Deworming a nation

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en years ago, Francisco Cal Xol, a Mayan resident of Sarstun, was working with a nurse named Lucia when a man arrived at her home with his young son. The man had arrived at the nurse’s home seeking medical attention for the young boy in his arms. His small face looked deadly pale, his belly was swollen and he could not stop vomiting.

Francisco stood by watching as the man held the boy, worms swirling out rapidly from inside the boy’s tiny mouth. When the boy coughed, worms would spew out his nose too, falling to the ground. The boy tossed and turned from the pain, to no avail.

He’s going to die, Francisco thought.

Lucia took to her kitchen to find a garlic plant. She crushed the garlic plant into a paste and blended it with boiling water. She had the child drink the concoction and eventually his color started to return.

“At that time there was no medicine to get rid of worms,” Francisco said.

The drink Lucia gave the boy was a makeshift medicine which helped deworm him. After drinking it, the boy made a slow recovery until eventually he was back to normal. His belly size shrunk back to normal and the color returned to his cheeks. He was alive again.

Today, medicine, made readily available to the community, has largely put a stop to the proliferation of parasite-related illnesses.

Refuge International, a Texas-based medical group, has developed a school program, "Adios Lombrices!," which is an effort spearheaded by the nonprofit organization to deworm the families of villagers living along the Sarstun River near the border of Belize and Guatemala.

The program, founded in March 2007, last year distributed over 4 million doses of the medication in schools all over Guatemala. Deworming pills are handed out in school to children ages 3-15. It is school based because studies have shown that treating intestinal worms is the best way to raise school attendance in developing countries.

“The first time we came into this area, the children were all severely malnourished,” said Deb Bell, president and founder of Refuge International.

Since then, the number of parasite related deaths in the communities covered by Refuge International is zero and attendance rates have increased.

Bell said the children initially had bloated bellies and their hair had a reddish tint to it, both caused by malnourishment and worms.

Three months after treating them with deworming pills, Bell said the difference was night and day. The children’s hair had grown, their skin cleared up and the bellies were gone.

Refuge International treats families in 18 different communities throughout Guatemala.

In 2011, there were more than 400 cases of diarrhea, most likely caused by parasites, in the 18 communities. In 2013, that number dropped to 98 cases.

The dirt on worms

Hookworms live in soil, attach themselves to the skin of a host and burrow underneath, forming a cyst. The parasites travel through the lymphatic system and arrive at the lungs, where they are coughed up and swallowed, ending up in a person’s intestines. The worms latch on to the intestine and may cause severe anemia.

Roundworms are transmitted through contaminated food, which will transmit the worm eggs. These worms absorb the nutrients a person needs and should be absorbing. They also cause a wide range of infections. These worms also cause a bloated stomach in children, because they fill up their stomach.

Whipworms are less pathological than hookworms and roundworms. These worms locate themselves low on the intestinal tract, and give a person the urge to defecate constantly. This often results in a rectal prolapse, where the rectum becomes stretched and protrudes out of the anus.

Worms account for about 40 percent of the morbidity from infectious diseases across the world.

To find out more about the "Adios Lombrices!" project and how to contribute, visit RefugeInternational.com

When patients visit any of the clinics set up by Refuge International, they are given an orange Albendazole pill for each member of their family. The pills should be taken every six months to rid the body of any parasites. If someone presents worm-related symptoms, they are given a pill to expel the parasites. Albendazole is used to treat three different types of worms found in Sarstun: hookworms, roundworms and whipworms.

Jose Esteban Chun, a fisherman, saw his younger brother almost die because of parasites years ago.

He said since the clinic was established in Sarstun by Refuge International, he does not know anyone who suffered because of worms. He said the clinic has helped the community immensely since they no longer have to worry about the lack of treatment.

“It’s a huge problem, not just in Guatemala, in all developing countries,” Bell said.

Currently, Refuge International has about 4.5 million doses of Albendazole sitting in their warehouses awaiting distribution. In the past, Refuge International has worked with the national Ministry of Health to coordinate a country-wide distribution.

Bell said it’s often difficult because the staff at the Ministry of Health is constantly changing. However, Refuge International currently has a contact within the department who might help them carry the program out.

The overall cost of treating 4.5 million children in Guatemala, six different times, is $800,000.

Pills are purchased through collaboration with other organizations and cost about 3 cents a dose.

“Walking along the street if you find three pennies,” Bell said. “You could deworm a child in Guatemala.”