At Work Around the World

Togo

Through the help of The Carter Center, Togo has dramatically reduced the incidence of Guinea worm disease.


Building Hope

Encompassing six different geographic regions and home to 37 different African tribes, Togo is a diverse nation with health concerns that are universally shared by its people. Since 1992, The Carter Center has been working with the Togolese people (Ewa, Mina, and Kabre alike) to build a healthier, more prosperous future through agricultural development and Guinea worm disease eradication.

Eradicating Guinea Worm

Current status: Transmission stopped, December 2006
Certification of Dranculiasis Eradication: Pending 

In 1992, the national Guinea Worm Eradication Program in Togo began its first search for cases of Guinea worm disease and found  8,179 cases cases of infection in 584 villages. Since then, The Carter Center has worked with the national program to reduce the incidence of Guinea worm disease. These efforts yielded success in December 2006 when the program declared its last case in the village of Kpégno Agoromé.

Togo is the size of the U.S. state of West Virginia, making the short distance between Guinea worm disease endemic and nonendemic areas a concern for eradication efforts. 

Since 2002, 17 Guinea worm care centers, or case containment centers, have been established. While receiving basic medical attention for their wounds, patients receive education from volunteers on how to prevent the spread of the parasite to others. The program, in partnership with the U.S. Peace Corps volunteers, also has conducted multiple, successful educational outreach programs called "Worm Weeks."

The Togo program has tried a wide array of health education strategies. Two of the strategies that that were effective for all endemic districts were the use of t-shirts and medical bags with the transmission cycle printed on them. Village-based health workers and Guinea worm supervisors use these items to teach the transmission cycle. These combined efforts helped lead to interruption of transmission of the disease in 2007.

Read Guinea Worm Eradication in Togo: A Firsthand Account

Because of the risk of imported cases from other countries, it is crucial for Togo to intensify efforts, especially surveillance, to prevent Guinea worm and to help in the final push to eliminate Guinea worm from West Africa in the next few years.

One of Togo's biggest obstacles to complete elimination of the disease is the migration of infected people to and from Ghana and Togo. It is imperative that Togo monitors and reports the importation/exportation of Guinea worm cases across its borders as well as in all local districts, whether believed to be endemic or not. Continued dedication of village-based volunteers is essential for Guinea worm eradication to remain a top priority.

Through Togo's efforts, the suffering caused by this debilitating disease has been averted. Eradicating Guinea worm positively impacts families, communities, and economies; people can return to work and children can go to school.

UPDATED MAY 2008

Read more about the Carter Center's Guinea Worm Eradication Program.



Increasing Food Production

In addition to the Guinea Worm Eradication Program, The Carter Center began assisting Togo with agricultural development in the early 1990s as part of an overarching vision to build healthier lives in the country.

From 1993 to 1998, the Carter Center's Agriculture Program, in partnership with the Sasakawa Africa Association, led by Nobel Peace Prize winner Norman Borlaug, helped Togolese farmers improve food security in Togo. The Togolese program is part of a larger effort that has helped more than 4 million Africans grow more food and enjoy better nutrition and health.

The prescription is simple: Farmers are provided with credit for fertilizers and seeds to grow production test plots. As part of a post-harvest program in 1996, 360 cribs and 90 silos were constructed to store produce. A year later, in conjunction with Togo's Ministry of Rural Development, 1,000 Togolese farmers planted a total of 500 maize test plots, 500 cassava test plots, 300 rice test plots, 750 mucuna plots, and 150 quality protein maize test plots.

Following successful harvests, which usually exceed previous harvests by 200 to 400 percent, the farmers teach their neighbors about the new technologies, creating a ripple effect to stimulate food self-sufficiency in the nation. Through this program, tens of thousands of farmers have learned how to integrate green manure and weed control legume into their cropping systems in order to increase crop yield. Adopting new technologies to improve crop yield is only half the battle, as farmers then must find ways to sell their surplus crops.

The program also helped Togolese farmers identify local markets for these surpluses, because transporting them can be costly and inefficient. Often, road conditions are poor or impassable, and farmers rarely have places to store their harvested crops. These obstacles can force farmers to sell their harvest during peak harvesting season alongside other farmers, greatly reducing the margin of profit. Program projects also focus on post-harvest technologies, including methods for processing and storing. Neighboring countries in the program that share crop seasons are encouraged to foster lasting cooperative efforts.
During the five years of the program's work in Togo, 15 rural savings and loan companies were established, helping more than 2,000 farmers to save their money and develop their farms.

These successes and others in agricultural development programming have led The Carter Center and the Sasakawa Africa Association to end its in-country food security activities in Togo in 1998.

Click here for more information on the Carter Center's Agriculture Program.