Blindness from the River
By “Awake!” correspondent in Ivory Coast
“ONCHOCERCIASIS! What a word! I’ve never heard of that before. What does it mean?” inquired Jerry, my European friend.
“Blindness,” was my simple answer. “Blindness from the river. That’s to say, provoked by a fly that breeds in some tropical rivers.” Jerry listened intently as I explained.
“Wayen, for instance, is a small half-abandoned village, some 70 kilometers (44 miles) west of Ouagadougou, the capital of the West African country of Upper Volta. It is in the proximity of the White Volta, one of the highly endemic river basins. Most of its inhabitants are disease-ridden, either blind or have serious impairment of sight.”
“You’ve been to Wayen?” Jerry asked.
“Several times. During my last visit, I met Moussa. He’s just one of the 70,000 blind people in the Sahel region of West Africa. There are an estimated 1,000,000 victims who, though not blind yet, are suffering in one way or another from onchocerciasis.
“Actually, Moussa is not an old man, the way the wrinkles in his skin seem to imply. He’s only about 40; and under normal circumstances, still in his active years. But there he was, prematurely old, his skin horribly thickened and wrinkled. On his shins, I could see that the pigmentation was worn away from much scratching, leaving pinkish blotches tinged with a gray, sickly hue.
“He’s married and has four children. But they live in abject poverty. The oldest child has left the village. He has run away before he gets blind. I saw his brothers among other children there, with rough stones and sand in their hands, scratching their itching arms and legs. Their degree of infection is still mild. They haven’t lost their sight yet. That’s why they serve as guides to their aged and blind parents. In time, they too will become blind, for blindness has become a way of life for them.”
Transmission of the Disease
I explained to Jerry how the disease is transmitted from man to man by a small hunchbacked blackfly, called Simulium damnosum by the experts. It breeds in fast-flowing rivers and streams and, for food, lives on human blood. The disease is not limited to tropical Africa. It is also found in Yemen, Mexico, Central and South America.
In the case of Moussa, tragedy struck right in his infancy. An infected female blackfly bit him, injecting him with a wormlike parasite Onchocerca volvulus. Living in a heavily infested area, young Moussa got bitten over and over again.
Once Onchocerca volvulus gets into the human body, the victim undergoes a slow debilitating process. The more he’s bitten, the more worms gather in his body. For the next 15 years or so, several male and female adult worms coil up under his skin, forming visible nodules on his back, haunches, buttocks, around the knees and in some cases even on the head. They breed within him, producing anywhere between 50 and 200 million “baby” worms. These invade the body and eventually reach the eye. When they die in the cornea, a cellular reaction takes place, an opaque spot is created and blindness ensues.
“Tell me one thing,” Jerry asked, “does the disease kill?”
“Onchocerciasis does not kill,” I told him. “At most, it induces old age and diminishes life expectancy. However, the economic hardships are great. When you have most men between 25 and 45 years of age—your active working population—blind, you have a crippled economy. It is for this reason that in some areas of the Volta River basin in West Africa, people have deserted fertile river valleys, only to settle on much poorer lands, to escape from the flies.”
Medication and Control Program
“What,” Jerry wants to know, “does medical science have to offer to relieve these poor people who suffer from ‘river blindness’?”
My answer is not very reassuring. “Research has been under way for some time now. So far, two drugs, suramin and diethylcarbamazine, have been developed. However, both of them have serious side effects and can only be administered under very close and strict medical supervision. In fact, they are not practical for mass-campaign treatment.”
“What about surgical removal of the worm nodules?”
“That might seem a more practical solution. It has, in fact, been practiced in Central America. This solution does not, however, seem to work in the Volta River basin where the infection rate is such that by removing nodules you only create more room for the younger worms.
“The only feasible and effective means at present seems to be the application of insecticide to the breeding sites of the blackflies. This is what the Vector Control Unit of the Onchocerciasis Control Programme has been doing weekly by helicopters and small airplanes in the Volta River basin area since 1974.
“The program is arranged by the World Health Organization of the United Nations, with financial support from voluntary donor countries and the participating countries. These seven countries, Benin, Ghana, Ivory Coast, Mali, Niger, Togo and Upper Volta, hope that fertile land will recuperate from the disease so their populations can be resettled along the rivers. The control program has set for itself a goal of 20 years to accomplish this task. To date, over $46 million [U.S.] has been spent in the fight against the blackfly.”
“What success has there been so far?”
“Well, the transmission of the disease has been interrupted in some areas. Already some migrant populations are resettling in the ‘successfully’ controlled river valleys. But as an official of the control program once remarked: ‘This is far from eradicating the disease. We can only talk about reducing it to the barest minimum perhaps.’”
Of course, onchocerciasis is but one of the many afflictions exacting an appalling toll among mankind. Human relief efforts are limited and temporary. What a joy it will be, when victims of this disease can not only boast of ‘skin that is back to its youthful state,’ but also have their ‘blind eyes opened!’—Job 33:25; Isa. 35:5.