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In Mali, Peace is the Path to Rout Guinea Worm

  • Dr. Moussa Saye has been been part of the Carter Center team working to eradicate Guinea worm in Mali since 2005.

When Dr. Moussa Saye was a boy, the rainy season brought great suffering to his village in the Bankass district of central Mali. 

“There were thousands of cases of Guinea worm in our village and other villages nearby,” he said. “There were whole families who couldn’t go to work. We called it ‘The Disease of No Food,’ because people couldn’t work in the fields and put away food.” 

Today, Saye serves as a technical advisor for the Carter Center’s Guinea Worm Eradication Program, dedicating his days to ridding the Mopti region in central Mali of the insidious worms. The Center’s efforts have proved successful: In 1992, Mali recorded just over 16,000 cases; in 2019, it hasn’t recorded a single human infection. In fact, no human case has been reported since 2015, and there have been only nine animal cases so far this year, all in central Mali. 

But recent intertribal and jihadist violence in the region threatens to undermine this progress. 

“The insecurity isn’t preventing us from doing our work, but it is making it more difficult,” Saye said. “Armed groups don’t attack health care workers, but we must travel with caution because most of the roads are mined. Even if you are not attacked directly, there is danger.” 

The Carter Center’s team relies on an extensive network of village volunteers – there are only about 20 Center staffers in all of Mali but about 1600 volunteers in the Mopti region alone. The volunteers educate their neighbors about how to avoid contracting and spreading the disease, go door to door in search of emerging worms, and put up posters offering rewards for reporting cases

  • Dr. Moussa Saye displays a Carter Center poster that announces rewards for Malian citizens who report Guinea worm cases. (All photos: The Carter Center/ J. Hahn)

“We get those posters to the most remote villages,” Saye said with pride. “We want to increase the population’s knowledge so we can be sure all cases are getting reported and stop the transmission in animals.” 

Getting to and from the villages has become increasingly stressful because of the violence, which has killed hundreds and forced tens of thousands from their homes. 

“We used to be able to sleep on the side of the road on work trips, but that’s not possible anymore,” Saye said. “You worry that you won’t get there, and then if you do get there, you worry that you won’t get back.” 

But Saye and the team remain hopeful. 

“We know what to do,” said Dr. Cheik Dumar Coulibaly, national coordinator for Mali’s Guinea Worm Eradication Program. “I believe by 2020 Mali can get rid of the disease. Unlike some countries, Mali does not have wild animals for the Guinea worm to move to, or the forests that can slow progress.” 

The one thing that could hamper progress, he said, is the growing conflict: “If we have full access, there is no doubt we can do it. Lack of security is the only thing that can stop us.” 

The Carter Center’s Conflict Resolution Program has been working to support peace in Mali since 2018. In the fall of 2019, it launched an innovative joint project with the Guinea worm team that aims to provide health services and conflict mediation training in key areas where Guinea worm still exists. 

For Saye, who still vividly remembers the way the disease affected his village, the effort is worth the risk. 

“Guinea worm causes poverty. It causes handicaps. It causes educational delays,” he said. “We need a world without Guinea worm.” 

Learn more about the Center's Guinea Worm Eradication Program »

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