Bartering Away Guinea Worm

Bartering Away Guinea Worm

Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

This social-enterprise innovation will pilot a barter exchange financing mechanism to tackle guinea worm infection and other water borne diseases in Southern Sudan

About You
Project Street Address
Project City
Project Province/State
Project Postal/Zip Code
Project Country
Your idea
Field of Work


Year the initative began (yyyy)


YouTube Upload
Positioning of your initiative on the mosaic diagram:
Which of these barriers is the primary focus of your work?

Public information alone doesn’t change behaviors

Which of the principles is the primary focus of your work?

Financing for the new consumer

If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic

The project adopts barter system of trade: It trains local entrepreneurs to deliver information, drinking filters, water treatment chemicals and Guinea worm treatment services to the community in exchange for Gum Arabic, a substance that is taken from acacia trees and used to make a number of products such as bubble gum, cosmetics, watercolor paint and shoe polish. This builds local private-sector led healthcare delivery system in a region where there is no private sector or public sector healthcare providers. The local providers will ensure that the community has information and equipment to enable them to identify, treat and prevent future infections. This project will reach 2,000 people with information, preventive and curative services.
Delivery Model: The Project utilizes a comprehensive approach to the management

What is your signature innovation, your new idea, in one sentence?

This social-enterprise innovation will pilot a barter exchange financing mechanism to tackle guinea worm infection and other water borne diseases in Southern Sudan

Describe your innovation. What makes your idea unique and different than others doing work in the field?

Guinea worm causes excruciating pain and often leads patients to poverty, as they are incapable of working. Eradication of the disease, contracted through consumption of water contaminated with microscopic water fleas carrying infective larvae, requires a curative and preventive approach. In a region where government healthcare services are non-existent and private sector providers are absent, the residents of Karkomuge use traditional practices to treat the illness, but these are ineffective. There is a need for an approach combining education, prevention and treatment, while developing local capacity for long-term management of the disease. This innovation will, jointly with the community, develop a locally driven barter exchange approach that will enable community members to exchange a locally occuring natural resource for important water treatment equipments that would radically reduce the incidence of guinea worm and other water borne diseases. This idea is unique because it buolds onexisting practices, but introduces a comprehensive approach to managing a serious public health and water quality problem in the community.

Delivery Model: How do you implement your innovation and apply it to the challenge/problem you are addressing?

The Project utilizes a comprehensive approach to the management of the guinea worm problem. The project will provide, information, preventive and curative services to those infected and those at risk of being infected. This will be done by developing local capacity for the management of guinea worm problem. A number of strategies will be used;
• Provision of information/awareness – this will increase awareness about the worm and provide useful information about identification and management of the worm. Early detection is key to the eradication of the worm
• Design and production of filters and water sieves – water sieves and filters that are appropriate to the water containers and drinking habits of these indigenous people will be designed and mass produced using local artisans. The sieves will be appropriate for use under different circumstances so that the users are able to use them wherever they are faced with the need to drink water.
• Procure water treatment chemicals – These chemicals are those used for disinfecting ponds (temephos) and home use water (water-guard). These will be distributed to households for use, especially on water from ponds. This will increase quality of water and prevent other potential waterborne diseases.
• Build capacity of local entrepreneurs to distribute filters, sieves and chemicals in exchange for gum Arabic – Local traders will distribute the sieves, filters and chemicals through a social-marketing initiative. TIn exchange for the sieves, the traders receive gum Arabic from the community members.

How do you plan to expand your innovation?

Over the next five years;

- Reach at least 5,000 households with information, water filters, water sieves and water treatment chemicals. This will reduce guinea worm infection in the community. This is critical because we wish to bring an end to suffering of the people, before focusing on the commercial side of the project.

- Establish a viable gum arabic marketing channel that is reliable and profitable to the participants in the value chain. This is critical for sustainability of the project and also to open up the region to private sector and hence monetary economy.

- Build local capacity for the production of simple water sieves and water filters. This will ensure that the community can make their own filters even after the end of the project.

Stage of the initiative: Start up
Expansion plan: We envisage that by the end of the fifth year, the project will expand to another guinea worm endemic location within south Sudan.

Do you have any existing partnerships, and if so, how do you create them?

Main Partner Organization: This project is implemented in partnership with Kapoeta Development Initiative (KDI). KDI is a local Sudanese organization that is involved in improving service delivery in the areas of health, education, water and infrastructure. KDI was registered in 2005 as a local development agency immediately after the signing of the Comprehensive Peace agreement. Since registration, KDI has implemented a number of small scale health and education projects in Eastern Equatoria. They have been leading a consortium of local NGOs in construction of Primary Health care Facilities in Eastern equatorial. They have been leading a consortium of local NGOs in cleanliness and sanitation program in the project area, including construction of toilets. KDI have extensive knowledge of the project area and they speak the local dialect making it easy for communication of project idea to local community. KDI will also provide useful linkages to the local administration since they are recognized by the local administrators.

Provide one sentence describing your impact/intended impact.

Eradicate the incidence of guinea worm for 5,000 households (42,000 people) living in Karkomuge over the next five years.

What are the main barriers to creating or achieving your impact?
How many people have you served or plan to serve?

This project is at the start-up phase. We have only started setting up the project base.

In the next two years, EPS program expects to reach 2,000 villagers with information, water filters, water sieves, water treatment chemicals and guinea worm treatment services during the project period.

