Last night as a result of eating a slice of key lime pie that was at least twice as large as I wanted, I had a nightmare. The nightmare was that I scratched a bump on my leg that I thought was an ingrown hair (I get lots of ingrown hairs around my knees, hips, and shoulders where my clothes fit close) but when I scratched it, it wasn’t an ingrown hair, but rather a guinea worm.

In my dream I was so angry when that happened that I started jumping up and down and swearing. I’ve never had a guinea worm and I don’t know anyone who has, but from reading about Jimmy Carter’s post presidential projects I know what they are and that they’re really bad.

I’m gonna elide a lot of stuff about the nonprofit industrial complex and plainly state that the intervention of the Carter Center has probably done more than anything else to bring Guinea worm to the near point of eradication, simply by changing the colonial appreciation of it from “a tropical disease” (that we don’t have to worry about now that we know how to not catch it) to “a preventable source of misery to human beings.”

I wanted information on the history of Guinea worm because I suspected it was not a significant problem prior to the Atlantic space trade and although the evidence I found doesn’t conclusively say so, the circumstantial evidence is very good.

Basically you get guinea worm from drinking or immersing yourself in still, stagnant water that has infected copepods (bugs) in it as a result of an infected larger animal being in the water

The way you *don’t* get guinea worm is by *not* using still, stagnant, infested water for drinking or bathing. In a pinch, you can strain your drinking water through a filter, which for this disease, a tightly-woven cloth will do. In fact, that was the most granular intervention the Carter Center did, was to make sure everybody walking around had a filter straw in case they had to drink bad water.

In other words, you do what pretty much all healthy, intact cultures do: you drink from fresh, running, moving water, and you try not to contaminate that water. The water hygiene failures all started with enslaved people in holding pens drinking the only water there was.

A brief history of Guinea worm research in the modern period, 1698–1931

Here’s the piece I read. It’s informative, but nowhere near explicit enough in stating that, as I suspected, colonial rearrangement of land, people, and culture was responsible for pretty much all the misery that Guinea worm caused and still causes.

The narrative actually goes from describing the assumption that this was an African disease that impacted Africans in Africa, to it being an African disease that impacted Africans wherever the slave trade took them, to seeing it as a tropical disease that anybody could pick up in Africa or to wherever it had spread from Africa, in the bodies of people.

Nobody ever got to the final step of “This is a disease of objectification, of separating people from their basic right to be free in the world and eat clean food and drink clean water.” This was a disease of keeping people in sheds like machines, under the nutritional and sanitation conditions of a roadside zoo. In other words, guinea worm existed before Europeans came to Africa, but Europeans made it an infectious disease.

Why this particular tangent? This is just one of the things I think about with respect to the way westerners think about Africa and a lot of Asia — that these are poor, fucked up places, and always have been, and the technologically advanced north has gone to great trouble to save them from themselves.

It’s not true of course. Europe and America have gone everywhere like Ray Bradbury’s firemen, burning things down and then offering “help.”

A long time ago I worked for an accountant whose son entered the peace corps after graduating university. I had always admired peace corps volunteers. Anyway, the young man was sent to Bolivia as an engineer to help improve water and sanitation infrastructure in a village. At his request, my husband translated some of the documents from the village leaders to the leaders of the peace corps group. The letters were upsetting.

The village leaders basically loaded the letters with obsequies and gratitude, understanding that this was their best chance at getting their drinking water and waste treatment sorted out. People in the village were getting sick from sewage intrusion into the drinking wells.

My husband was irritated. He pointed out that basically all the sanitation problems in the “New World,” the Americas and Africa, are due to Europeans coming in and using money and guns to alter the landscape and the societies. They took the best land for whatever — mining, forestry, agriculture, etc., and moved the original residents off of it. Now people are living in configurations that aren’t healthful in the way that their original systems were.

Changes in proximity, concentration, from nomadism to permanent dwellings, from herding to farming, from farming to industry, etc etc. This changes land and water use, leading to a need to mechanically separate sanitation in ways not needed before. It’s not that people lived in dirt and filth before colonization; it’s that they managed space in a way that allowed sanitation to function with less intervention. Read about the history of polio for example.

Anyway I didn’t understand it at the time, but I have come to understand that the peace corps is not pure altruism, but rather a product of colonial guilt, shame, and debt. We are sending back some of our most talented people to at least partially unfuck our own damage. Peace corps is such a good resume point that volunteers always get the better part out of their service.

Anyway, I guess the people in the Bolivian village got their wells and sewage stations fixed. They probably wouldn’t have needed that if they hadn’t been forced to live in greater concentrations than before, in a land use that probably wasn’t suited to the geography, which probably wasn’t their own original geography. People still love the peace corps. And the kid came home and got a great job making lots of money.

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