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Business Casual: Heroes and Warriors

Funny how real superheroes don’t come with capes or masks or arsenals of high-tech gadgetry. The powers they rely on are compassion, humanity and commitment. And there’s a lot more humility than bravado.

On a warm spring evening, two men sit down at the Carter Library in Atlanta for a quiet discussion of an astounding healthcare triumph: the near-eradication of Guinea worm disease, a debilitating condition contracted by drinking stagnant water contaminated with Guinea worm larvae.

The two are Makoy Samuel Yibi, coordinator for neglected tropical diseases with the South Sudan Ministry of Health, and Mark Siddall, a parasitologist and curator at the American Museum of Natural History in New York.

Yibi has been a leader in eradication efforts in southern Sudan for more than a decade, and Siddall created the Countdown to Zero: Defeating Disease exhibit, which tells the story of the fight to eliminate Guinea worm and other tropical diseases. The exhibit is on display at The Carter Center, which has been working for more than 30 years to eliminate Guinea worm and is now closing in on that goal.

The disease the two are discussing will be the second ever eliminated; smallpox is the only other.

Just 25 cases of Guinea worm remain in the world, located in three African countries: South Sudan, Chad and Nigeria. (See“Defeating the Fiery Serpent,” page 75.)

In the audience is The Carter Center’s long-time adviser on Guinea worm, Donald Hopkins, and a group Yibi and Siddall call “Guinea worm warriors,” a mix of coordinators, technical assistants and others who have worked to help locate and treat cases and to assist with prevention – basically teaching people to filter water before they drink it.

Their efforts have paid off: There are only six cases of Guinea worm in South Sudan now – all in remote areas without ready access to clean water; in 2013 there were 500 cases.

“It is a disease not found in cities,” Yibi says, which makes eliminating those last few cases especially difficult.

South Sudan, which only became an independent nation in 2011, has been plagued by civil war and political unrest; it is a poor country with few good roads and inadequate food supplies in many areas.

Early on, Yibi’s office was under a tree. The eradication effort was put together step by step, with the support of his government, funding and assistance from The Carter Center and great personal determination. He worked with a few paid assistants and countless community-based volunteers.

Siddall, in the role of interviewer, asks about a journey Yibi and a team of eight workers once made – on foot – to find a single Guinea worm case.

“We walked a long way to investigate a Guinea worm infection reported,” Yibi says. “It took three days to get there. We tried not to walk at night because we didn’t know the way.” And because there were animals they did not want to encounter in the dark.

“I cannot ask any of my subordinates to do anything I cannot do,” he says simply. Some of the technical assistants who worked with him “had to go back to the last century” to track down the disease “in places where conditions have not changed for 100 years or more.”

And now the goal of complete eradication is in sight. “My life has been given to this fight,” he says. “I want to see it to the end.”

He declined a promotion from his government so he could stay with the Guinea worm project. “I am scared of being promoted to the point of inefficiency,” he jokes. Then, more seriously, “I have to do this first.” He believes the final stage of the fight will require stability and does not want to jeopardize the program. “If we stop doing what we are doing, it may come back.”

An audience member asks what he would like to see on the Guinea worm “tombstone” when it is finally vanquished. “A lot of stones,” he says, piled high on top of the grave, so it will never return.

The collegiality and common purpose in the room among those who have worked on Guinea worm eradication is palpable. Those of us listening and observing can sense it, even though we haven’t earned the right to share in it.

Still, it’s a fine thing to be in the presence of superheroes.

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