Torture by Worms

February 18, 2007
Op-Ed Columnist
By NICHOLAS D. KRISTOF

JIMMA, Ethiopia

Presidents are supposed to be strong, and on his latest visit to Africa Jimmy Carter proved himself strong enough to weep.

The first stop of Mr. Carter’s four-nation African trip was Ghana, where he visited his projects to wipe out the Guinea worm, a horrendous two-foot-long parasite that lives inside the body and finally pops out, causing excruciating pain.

Mr. Carter was shaken by the victims he met, including a 57-year-old woman with a Guinea worm coming out of her nipple.

“She and her medical attendants said she had another coming out her genitals between her legs, and one each coming out of both feet,” Mr. Carter added. “And so she had four Guinea worms emerging simultaneously.”

“Little 3-, 4- and 5-year-old children were screaming uncontrollably with pain” because of the worms emerging from their flesh, Mr. Carter said. “I cried, along with the children.”

We tend to think of human rights in terms of a right to vote, a right to free speech, a right to assembly. But a child should also have a right not to suffer agony because of a worm that is easily preventable, as well as a right not to go blind because of a lack of medication that costs a dollar or two, even a right not to die for lack of a $5 mosquito net.

As president, Mr. Carter put the issue of human rights squarely on the national agenda. Now Mr. Carter argues — and he’s dead right — that we conceive of human rights too narrowly as political and civil rights, and that we also need to fight for the human right of children to live healthy lives.

He has led the way in waging that battle. Because of Mr. Carter’s two-decade battle against Guinea worm disease, it is expected to be eradicated worldwide within the next five years. It will be the first ailment to be eliminated since smallpox in 1977, and it has become a race between the worm and the ex-president to see who outlasts the other.

“I’m determined to live long enough to see no cases of Guinea worm anywhere in the world,” Mr. Carter said as he walked in blue jeans through a couple of villages in a remote corner of southwestern Ethiopia, the third country of his African tour.

After leaving the White House, Mr. Carter ended up “adopting” diseases like Guinea worm disease, river blindness, elephantiasis, trachoma and schistosomiasis that afflict the world’s most voiceless people. These are horrific diseases that cause unimaginable suffering, yet they rarely get attention, treatment or research funding because their victims are impoverished and invisible.

When Mr. Carter met with Mohammad Zia ul-Haq, then Pakistan’s president, President Zia had never heard of Guinea worm and didn’t know it existed in Pakistan. Nor did his health minister. But after Mr. Carter put the issue on the agenda, Pakistan worked energetically with the Carter Center to eliminate the parasite in that country.

The villages here in Ethiopia that Mr. Carter visited cradle a fast-moving creek, making a lovely image of thatch huts and bubbling water. But the creek is home to the black flies whose bites spread the parasite that causes river blindness, leading to unbearable itching and often eventually to blindness.

“It’s almost impossible to imagine the suffering of people with river blindness,” Mr. Carter said as he traipsed through the village beside his wife, Rosalynn.

Already, Mr. Carter’s campaign is making huge progress against the disease.

Kemeru Befita, a woman washing her clothes in the creek near Mr. Carter, told me that two of her children had caught river blindness in the last couple of months. After a visit to the witch doctor didn’t help, she took them to a clinic where — thanks to Mr. Carter’s program — they received medicine that killed the baby worms. They are two of the nearly 10 million people to whom the Carter Center gave medication last year alone, who won’t go blind.

At the end of the day, this one-term president who left office a pariah in his own party will transform the lives of more people in more places over a longer period of time than any other recent president. And I hope that he can also transform our conception of human rights, so that we show an interest not only in the human rights of people suffering from the oppression of dictators, but also from the even more brutal tyranny of blindness, malaria and worms.