Reducing guinea worm in Ghana

WaterAid has helped people like Fusiena from Nyohini in Tamale build a new water supply.

Credit: WaterAid / Jon Spaull

Thanks to safe water and hygiene education projects, Ghana is making good progress towards eradicating guinea worm.

Guinea worm is an intrusive disease where parasitic worms grow up to three feet long inside a person before painfully breaking their way out of the body through the skin.

It has been particularly prevalent in Ghana, but figures show the numbers have been drastically reducing. Last year cases of guinea worm dropped to 3981 from 7275 the year before, a 45 percent decrease and a far cry from the 123,793 cases reported in 1990.

However, despite progress, Ghana still remains the country with the third highest rates of infection after Nigeria and Sudan.

Children are particularly susceptible to the disease. In 2004, a UNICEF report highlighted that 60% of all the cases in Ghana occurred among children. In some places 72% of Ghanaian children are infested with the guinea worm parasite, negating any resources put into education as they are often too sick to go to school.

Like many children in Tamale, a city in the north of Ghana four-year old Sambla has guinea worm. She has it in her foot. "The worms come from the water source," her grandmother explains.

"They get into your body. It hurts Sambla the most when we are getting her ready for bed. There are six children in our house and four of them are suffering with guinea worms."

The disease is spread through contaminated water supplies making its very presence symptomatic of a far more fundamental problem: a lack of clean water.

In the Upper East Region, WaterAid's work with Rural Aid has demonstrated that safe water, sanitation and hygiene projects can solve the guinea worm problem. 23 year old Fusiena Abdul Rahman from Nyohini in Tamale knows this only too well.

"Before the pump was installed, it was very different here. The water used to be red but now it is clear. We used to get guinea worm but now we don't get sick. Children are much healthier now. I hope that if I have children, they will be healthy and live long. I hope the same thing for myself too!" 

For this community, a safe water supply means people no longer have to drink water contaminated with the disease and WaterAid is working to replicate this success across the rest of the guinea worm affected city of Tamale.

Guinea worms can take weeks and sometimes months to fully leave a person's body. During this time it dangles from where it emerged, usually from the foot or the ankle. If the worm makes contact with water at this stage, it releases hundreds of thousands of guinea worm larvae, re-infesting the water and thus perpetuating the cycle. To help stop its spread, WaterAid also teaches communities how to break the worm's life cycle by preventing people with emerging worms from entering water sources.

Where a safe water source is not available, communities are taught to filter water fleas carrying guinea worm larvae from their drinking water using fine-mesh cloth or preferably a nylon fine-mesh filter. Boiling the water can also purify the water but can be costly where fuel is scarce. In some cases, surface waters are treated with a chemical that is toxic to worm larvae but not humans.

Though there is still work to be done to complete the eradication of the worm, Ghana has achieved remarkable success in reducing the transmission of the disease through projects like these.

This success has motivated the Ghanaian Government to pledge its continued support to water projects in rural areas and to prioritise work in guinea worm endemic communities.

This is good news for communities affected by guinea worm in Ghana. Eradicating guinea worm has many positive repercussions beyond health. As the worm often emerges during harvest time, it affects livelihoods and food production and its debilitating nature prevents children from attending school. With a little more work, Ghana can free all its communities from these burdens.