Mobilization Strategy for Guinea Worm Eradication in Nigeria

Abstract

The transformation of dracunculiasis from an obscure and neglected rural disease to the highly visible target of a national eradication campaign in Nigeria is described in this report. This process progressed through four overlapping stages: documentation of the extent and nature of the disease as a national problem, demonstration in Nigeria that dracunculiasis could be effectively prevented by targeted provision and use of protected rural water supplies, mobilization for community participation in, and political support of, the eradication effort, and implementation of interventions nationwide. The conduct of the first national village-by-village search for cases and documentation of the adverse socioeconomic impact of the disease (e.g., on rice production) in Nigeria were the key elements used to solicit greater attention to the problem and mobilize support for its eradication. The critical role of the mass media in this effort and other benefits of this mobilization strategy are also highlighted.

Nigeria's Triumph: Dracunculiasis Eradicated

“…Readers are referred to a previous report 6 that describes the critical earliest stages of this program in more detail. In retrospect, NIGEP was fortunate in the transitory coincidence of a few supportive personalities who were in key positions during this vulnerable formative phase of the program, when Guinea worm eradication was neither as obviously successful nor as popular as it is now.…”

“…6 Convening the first national conference in 1985 after two years of preparation, establishing the first state task force in Anambra State in 1986, conducting the first nationwide village-by-village search for cases in [1988][1989], and hosting an international donors conference in 1989 were major highlights of the early stages, which included two visits by former U.S. President Jimmy Carter after The Carter Center began spearheading the global eradication campaign in 1986 ( Table 1 and Figure 1 ). Although the impact of dracunculiasis on school attendance was recognized earlier, a United Nations Children's Fund (UNICEF)-sponsored study released in 1987 that documented huge losses of agricultural productivity in a fertile, but highly diseaseendemic area of southeastern Nigeria provided important additional evidence of the hidden costs of this disease.…”

“…5 When Nigeria finally conducted a nationwide village-by-village search for cases in [1988][1989], it reported more than 650,000 cases in nearly 6,000 villages, more than three times as many as the next highest disease-endemic country. 6 This report summarizes the achievement of zero cases in Nigeria by 2009.…”

Dracunculiasis (Guinea Worm Disease) and the Eradication Initiative

“…One such study (50), based on a survey of 87 households, estimated that the rice-growing areas in three states of southern Nigeria sustained an annual loss of $20 million due to guinea worm disease. In spite of its simplistic argument, this study was extremely effective in mobilizing the support of senior politicians in Nigeria for the eradication of the disease (64). It has been argued previously that this method of calculation uses an oversimplified approach and is likely to overestimate the cost (75,128), as it does not allow for the various coping strategies by which households respond to illness (such as abandoning other tasks and using additional labor), which qualitative studies have found to be common in peasant farming (23,38).…”

“…This advocacy effort needed to be replicated in each country to get a national program established (64). In 1982, India was the first to initiate a national eradication campaign.…”