When Fernanda, of Jinotepe, Nicaragua, gets intestinal worms, the athletic fourth grader who plays several sports feels listless. “I have a stomach ache. I feel really tired. I don’t want to eat,” says Fernanda.
Fernanda is one of 400 million children worldwide at risk of infection with soil-transmitted helminths, or STH: roundworms, whipworms and hookworms. Found mostly in tropical and subtropical areas, STH is caused by a lack of clean water and sanitation. Intestinal worms are especially harmful to children because they lead to malnutrition, anemia, stunted growth, impaired cognitive development and poor school attendance and performance.
Every year, Fernanda lines up at school and receives a deworming tablet. To prevent reinfection, she learns to purify the drinking water stored in her kitchen bucket, wash her hands and scrub her fruits and vegetables. Fernanda’s deworming medication, mebendazole, is donated by Johnson & Johnson through a program called Children Without Worms. It provides mebendazole to treat children in eight countries and partners with governments and organizations to stop reinfection through hygiene education and access to improved sanitation and clean water.
“She’s physically healthier and she’s more knowledgeable so she doesn’t reinfect herself,” says Fernanda’s mother, Grissell Vargas.
20 Million Healthy, Active Kids
In 2005, Johnson & Johnson partnered with The Task Force for Global Health to create Children Without Worms, the first program to focus solely on global treatment and prevention of STH. It treats approximately 20 million of the world’s most at-risk children and represents the largest health care company donation that targets STH. The donations began in 2007 with Bangladesh, Cameroon, Uganda and Zambia. In 2008, CWW expanded to eight countries, adding Cambodia, Cape Verde, Lao People’s Democratic Republic and Nicaragua.
As a result, these countries have greatly expanded their deworming outreach. Cameroon, the first country that partnered with CWW, reaches all four million school children, a 20-fold increase over the 200,000 children treated prior to the Johnson & Johnson donation. Nicaragua expanded its program to reach all children through age 12.
“The support of Johnson & Johnson has been fundamental in improving the health of our children,” says Dr. Martha Reyes, Director, National Immunization Program, Nicaragua Ministry of Health. “One of the benefits of our deworming campaign is our increased school attendance and school performance.”
Prevention Breaks the Cycle
But CWW reaches beyond mebendazole donations. CWW forms partnerships to provide hygiene education, improved sanitation and safe drinking water. Found mostly in tropical and subtropical areas, intestinal worms are a disease of poverty and caused by a lack of clean water and sanitation.
“You must have a prevention component or children will be continuously reinfected,” says Kim Koporc, CWW Acting Director. “The prevention component breaks the cycle.”
For example, CWW partners with Helen Keller International, which is working with the education ministry in Cambodia to incorporate hygiene education into the school curriculum. In Cameroon, CWW partners with World Wildlife Fund to provide latrines and clean water in remote communities.
Ultimately, CWW hopes to increase partner collaboration to break the cycle of reinfection in countries where it currently works and to donate to other areas with need. “Our vision is to rid the world’s children of intestinal worms so they can grow, play, learn, and enrich their communities,” says William Lin, Manager, Corporate Contributions, Johnson & Johnson.
Nicaragua’s deworming program takes place in April during national health campaign week. Teachers give each student a deworming tablet while health workers give immunizations and vitamin supplements. Teachers also give health and hygiene instruction, which makes a world of difference for students, says Yessenia Espinoza, a teacher at Maria’s school. “The children have more energy, they’re paying better attention, they get sick less often and miss less school,” she says.
At home, Maria reminds her mother to chlorinate the water. She runs after brother Luis, 3, to scrub his hands with soap and to wear shoes to prevent hookworm. When Luis drops his mango, Maria grabs it and washes it with treated water before he takes another bite. When worm-free, their mom laughs, “They’re active, they eat a lot, they don’t stop!”