The Carter Center - by Hope Allen

The evening I received and read the material from The Carter Center in Atlanta, GA, I found that for most of that night sleep would not come. In its place were images of unseeing milky eyes and worms being pulled from the legs of children. As I went through the information on two of the many diseases being targeted by former President Jimmy Carter’s organization, I was ill-prepared for the photographs that captured a kind of suffering from which I have been blessedly insulated. When I read how easily treated and preventable these conditions are, I sat in wonder that I had not even heard of Guinea worm or river blindness. How could I know the dating habits of even minor celebrities and yet know nothing of the incredible humanitarian efforts being made on behalf of, literally, the poorest people on the planet? I’m sorry to report that I have no palatable answers for what is deemed newsworthy and what is not. I can, however, pass along a little bit of what I have learned about the extraordinary power of goodness.

Dr. James Zingeser, senior epidemiologist and technical director of health programs at The Carter Center, was generous with both his time and patience as he tried to help me understand in both technical and human terms what The Carter Center is accomplishing. I expected a sadder story and a darker disposition from someone who lived among these illnesses for three years in Sub-Saharan Niger. Instead, I was struck by his positive attitude and his genuine respect and affection for these people. He describes them as enormously generous and spirited. Dr. Zingeser tells of how even the poorest among the villagers welcomed him into their dwellings to share the only thing they had—a cup of tea. He describes people who under the most dire of circumstances manage to stay open and guileless.

Carter himself writes about witnessing “the capacity of destitute people to persevere under heartbreaking conditions...and of coming to admire their judgment and wisdom, their courage and faith, and their awesome accomplishments when given a chance to use their innate abilities.” In his address to his Oslo audience upon winning the Nobel Peace Prize, the 39th President of the U.S. discussed what he believes is the greatest challenge the world faces. He said, “Among all the possible choices, I decided that the most serious and universal problem is the growing chasm between the richest and poorest people on earth. Citizens of the ten wealthiest countries are now 75 times richer than those who live in the ten poorest ones, and the separation is increasing every year, not only between nations but also within them. The results of this disparity are root causes of most of the world’s unresolved problems, including starvation, illiteracy, environmental degradation, violent conflict and unnecessary illnesses that range from Guinea worm to HIV/AIDS. Tragically, in the industrialized world there is a terrible absence of understanding or concern about those who are enduring lives of despair and hopelessness. We have not yet made the commitment to share with others an appreciable part of our excessive wealth. This is a necessary and potentially rewarding burden that we should all be willing to assume."

According to Dr. Zingeser, the most important thing to understand is why The Carter Center has been able to succeed where countless others have failed in trying to provide aid and effective disease eradication programs. Carter’s position as a former U.S. President has enabled him to go to the leaders of at least sixty-five countries since 1982 and build the trust necessary for implementing even the simplest of projects. The problem is a basic distrust of outsiders, often including neighboring countries and even neighboring tribes; therefore, it can be nearly impossible for recipients to accept our foreign technological advice and medicinal remedies. Using his influence to build a foundation of trust and cooperation where none had existed before, President Carter gets heads of nations to persuade local leaders to allow implementation of The Carter Center’s programs. Much progress has been made by teaming with organizations like Lions Club International Foundation, the largest service organization in the world. Many Lions Club members are actually from the communities being aided.

Surprisingly, Dr. Zingeser explains that securing and distributing medications are still major hurdles in poorer countries, and The Carter Center devotes a major portion of its efforts to these tasks, often in partnership with American pharmaceutical companies. Donations from U.S. drug manufacturers have played an extraordinary role in fighting these diseases that have overstayed their welcome by at least a century. Merck & Co. just administered the 250 millionth dose of Mectizan in a small village in Tanzania after vowing 15 years ago to donate Mectizan tablets for as long as needed to control river blindness. Help has come by way of other types of companies as well. In the fight against Guinea worm disease, E.I. du Pont de Nemours & Co. and Precision Fabrics Group created and donated more than eight million cloth filters to ensure safe drinking water. The American Cyanamid Co. has donated more than $2 million worth of Abate larvicide, which destroys the Guinea worm larvae in water supplies yet still leaves water safe for drinking.

People are infected by river blindness (onchocerciasis) when they are bitten by a blackfly of the genus Simulium, which harbors one or more infectious larvae. The larvae are deposited in the wound and transform within a year to the adult stage. Adult female worms measure 30 to 50 centimeters (12 to 20 inches) in length. Males are much smaller, measuring 3 to 5 centimeters (1 to 2 inches). When the male and female worms come together inside the human body, they gather in groups of five or six, intertwined and encased in a fibrous capsule that forms a nod ule. Nodules can often be felt under the skin.

The uterus is the most prominent organ of the female worm, occupying some 80 percent of her internal space, and enabling her to produce thousands of embryo offspring called microfilariae (about the size of a period on a type-written page), which leave the nodule and migrate into the eyes, skin and other organs. Persons with many fertilized female worms in their bodies may harbor as many as 200 million microfilariae. However, a person must receive many bites to acquire a heavy body load of adult worms and microfilariae. Blackflies breed in rapidly flowing streams and rivers, and their numbers increase the closer one gets to those breeding sites. Thus, villagers living near rivers have a greater risk of being infected and acquiring heavy body loads of adult worms and microfilariae.

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