At Work Around the World

Yemen

The reputed home of the Queen of Sheba, Yemen only recently stopped transmission of a disease that has existed in the nation since biblical times.


Building Hope

Yemen is a young nation founded in 1990 by the merger of the traditionalist North Yemen and Marxist South Yemen. Yet, Yemen has existed since biblical times, known to ancient Romans as Arabia Felix. Today, scarcity of water and a primarily agricultural lifestyle are as common as they were centuries ago. As a result, some of the same health problems that plagued the nation in biblical times continue to threaten and debilitate the people of Yemen today. However, The Carter Center and the Yemen Ministry of Health have worked together to build a healthier future.


Fighting Disease

Eradicating Guinea Worm Disease

Current Status: Transmission stopped, 1997
Certification of Dracunculiasis Eradication: 2004

In a land of arid mountains and seasonal rains, Yemen's water sources are scarce and waterborne illnesses present a particular threat to the Yemeni people. However, in 1997, Yemen finally defeated a debilitating waterborne parasitic disease when it reported zero cases of Guinea worm disease for 12 consecutive months, which meant disease transmission had stopped.

Yemen was known to be endemic to Guinea worm disease in the 19th and early 20th centuries, yet by the late 1980s when the global campaign to eradicate Guinea worm disease began, it was thought Yemen no longer harbored the disease. Technical assistance from the U.S. Centers for Disease Control and Prevention to Yemen's Guinea Worm Eradication Program in 1995 led to the establishment of a reward system for reporting cases of Guinea worm disease. After hearing this news, a Yemeni member of Parliament was the first to report an incidence of Guinea worm in one of the villages he represented. Although transmission of Guinea worm disease in Yemen had continuously occurred since the turn of the 20th century, the remoteness of the affected villages and insecurity due to banditry and hostage-taking in these areas led to the apparent disappearance of the disease. That year, 72 cases of Guinea worm disease were reported from Dhamar governorate, five from Sana'a governorate, and one from Taize governorate. House-to-house and market searches for cases of the disease were also employed. By 1997, Yemen stopped transmission of Guinea worm disease.

As in other countries, Yemen's Guinea Worm Eradication Program intervened against transmission of the disease by providing health education, distributing nylon filters to strain out the water fleas that host infected larvae, treating stagnant sources of drinking water with ABATE® larvicide, and advocating with water sector organizations for the provision of safe sources of drinking water. Supervised by the program, trained village volunteers carried out monthly surveillance and interventions.

The Carter Center held a special ceremony in Atlanta in 2000 to honor Yemen, Senegal, Cameroon, Chad, Pakistan, India, and Kenya as having reached a milestone in Guinea worm eradication efforts. These nations were the first among the 20 endemic countries to stop transmission of Guinea worm disease for at least one year. In 2004, the World Health Organization certified the nation as Guinea worm-free. Read more about Guinea worm disease eradication in Yemen (PDF).

Click here for more information on the Carter Center's Guinea Worm Eradication Program.


Trachoma Control Program

In late 1998, The Carter Center began to apply its experience and knowledge gained from the Guinea Worm Eradication Program to work with Yemen and partner organizations to achieve control of trachoma, a bacterial infection spread from person to person, especially among young children and their mothers and caretakers. If a person suffers repeated re-infection over years, scar tissue forms on the inside of their upper eyelid. The scar then contracts, causing the eyelashes to turn inward, often resulting in painful abrasion of the cornea and, in severe cases, untreatable blindness.

Trachoma, the world's leading cause of preventable blindness, can be prevented through improvements in personal and environmental hygiene.

Today, almost all of the 146 million people who suffer from trachoma live in developing countries in Africa, the Middle East, and Asia. Surveys conducted in 1996 and 1999 in Yemen found that trachoma is the third leading cause of blindness in the nation and is prevalent among approximately 12 percent of all children younger than 5 years old.

Program interventions focused on prevention of blinding trachoma through health education to promote better hygiene, improvements in environmental sanitation, and the distribution of antibiotics in endemic communities. These efforts were coordinated with surgery, performed by other partner organizations collaborating to correct advanced infections. Many obstacles exist to controlling trachoma in Yemen, including a lack of recognition of blindness as a health priority. Budgetary constraints and low government health coverage also complicate efforts to control the disease.

However, the successful end of transmission of Guinea worm disease in Yemen offers hope for the control of trachoma in the nation. Vital to this step has been the partnership between The Carter Center and the same government individuals who worked to eliminate Guinea worm disease.
Yemen can control trachoma, and it must. Hard work today will mean a brighter future for many who risk permanent loss of sight.

The Carter Center's work in Yemen ended in 2003.

For more information on the Carter Center's Trachoma Control Program click here.