Field Experience Provides Insight on Guinea Worm

Adam Weiss has pulled thousands of Guinea worms from the legs, arms, and feet of Ghanaians and Ethiopians. But a few stand out. He remembers one small boy in northern Ghana with a worm emerging from his scrotum. Weiss drove 15 minutes every morning at 6:30 a.m. to slowly, carefully extract his young patient's worm, little by little, for two weeks.

"I remember this overwhelming feeling of pressure," Weiss said. "I didn't want to ruin his life." Because, Weiss said, in Ghana it is important for men to become fathers, a wrong move by Weiss might break the emerging Guinea worm — sometimes 2 to 3 feet long — and cause irreversible damage in this sensitive area of the boy's body.

Weiss, who was named director of the Carter Center’s Guinea Worm Eradication Program a little more than a year ago, brings to the position both experience in the field and at the Center's headquarters in Atlanta. With eight years living in Ghana and Ethiopia in many Guinea worm program roles, Weiss is uniquely positioned to understand the challenges of eradicating Guinea worm disease, an international campaign spearheaded by The Carter Center that has reduced cases more than 99.9% since 1986.

Weiss got his first taste of Africa in college when he spent a semester abroad in Tanzania, an experience he relished. He decided to enter the Peace Corps after graduating and was sent to a Ghanaian village to help with water and sanitation — and Guinea worm disease. All of it was new to him. "I had to get up to speed quickly," he said.

One year into his service, Weiss was asked to leave his village and help coordinate other Peace Corps volunteers fighting Guinea worm. He stayed on to work for The Carter Center in Ghana. On his last day in the country, he pulled the last worm out of the last person in Ghana to ever have Guinea worm disease. After a stint in Ethiopia, Weiss settled in Atlanta as assistant director of the program.

"I understand the demands that the program places on people, on the supervisors, and how that trickles down to the villages," Weiss said. Because some animals have become infected with the disease, something not thought possible in the earlier years of the eradication campaign, The Carter Center is implementing new intervention ideas and working with partners on research projects. Through it all, Weiss is the voice for the people on the ground.

"My bottom line is: How do these ideas play out at the village level in a way that stops Guinea worm disease as quickly as possible," he said. "We cannot get to zero cases by cutting and pasting the strategies that worked before to today."

But Weiss believes the staff are well suited to face whatever comes their way. "We're a very different program than we were in 1986 or 2000 or even 2010," he said. "But that's a testament to how we are adapting to an ever-changing environment and a Mother Nature that throws curveballs."

Weiss believes the key to success is remembering that the people in endemic communities are the real owners of the Guinea worm program. "We need to respect that and empower them at every turn," he said. "We need to ensure the resources are there and they have the space to think creatively and to talk openly and candidly."

After 16 years dedicated to Guinea worm disease, Weiss hasn't lost his focus. "We're trying to make people’s lives better," he said. "I think it’s a reasonable goal."

Learn more about the Center's Guinea Worm Eradication Program »