Niagassadiou on 5 May under the slogan "zero cases by 2005." "It is a scandal that this scourge has not been eradicated....to overcome this nightmare disease, it is necessary to change the mentality of local people," Baye Konate, the prefect of Mopti region told IRIN. Health workers are worried by a recent rebound in the number of cases, and not just in Niagassadiou. In 1994, when Mali launched its first campaign against guinea worm, the government recorded 5,581 cases of the disease. By 2000 the number had fallen to 290. But by by last year the number of casese had crept back up to 829. The guinea worm enters the body through contaminated drinking water and then develops into a worm, which can grow up to on metre long. After about one year, the mature worm partially exits the body forming a blister, usually on the feet or legs. When that blister comes in contact with water, such as a river or a stream, the worm releases more larvae, infecting the water and starting a new cycle. The mature worm must be removed surgically or wound out of the body carefully on a stick - a process that usually takes several days. Unless the parasite is beaten in villages like Niagassadiou, new infections will continue to appear each year across West Africa. Every year, after the harvest, there is a mass exodus of young people from the village in search of work. Idrissa Ongoiba, a literacy worker with the Near East Foundation in in Niagassadiou, said two thirds of these migrant workers head for Burkina Faso, 26 km to the south. Others spread out across Mali and a minority make it as far as Ghana, Niger and even Saudi Arabia.