There are so many things we take for granted in America. One of them is that our children are not regularly infected by one of the tropical diseases so common among the world's poorest people.
When I was just starting my career in medicine, I worked for a year in Bangladesh studying the polio vaccine. I spent several months serving as the doctor in a clinic run by the Marist sisters. I kept a journal of my experiences that I came across when I was cleaning out my desk the other day.
Flipping through the pages reminded me why I went into public health in the first place: the opportunity to address some of the health inequity that I saw.
One of the diseases I treated while working at the clinic was ascaris, also known as roundworm infection. As many as one billion people around the world are infected with this parasite, according to the Center for Disease Control and Prevention.
Along with hookworm, trachoma, elephantiasis, whip worm, snail fever and river blindness, roundworm is considered one of the seven parasitic and bacterial infections that together have a higher health burden on the world's poor than malaria and tuberculosis.
In medicine, we refer to these as the "neglected tropical diseases." They infect nearly one in six people worldwide, including half a billion children, and lead to tremendous suffering and loss of life. Yet, the estimated cost to treat these diseases is less than 50 cents per person.
Roundworm is spread through contact with soil contaminated with feces containing eggs or early worm forms. Symptoms may be mild - but long-term infections with worms can cause micronutrient deficiencies that impair growth and stunt brain development.
Each year, an estimated 60,000 people die from roundworm infection. These are preventable deaths.
I am still haunted by one little boy I treated in Tuital, a rural village that is six hours by boat from Dhaka, the capital city of Bangladesh. He must have been 9 or 10 years old. Like most of the children I saw, his family brought him to the clinic as a last resort. Travel was difficult and local remedies were trusted more than conventional medicine.
Here is what I wrote in my journal at the time:
Jan. 28, 1990. "There is a little boy I'm caring for who has an intestinal obstruction from worms. I'm quite worried about him. After one enema, he passed a few worms. That was yesterday. I am afraid he will perforate his bowel and die. In the morning we may try again to convince the family to go to Dhaka. I would love to do an abdominal x-ray and then scope him. It is truly a cruel world if this child dies needlessly."
Jan. 30, 1990. "The little boy is hanging in there but in the morning we are sending him to Shishu Hospital in Dhaka……
March 5, 1990. "I met the family of the boy with worms that we sent to Dhaka. He died three days ago after two operations for resection of dead bowel. He was obstructed from worms as we thought. I can't help but wonder whether we had kept him here for too long….."
The World Health Organization has a plan for eliminating intestinal worms transmitted by contact with contaminated soil: treat all children with a cheap medication to "deworm" them; provide clean water and proper sanitation to prevent new infections.
Sounds pretty simple right? On my weekly tweet chat today, I'll explore why this hasn't happened yet and what it will take to get it done.
The one-hour chat takes place on Twitter today from 1-2 p.m. ET. This week, I'll be joined by the not-for-profit groups End 7, The Carter Center and Every Mother Counts, as well as the Center for Disease Control and Prevention, plus dozens of hospitals and caring citizens from around the globe.
I realize that the average American isn't likely to encounter a deadly tropical disease. But for the rest of the world, these diseases have devastating consequences. Won't you join me to learn more about this important issue and what you can do to get involved in the fight to the needless suffering caused by these diseases?
Participation is simple. Here's how. Follow the conversation or jump in with comments and questions of your own.