Wednesday, November 30, 2011

Horrifying Parasites (part 1)

(Swollen stomachs are one of the most obvious signs of worms)

Intestinal parasites. Worms. 2 billion people have them. 562 million of those are kids. 300 million of that 2 billion have severe or permanent health problems because of them, and over 50% of those are school-age children. And how much does it cost to treat these sinister little invertebrates? Between $0.02 and $0.20 a year, depending on the type of worms you have.

Other than iodizing table salt this is perhaps the single cheapest, easiest and best public health investment a developing country can make. And it seems most of the table salt in northeastern India is already iodized. So if we give every PMS student (the unfortunate acronym for Partnership Ministries Society) one 400mg pill of Albendazole, with a Praziqantel if they are near a body of fresh water, once year it will decrease the total burden of the parasites on the community by 70%. To treat those 8,000+ kids will cost us around $200. Not a bad investment.

We hit on this idea while I was meeting with my boss, John, and Ronnie, the V.P of education. The topic of discussion was if there was anyway to make a vitamin campaign at the schools effective and sustainable. Not really was the answer we came up with. It would cost tons of money if we didn’t them as a donation, and even then it would be difficult to secure more than a few months supply. And a few months worth wouldn’t be enough to make any meaningful difference anyway. Ronnie brought up the idea of deworming instead, which would accomplish more than vitamins at a fraction of the cost. Vitamins are not too useful if you have a swarm of helminths wriggling through your gut and consuming half the nutrients, and if kids can start getting the full benefit of the food they eat then, in comparison, that’s almost as good as giving them a supplement.

I was pumped. This was the embodiment of that annoying business/NGO term ‘low-hanging fruit.’ Like some proverbial, ripe melon on a waist-high branch, we hardly had to expend any effort to get a big reward. So I rushed off to my computer and did one of the few tangible things my degree really taught me to do well- research. Turns out that, along with the stuff I mentioned at the top, kids that get treated for worms will make an average of 43% more as adults than those with persistent infections. And the deworming campaign in 1950s Japan is one of the reasons credited for its subsequent economic boom.

(Me and John with a dead snake, its like worm only bigger and not)

We also certainly weren’t the first group to realize the benefits of deworming. WHO gives it special mention as an integral component in reaching the UN’s Millennium Goal of universal primary education. India currently even has the largest deworming program in the world. An awesome NGO call Deworm the World (a great idea for a Christmas present if you want to make a donation in someones name that will actually make a difference) partnered with the Indian government and are now treating 17 million kids for worms in the northern state of Bihar

Putting together a Power Point to train the teachers and nurses who would be administering the drugs was next. Though fascinating, learning all the fun facts on intestinal parasites and seeing dozens of photos of worms crawling into healthy skin and out through open sores brought on a paranoia similar to classes in abnormal psych. I began wondering if my lack of weight gain, in spite of impressive consumption, might be due to more than just a fast metabolism. Could it be that on one of my third world trips I had picked up a malevolent passenger? Could it be that for the last few years I had one or two silent monsters living inside of me? That, the satisfying thought of Albendazole starving a worm of glucose till it died what I hoped was an agonizing death, and the fact that the pill is only 2 cents led me to decide it was better to be safe than sorry. Though the deworming pill definitely made me sleep easier I am still finding myself thinking twice before wearing flip-flops outside.

Now that the slide show is done, and I am confirmed worm free for at least 6 months, its time to move on to the logistics of training and drug purchase and distribution. Deworming day isn’t until early January, which should give us more than enough time.


  1. Amazing Travis!! I am so intriqued, excited and proud reading this. One more year till I am a nurse and can get out there!!!

  2. This is awesome! I love the practical approach you're taking here. Don't let their look fool you. Sometimes the low fruit hang that way because of their weight.

  3. Thanks guys!I appreciate it and I'll keep you informed on how it turns out!