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Inspired by Health Challenges, Doctor Works Miracles in Burkina Faso

As a child growing up in the small village of Dakore in Burkina Faso, Dr. Dieudonné Sankara saw firsthand the debilitating affects of Guinea worm disease. Traveling from village to village with his father, a nurse, he became aware of a reality that seemed preventable, if only people understood the nature of the disease.

"They link Guinea worm disease with witchcraft, with traditional beliefs. The villagers just believe that's how life is," Dr. Sankara explains.

In truth, Guinea worm is a parasitic disease contracted through drinking water contaminated with larvae. Inside the human body, the larvae mature into long, spaghetti-like worms that eventually exit the body through painful blisters in the skin. The crippling pain leaves victims unable to work or attend school, sometimes for months, until the worms completely emerge from the body. There is no cure for Guinea worm, but the disease can be prevented through a series of low-tech measures including filtering contaminated water before drinking it.

Inspired by the work of his father as well as a cousin permanently disabled by Guinea worm disease, Dr. Sankara received his Doctorate of Medicine from the University of Ouagadougou in Burkina Faso and his Master of Science in medical entomology from the University of Bouake in Cote D'Ivoire. After his studies, Dr. Sankara acquired extensive experience in health care system management specializing in immunization and vector born disease control.

In 2000, it was determined that the number of Guinea worm cases had hit a plateau in reductions since 1996. As a result, leaders of Burkina Faso's Ministry of Health and the global Guinea worm eradiation campaign, spearheaded by The Carter Center, were looking for a replacement for the program's national coordinator. Burkina Faso's Minister of Health nominated Dr. Sankara, in hopes that proper coordination and strategic planning could salvage a failing mission.

"It was a challenge. It was exciting," Dr. Sankara remembers. "I said 'We'll see what we can do.'"

Dr. Sankara faced many challenges in his first months as national coordinator. Burkina Faso's Guinea Worm Eradication Program had few resources. Assessing the program's facilities, Dr. Sankara was shocked to realize the program had limited vehicles for field work, poor data management systems, and no working telephone. After convincing the secretary general of the minister of health to install telephones in the program office, Dr. Sankara began to utilize organizations including The Carter Center and UNICEF, each of which provided the program with resources.

Over the next five years, Dr. Sankara and his team, including regional and district health experts, went directly to the affected villages where they supported villagers and community health workers in their daily fight against the ancient scourge. Dr. Sankara knew that the only way to initiate change was to develop a rapport with influential village officials and leaders. Trust became the essential element to convincing villagers that a problem existed and was preventable.

"We had to be innovative because the program at that time was not proactive," Dr. Sankara says. "We needed to get people motivated, not just the workers, but the villagers themselves. Once they were motivated, we provided them with information on what they could do to prevent the disease."

In each village, Dr. Sankara taught people that they could help themselves if they were willing to commit to change. This meant educating people about the source of the disease, providing households with cloth filters to strain Guinea worm larvae from drinking water, and enlisting village volunteers to help detect cases for the program, in addition to advocating for safe drinking water to sustain the interruption of Guinea worm transmission.

Typically, once the team achieved success in one village, they were often tipped off by volunteers about little known villages, accessible only by camel or motorcycle, which suffered from the disease as well. This was the case for the village of Zeri, located 13 miles from the nearest health facility. The roads to the village were difficult to traverse and it took Dr. Sankara and his team two hours to travel the distance. But Zeri, with 35 Guinea worm cases for just 120 inhabitants, was discovered to be the epicenter of Guinea worm disease in the region.

"I saw one lady with more than seven worms, and she had a little child with anemia. The lady couldn't even walk," he remembers.

The team's extensive investigation included speaking with villagers, identifying those infected, and determining the origins of the village's water supply. Today, Dr. Sankara prides himself on the fact that Zeri became free of Guinea worm after only one year of intervention by the Guinea worm eradication program.

Dr. Sankara witnessed the rewards of his hard work as he saw Guinea worm cases in Burkina Faso steadily decline from 1,956 in 2000 to 24 in 2005. Thanks to Dr. Sankara's vision and the hard work of the Burkina Faso Guinea Worm Eradication Program, the country reported zero cases for 12 consecutive months at the end of November 2007, implying that transmission of the disease was stopped during 2006.

While Dr. Sankara has achieved extraordinary accomplishments in public health, his quest to help people has only begun. After receiving the 2005 Foege Fellowship in Global Health Leadership, he pursued his Master of Public Health at Emory University's Rollins School of Pubic Health.

While pursuing his education in Atlanta, Dr. Sankara maintained contact with the Guinea worm eradication campaign. On the Carter Center's behalf, he returned to Burkina Faso in the summer of 2006 to continue to support nationwide surveillance and intervention efforts in the country.

Just prior to completing his studies, Dr. Sankara received the prestigious Charles C. Shepard Award from the university in recognition of his scholarly master's thesis. When asked about his plans for the future, Dr. Sankara replied with his trademark grin, "I will find a job in public health-to help people do better and better and better. I am learning. I want to do more for people; not just Burkina Faso."

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Note: Since June 2007, Dr. Dieudonné Sankara works as senior neglected tropical disease control specialist with The USAID Neglected Tropical Disease Control Program based in Washington D.C. The program supports countries in Africa and in the Caribbean to reduce neglected tropical disease burden in affected communities.

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Photo credit: The Carter Center

Educating people about the source of the Guinea worm disease and providing households with cloth filters to strain Guinea worm larvae from drinking water can help prevent cases of the disease. Once the parasite's cycle is broken in humans, the disease will be gone forever.

Photo credit: The Carter Center/D. Hakes

As Burkina Faso's National Guinea worm Coordinator, Dr. Dieudonné Sankara oversaw Guinea worm's steady decline in the country from 1,956 cases in 2000 to only 24 in 2005.

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