An astonishing victory in Yemen
Last month, victory was declared in a war that Yemen has been fighting against a brutal enemy for the past two decades. But in the wider world, the triumph passed almost unnoticed.
Since 2011, the attention of the world's media has been focused exclusively on the struggle between Yemen's government and the Houthi rebel insurgency. One of the many tragedies spawned by that catastrophic conflict, which continues unabated, is that it has come utterly to define Yemen and its people, dominating the national narrative in the eyes of the world and reducing an entire nation and its population to a one-dimensional stereotype. In Yemen, you are either a soldier at arms, pursuing a deadly game of tit-for-tat strikes and counter-strikes, or you are a helpless civilian, at the mercy of fate and driven to the brink of starvation.
Yet against the background of Yemen's apparently all-consuming conflict of arms, and to the credit of the government and a small army of volunteers and health-care professionals, this war-weary nation has somehow found the time and force of will to wage and win a war of attrition against one of the world's most devastating diseases. That it has done so is not only a credit to those involved, and to the international organizations that have supported
them through thick and thin. It also serves as a reminder - and, perhaps, as an inspiration - to other nations burdened by apparently all-consuming civil strife.
Yemen's victory over lymphatic filariasis, perhaps better known as elephantiasis, is proof that real life can, and does, continue to thrive in the cracks between the slabs. Filariasis is one of 20 conditions categorized by the World Health Organization as a Neglected Tropical Disease. It is among the most disturbing.
The cause is a tiny parasite, the thread-like filarial worm, which is transmitted to human beings by mosquitoes, often in childhood. The worms nest in the lymphatic system, a bodywide network of vessels whose primary purpose is to transport fluid away from tissues, filter it and return it to the circulatory system where it joins the bloodstream.
Yemen's victory over lymphatic filariasis, perhaps better known as elephantiasis, is proof that real life can, and does, continue to thrive in the cracks between the slabs
Each worm can live for up to eight years, often unnoticed by its host but nevertheless quietly producing millions of larvae that circulate throughout the body. For the majority of people, infection goes unnoticed, although they contribute to the spread of the disease by passing on the worms to others via mosquito bites. For some, however, the effect is devastating, not only damaging the kidneys and the body's immune system, leaving the host prey to all manner of diseases, but also causing tissues and skin to swell and thicken alarmingly.
This is elephantiasis, in which a person's skin comes to resemble that of an elephant, leaving victims with grotesquely disfigured body parts, usually arms and legs but also breasts and genital organs. For some, the effect is permanent. These patients, as the WHO notes, "are not only physically disabled, but suffer mental, social and financial losses contributing to stigma and poverty." In 2000, a global survey estimated that around the world more than 120 million people were infected, of whom 40 million had been left disfigured and incapacitated.
Filariasis was first recognized as a problem in Yemen in 2000. The government immediately adopted a WHO protocol for the elimination of the disease - the Program for the Elimination of Lymphatic Filariasis - and embarked on an extraordinary public health campaign. The initiative immediately earned the support of international organizations, including the Task Force for Global Health, an independent USbased non-governmental organization that, through its Mectizan Donation Program, donated hundreds of thousands of doses of drugs supplied free of charge by the pharmaceutical companies Merck and GlaxoSmithKline.