Revista Horizontes: primavera/otoño 2013 | Año LVI-LIX Núms. 108-115

DR. ERNESTO RUIZ-TIBEN: DEFEATING GUINEA WORM DISEASE Walker Griffith Public Information Office The Carter Center. Summary Dr. Ernesto Ruiz-Tiben, a 1964 graduate of the Pontificia Universidad Católica de Puerto Rico, leads the Carter Center’s campaign to eradicate Guinea worm disease. Guinea worm is a debilitating parasite found in some of the world’s most remote communities. It is on track to be the second human disease eradicated, after polio. When the Carter Center began its campaign in 1986 there were an estimated 3.5 million cases found in 21 countries in Africa and Asia. In 2013, the campaign expects to report fewer than 150 cases in four countries, Chad, Ethiopia, Mali, and South Sudan. Ernesto Ruiz-Tiben. The Carter Center. E. Staub. Dr. Ernesto Ruiz-Tiben: Defeating Guinea Worm Disease “Sometimes it’s like dragging a dead elephant through a swamp by its tail,” says Dr. Ernesto Ruiz-Tiben about the campaign to eradicate Guinea worm disease. Dr. Ruiz-Tiben, a 1964 graduate of the Pontificia Universidad Católica de Puerto Rico, serves as the Director of the Guinea Worm Eradication Program at The Carter Center, a not-for-profit organization founded by former U.S. President Jimmy Carter. While ridding the world of a disease is a tremendous challenge, Dr. Ruiz- Tiben does not shy away from tackling difficult problems. “We’ll be standing until the last worms goes,” he says. Since the Guinea worm never sleeps, the program must, “outdo it at all places and at all times.” Fifteen years ago, in 1998, Dr. Ruiz-Tiben, then in his early 50s, was contemplating retirement. An epidemiologist, he’d served for 27 years as a commissioned officer of the U.S. Public Health Services at the Centers for Disease Control and Prevention, and in his retirement hoped to do some traveling. However, the opportunity arose to work with his former CDC colleague, Dr. Donald Hopkins, vice president for health programs at The Carter Center. “Don put together a team unrivaled in its abilities and effectiveness. It’s the reason I continue to work.” In his second career, Dr. Ruiz Tiben does get to travel, although most of his trips are to the world’s poorest and most remote regions where the scourge of the Guinea worm still lingers. “I never did retire,” says Dr. Ruiz-Tiben, “I came to work with The Carter Center.” The Center is grateful he made that decision. Thanks to the work of Dr. Ruiz-Tiben and his program team, The Carter Center and its partners, including national Guinea worm programs, the World Health Organization, and CDC, has helped eliminate the disease in 17 countries. When the Carter Center began the campaign in 1986 there were an estimated 3.5 million cases found in 21 countries in Africa and Asia. In 2013, the campaign expects to report fewer than 150 cases in four countries, Chad, Ethiopia, Mali, and South Sudan. The Center is now targeting those four countries to complete the eradication process. Guinea worm disease, an ancient parasitic infection believed to be the “fiery serpents” of the Bible, infects people when they drink water contaminated with the parasite’s larvae. After a year maturing inside the body, the approximately meter- long worm emerges through painful lesions, often from the backs, breasts, legs, and genitals of their victims. Defeating the parasite is primarily “a matter of education,” says Dr. Ruiz-Tiben. When villagers learn to filter their water through simple nylon water filters before consumption, and not to enter the water when they are infected, the parasites disappear – they cannot survive without their human hosts. “That’s why it can be eradicated worldwide,” he says. When setbacks occur Dr. Ruiz-Tiben remains undiscouraged. Remembering an outbreak in Ghana in 2008 he recalls, “It was one of the largest outbreaks I’ve ever experienced, with more than 1,000 reported cases, most in children. At one clinic, there was a chorus of children crying, having their worms pulled out. That’s when I knew we had to keep going. There’s no reason for suffering like that.” Dr. Ruiz-Tiben is confident that eradication will be achieved and continues to work tirelessly with the Center and locals to complete the eradication process. “We will continue until we have eliminated the last worm.” horizontes@pucpr.edu Años LVI-LIX Núms. 108-115 Horizontes – primavera / otoño 2013-2016 15