Jason Beaubien
Appearances
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
He was a major champion for human rights. He continued to work on peace in the Middle East. You know, he was working on elections. He helped negotiate some really sticky political stalemates in Central America. And for all of that work, he was recognized not just in the U.S., but globally.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
Yeah. And that was in 2002. And he had two more decades ahead of him. And one of the things that he worked on was trying to eradicate this really horrible disease called guinea worm.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
So the World Health Organization has a list of so-called neglected tropical diseases. You know, these are diseases in need of more research, more treatment. He, however, had a former employee from the White House who got involved with working on clean water. And this guy came. gave this pitch to Carter, and Carter was like, this is doable.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
He was driven by this worldview of the need to ease suffering, to help the less fortunate. So taking on neglected tropical diseases that were being overlooked and ignored, this was right up his alley.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
Yeah, he has. And, you know, it wasn't just him. But you have to look back. It was the mid-1980s. Carter decides to start focusing on wiping out guinea worm. At that point, the World Health Organization estimated that there were like 3.5 million cases of guinea worm disease globally worldwide. Almost all of these were in really remote parts of sub-Saharan Africa and Asia.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
Last year, the WHO says there were only 13, one, three cases of guinea worm globally. Wow. Yeah, pretty impressive.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
It is amazing. Um, and I was talking to Paul Farmer about just how impressive this was and he gave us much of the credit to Carter.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
That's right. Paul Farmer, you know, co-founder of partners in health. So the subject of Tracy Kidder's incredible book, mountains beyond mountains, uh, Farmer, like Carter, was also a crusader his entire life for health care equity around the world. And I was talking to Farmer, obviously, before Farmer died last year.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
But Farmer was saying that in the overall history of human medicine, there hasn't been a lot of progress in entirely eradicating specific diseases.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
That was Farmer back in 2019. So, you know, even from 2019, we've gone from a fewer than 100 down to just 13. It really is on the verge of being wiped out as we speak.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
So I know we all like to respect all forms of life, but guinea worms, they're really gross. You know what?
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
I almost think of them as like evil. You know, that's sort of my scientific assessment. These are evil worms.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
That's right. I am a journalist with a degree in English, so I'm making that as a definitive statement.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
OK, so guinea worms, they're parasites. They spread through contaminated drinking water, but they've come up with this little evolutionary trick. And their life cycle goes like this. The guinea worms larvae, they are born in stagnant pools of water. They live in there. They're tiny. You can't see them. People come along who don't have access to clean drinking water.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
They end up drinking the water with these larvae. Then inside the human, they reproduce. The male worms die off inside the people. The females migrate to the person's legs. And then over the course of a year – They cause these massive lesions. And it takes months before they start to emerge. And it's incredibly painful. These open wounds at times.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
Look, he had an amazing life, both in politics and out of politics. So I think it's great to be able to celebrate Carter. And he's probably going to be remembered more for the work that he did after he left the White House rather than those chaotic four years that he spent in Washington in the late 1970s.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
If it's on someone's foot, they might not be able to walk. And here's their evil little trick. The worms cause this intense burning sensation under the skin right when they're about to release their eggs. And in an effort to extinguish that burning sensation... they plunge their leg into water, oftentimes a stream or a pond. And at that point,
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
All the worms, all their little eggs go out into the water and the whole cycle starts over again, infecting more people.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
So the key from an eradication point of view is to break that reproductive cycle.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
So this is one of the tragedies of this epic battle against guinea worm. You know, for decades, it was believed that humans were the only reservoir, basically the only hosts for this worm. And that the parasite needed that year-long period inside the human body to grow and reproduce. Unfortunately, as the numbers of cases dropped dramatically...
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
Researchers found that the worms were also turning up in some stray dogs and chads and fish, some other animals. So unfortunately, that complicates the eradication efforts because there's no longer just this one single place where you need to look. That said, the number of guinea worms that have been found in animals is quite small.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
Yeah. Clean drinking water is key and, you know, obviously there are a lot of other great benefits to making sure people have access to clean drinking water. Yeah. And if you can break that reproductive cycle of the worm living in stagnant water and reproducing and then spreading back into the water supply, yeah, you can defeat the parasite.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
But getting people better water supplies, you know, particularly in remote parts of some of the poorest countries in the world, it doesn't happen overnight. So education was a big part of the campaign against guinea worm, just letting people know what this cycle is, letting people know that they have the worms to not plunge their leg into a pool where People might later be drinking.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
They were also tracking where these parasites are turning up. They were testing water because obviously if health officials know where the cases are occurring, then they can focus more efforts and resources in those areas. And at one point, a number of places in Africa were offering rewards of $100 for any worms that anyone could turn in.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
This was at a time when things had gotten fairly low in terms of the numbers of cases that were occurring. And Kenya was even offering 100,000 Kenyan shillings. But I should point out that that was when they had pretty much wiped out the disease entirely. Wow.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
You know, the thing about Carter is that he did get out there to many of these places where guinea worm continued to be a problem. But you're absolutely right. You know, this war against this worm was not hand-to-hand combat between Carter and the worms. But what he did was he looked at this health problem and he said, this neglected tropical disease is fixable. We can solve this.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
It was. It was a very chaotic time. And so I was thrilled when I got word you wanted to chat about two of my favorite subjects, Jimmy Carter and guinea worms.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
And he made it a priority to keep global resources focused on it. And Carter would be the first to tell you that he didn't do this alone at all. You know, there's thousands of health care workers out there in the field.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
really drove Guinea Worm to the brink of extinction. And Paul Farmer points out that Carter's role was staying on top of it and keeping the focus for years and decades on this fight. And, you know, as Farmer said, convincing people.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
You know, as I said, guinea worm eradication was just one of many things that Carter worked on in his post-presidential life. But this project was incredibly important to him. And I should note that when he was diagnosed with cancer in 2015, he was still single-mindedly focused on eradicating guinea worm.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
I'd like the last guinea worm to die before I do. I mean, it's just a great line. And he didn't completely kill off the last guinea worm, but Carter did come incredibly close.
Short Wave
Jimmy Carter's Triumph Over The Guinea Worm
Absolutely. No brainer. As you should. Right here at the beginning, let's be clear. Jimmy Carter, he did a lot of things in his post-presidential time. His legacy goes well beyond his battle with guinea worms. You know, he became an advocate for Habitat for Humanity. He was out there actually swinging a hammer with them, building houses in the U.S. and in other places.