In April 2008, I interviewed President Jimmy Carter in Kathmandu, Nepal, when he was merely 83 years old. I was a reporter for the Financial Times, based in neighboring India. The Carter Center was helping to monitor Nepal’s first democratic elections. It was a historic moment, and the sunset of a 240-year-old monarchy. Elections were part of a 2006 peace accord that ended a decade-long civil war with Maoist rebels that claimed 13,000 lives.
The former U.S. president and his wife Rosalynn launched the Carter Center in 1982. The foundation focuses on humanitarian work, including promoting democracy, as well as wiping out diseases in Asia, Africa and Latin America.
When I spoke to Carter in Kathmandu, he smiled warmly and was whip-smart and articulate. He was brilliant and energetic, yet down-to-earth and friendly. In a photo captured on my old digital Kodak camera, now buried in storage, Carter looked radiant.
Meanwhile, I looked unkempt and tired. I regretted that I had not washed my hair. (A good rule of thumb: wash your hair before meeting any former presidents.)
In 2012, I went back to Nepal to write more articles, including one about a horrific blinding eye disease called trachoma. In the early 1980s, it affected more than 20% of the population in the lowland Terai region. But by 2012 the country was on track to eradicate trachoma; it did so in 2018. That’s especially remarkable considering Nepal’s tumultuous civil war.
There’s been much well-deserved coverage about the Carter Foundation’s work eradicating guinea worm. The ghastly disease results in a meter-long parasite emerging through skin lesions. In 1986, the Carter Foundation led an initiative to eliminate guinea worm. Since then, an international campaign has reduced human cases by 99.99%, from 3.5 million in 21 countries in Africa and Asia to just handfuls today.
“A forgotten disease”
The Carter Center starting focusing on neglected tropical diseases in 1986, starting with guinea worm. In 1998 it began work to end trachoma, a bacterial eye infection caused by lack of basic hygiene, clean water and sanitation.
In advanced stages of the disease, “eyelashes turn inward and scratch the cornea for an excruciating descent into blindness,” I wrote in my 2012 article from Nepal for The Lancet. “Patients have likened this pain to thorns scratching their eyes.”
That resonated with me because that year my cornea somehow got scratched in Delhi. I was in agonizing pain and was completely incapacitated until I got to a doctor. It was hard to fathom how anyone could carry on if they didn’t have access to medical treatment, as is the case for too many low-income people.
The Carter Center supports trachoma control in four African countries, but not Nepal. Yet its broader work on eliminating it and other neglected tropical diseases has had life-changing global impact.
About two dozen neglected tropical diseases affect a staggering 1 billion people worldwide, according to the World Health Organization.
Yet they are “a forgotten disease of a forgotten people who live beyond the end of the road,” said Paul Emerson, previously director of the Trachoma Control Program at the Carter Center, when I interviewed him in 2012.
That year in Nepal, I went with a team of optometrists to a pop-up rural eye health clinic three hours from the city of Pokhara. Locals did not have access to eye check-ups, so they trekked for hours to reach the clinic near a corn field.
Elderly men with canes and wizened women in saris walked barefoot. By mid-morning about 60 people, including mothers and children, queued to get their eyes examined. They included 75-year-old Krishna Bahadur Thapa and his 67-year-old wife, who walked an hour and a half. “We can get help to see the world,” Thapa told me. No trachoma cases were detected that day.
Neglected tropical diseases like guinea worm and trachoma are preventable and often curable with low-cost treatments.
In Nepal, trachoma prevention and treatment is inexpensive and involves face-washing, cleanliness, antibiotics and at later stages, simple surgery. Eye infections can be treated with antibiotics, with distribution costing as little as 10 cents per person each year.
Today 103.2 million people are at risk for trachoma, according to the Carter Center. That’s a huge number, but it’s an 11% reduction from 115.7 million in 2023. However, 1.5 million are at immediate risk for blindness. Much more work remains.
Through his foundation, Carter helped end neglected tropical diseases suffered by grossly neglected people. “We believe access to health care is a human right, especially among poor people afflicted with disease who are forgotten, ignored and often without hope,” he said.
Through the Carter Center, countless lives have been saved and incalculable suffering ended. Carter will be laid to rest in a state funeral in Washington, D.C. on Thursday, Jan. 9, but his mission and impact lives on in far corners of the world.
Amy Yee is a business and economy reporter for the Sun-Times.
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