|Description:||This image depicts the painful suffering being sustained by a young girl named Akouma, who is infected with Guinea worm, Dracunculus medinensis. Two health workers are extracting an adult worm from the girl’s lower right leg. The Guinea worm has migrated, over a period of approximately one year, to its site of emergence from its subcutaneous location, out through a ruptured blister, in order to release its eggs in a local pond or dam. This blister causes a very painful burning sensation and eventually (within 24 to 72 hours) ruptures. Once the white, spaghetti-like worm emerges from the wound, it is pulled out only a few centimeters each day, and wrapped around a small stick or piece of gauze. Sometimes a worm can be pulled out completely within a few days, but this painful process often takes weeks.|
Each time a worm emerges, persons may be unable to work or resume daily activities for months. The emergence of the worm usually occurs during planting or harvesting season, causing people to suffer crop losses when they cannot tend to their fields. Parents who have active Guinea worm disease may not be able to care for their children. People suffer food shortages when they are unable to work. For example, southeastern Nigerian rice farmers lost $20 million USD in one year because of outbreaks of Guinea worm disease.