It is early morning in Molujore village of Terekeka County in Southern Sudan, and Viviana Kolong, a 30-year-old mother of three, dresses carefully in a cool, yellow and white cotton dress and orange flip flops, adding a black bracelet and white beaded rosary to complete her outfit. As the wind picks up and the temperature starts its punishing rise, Kolong leaves her mud hut, passing by her home's empty grain stores. As usual, it will be a long day.
After spending the morning preparing her fields for planting season, Kolong will go home, eager to pick up her backpack full of basic medical supplies and health education materials. As the sun climbs toward noon, Viviana will leave home once more to begin her second, unpaid job with the Southern Sudan Guinea Worm Eradication Program in partnership with The Carter Center.
"I became a village volunteer because I was very frightened by the suffering I saw from Guinea worm in my community," Kolong says. "I saw that by sacrificing some of my time, I could help improve people's health."
A parasitic infection acquired by drinking contaminated water, Guinea worm disease-dracunculiasis-incubates in a human body for about a year until a worm as long as 1 meter (3 feet) exits painfully and slowly from a blister in the skin.
After a more than two-decade long effort spearheaded by The Carter Center, cases of Guinea worm disease worldwide have been reduced by more than 99 percent in the world's poorest and most isolated communities in Africa and Asia. Sudan, Ghana, Mali, and Ethiopia are the only remaining Guinea worm-endemic countries in the world. Today, Southern Sudan is considered the last frontier for Guinea worm disease, accounting for 86 percent of cases reported in 2009.
"This disease affects the community just at the time when we need to cultivate the fields," Kolong says. "I do not want people to have to suffer from hunger because they got a Guinea worm infection. This is why I work with the Guinea worm program--to teach people to filter their water and not to let someone with a Guinea worm go into the water source."
Kolong is one of many Guinea worm experts who have worked hard to eliminate cases in her village of approximately 500 people. In 2009, only seven cases were reported, down from 18 the year before. However, the program must remain vigilant as food shortages in the rest of Terekeka County are intensifying. Recent drought conditions have forced people to migrate from Guinea worm-endemic villages to non-endemic villages in search of food and water, perhaps unintentionally spreading Guinea worm disease.
Village volunteers have played a critical role in reducing the incidence of Guinea worm disease in Sudan from 118,578 cases reported in 1996 to 2,733 cases reported in 2009 - a 98 percent decrease. Since 2003, there have been no indigenous cases of Guinea worm disease in northern Sudan.
Conflict in Sudan constrained further program interventions for an entire decade until the signing of the Comprehensive Peace Agreement in 2005 paved the way for the establishment of a full-scale Guinea Worm Eradication Program. Today, insecurity remains the greatest threat to elimination from Southern Sudan, yet dedicated and courageous volunteers like Kolong reinforce that Guinea worm elimination is possible.
It is now mid-afternoon and Kolong is finishing up a demonstration of proper water filter use for a few neighbors. After she makes sure everyone understands and will use this important method for preventing Guinea worm disease, she will go back out to the fields. This time she will hunt for greens that have survived the scorching heat, which she can use to feed her family. When asked if she isn't tired after so much work, Kolong replies, "I must still feed my family."
"No one is working harder to eradicate Guinea worm disease than the Sudanese themselves. Sudan has a corps of more than 13,500 passionate and dedicated volunteer health workers -- foot soldiers of Guinea worm eradication under the very capable direction of the Southern Sudan Ministry of Health and supported by 43 Sudanese and expatriate technical assistants from The Carter Center."
~President Carter
Read More:
April 28, 2010: Winning the Worm War >
Photo credit: Carter Center/L. Gubb
(Click to enlarge)
Viviana Kolong treats Garbino Kenyi, young farmer with a Guinea worm emerging from his right foot. President Carter and Southern Sudan Guinea Worm Eradication Program Director Makoy Samuel Yibi observe how Kolong soaks the wound. Thousands of village volunteers like Kolong have been trained to care for victims in their communities, as well as provide health education on how to prevent Guinea worm disease. In February 2010, President Carter visited Kolong's village to commend and encourage community members to continue their hard work against the debilitating waterborne parasitic infection.
Photo credit: Carter Center/A. Mosher
(Click to enlarge)
Viviana Kolong, 30, stands in front of an empty grain store at her home. "This disease affects the community just at the time when we need to cultivate the fields," she says. "I do not want people to have to suffer from hunger because they got a Guinea worm infection. This is why I work with The Carter Center to teach people to filter their water and not to let someone with a Guinea worm go into the water source."
Photo credit: Carter Center/A. Mosher
(Click to enlarge)
"I became a village volunteer because I was very frightened by the suffering I saw from Guinea worm in my community," Guinea worm village volunteer Viviana Kolong says. "I saw that by sacrificing some of my time, I could help improve people's health." Kolong is one of more than 13,500 village volunteers in Southern Sudan who teach their communities how to prevent Guinea worm and provide free treatment to those suffering with the disease.
Photo credit: Carter Center/A. Mosher
(Click to enlarge)
Guinea worm Village Volunteer Viviana Kolong makes sure her three children--(left to right) Augustino Ani 8, Martinia Wyet, 10, and Doble Lodu, 7--know how to prevent Guinea worm disease by always using their pipe filters when drinking from local water sources.
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