Over the next 2 year, EPS program and partner will:

• Establish one village clinic in Karkomuge that will provide curative services to at least 200 Guinea worm infected persons from the community.
• At the moment the community uses water from ponds and pools hence increasing exposure to Guinea worm infection. The project will drill 2 boreholes in different location in Karkomuge to provide alternative source of water to pond and pool water. This will ensure available supply of guinea worm free clean water to at least 1,000 households.
• The project will also secure 5 water pans by fencing them to avoid contamination of water by those infected with guinea worms.
• Use the innovative distribution system to distribute at least 1,000 water filters and 1,000 water sieves to households in Karkomuge. This will reach at least 2,000 people. Other water treatment chemicals will also be distributed by the project.
• Train and build capacity of at least 20 members of the community to provide Guinea worm management services to the community. This capacity will ensure future sustainability of the project.
• Support at least 15 of these people to set up Guinea worm management enterprise. It is expected that this will lead to a multiplier effect over the project period to reach over 50 entrepreneurs. This will lead to development of a network of private sector service provides in the community.
• Create awareness about prevention, identification and basic treatment of guinea worm at household level to at least 2,000 people in


The project has only been up and running over the last 4 months. We have just started setting up the operational base for the project. We are making contacts in the community. Understanding the culture and water use behaviours. Establishing contacts with local administration and recruitment of local entreprenuers. We are about to start training activities of community workers.


Through village/community meetings, local people are starting to be aware that contaminated water that they usually consume is the cause of the health problems they face. Young memebrs of the community are beggining to get interested in working in the programme.

Please list any other measures of the impact of your innovation?

None at the moment. We wil be able to measure impact in the next eight months if this initiative is properly funded and the activities are implemented as envisaged in this proposal.

Is there a policy intervention element to your innovation, if so please describe?

THe community of Karkomuge is completely isolated from the rest of South Sudan. Access is a major problem and limited information is available o policy makers on how to improve service delivery to the community. This innovation hopes to create a mechanism for feeding back information to policy makers on the state of affairs at the community. With the information, this intervention hopes to advocate for priority service delivery and possibly development of a health service delivery policy for unreached/underserved communities.

Exactly who are the beneficiaries of your innovation?

The main beneficiaries of my innovation are

1. The 5,000 households (men, women and children) who live in Karkomuge. We hope to improve access to better quality water and disease reducing equipments.
2. The emerging local entreprenuers - who will derive a livelihood from exchange of water equipment with gum arabic

How is your initiative financed (or how do you expect your initiative will be financed)?

Being a new initiative, little revenue is expected to be generated during the first two years. However, the project will collect gum arabic from the communities in exchange for water filters, water chemicals and drinking filters. The gum will them be sold to generate revenue for the project.

It is expected that the revenue from sale of gum arabic will represent only 12% of total operating costs by the end of the second year. This revenue is expected to grow to about 60% by end of 4th year. Over the last four month, we have not earned any revenues from sale of gum. The project is still in its initial stages.

Provide information on your finances and organization:

The total annual budget for my organisation is $252K. This budget is for established programmes that we undertake in environ,mnet, education, microfinance and health.

For the last four months, my organisation has only allocated $9,000 towards this innovation. However, the total budget required for this innovation is $210,000 over th next two years. This means that at the moment we have a shortfall of more than $200,000 in order to make this innovation work.

Over the last two years, our annual buget was $78,000 and $154,000.

Most of the organisations budget has been financed by grants from the World Bank DevelopmentMarketplace and revenue generated from recycled used oil. We have also earned revenue from interests on micr loans that we give to our clients.

However, for this innovation, we are not earning any revenue at the moment.

What is the potential demand for your innovation?

Karkomuge alone has a total of 5,200 households. Each household has approximately 8 people. All these people are exposed to guinea worm infection and are potential users of the technology.
Southern Sudan in general is a guinea worm endemic region. If this pilot project succeeds, then there will be scope to replicate it in other areas of South Sudan. However, replication will means making modifications to project approach to suit different regions and locations.

What are the main barriers to financial sustainability?

1. Many residents of Karkomuge are not exposed to monetary exchange. This means that at the community level there is limited scope to develop a viabrant exchange economy that will create demand for water, health and sanitation services.

2. This innovation is dependent on a natural resource (gum arabic). This resource is a seasonal product and this may limit the expansion and therfore sustainability of the innovation.

The Story
What is the origin of this innovation? Tell us your story.

I regularly travel into South Sudan as a development worker, working for other agencies. On this visit I was undertaking an assessment of possible income generating activities in the village of Karkomuge. While in the village, I saw a small baby (less than 15 months old) who had a string- like worm comming out of its abdomen. The small child was in great pain. I was so moved by the situation, I abandon my assignment in order to help the mother to take the child to the nearest hospital (280 km away). At the hospital, I was informed that there is nothing much that can be done except to allow the worm to come out of its own accord. I was told that if forced out the worm would mutate into several worms in the body the child. But the doctor explained that the only way to prevent infections by guinea worm is by drinking clean/filtered water. This set me out to find a solution for the problem.

Please provide a personal bio. Note this may be used in Changemakers marketing material

I am a Development Expert with 15 years of experience particularly in private sector development. I have wide experience in designing innovative private sector- led approaches to delivery of health, education and micro-finance services to poor people. I am a winner of the DevelopmengtMarketplace Global Award for Innovation, 2005 and a GSBI Fellow at Santa Clara University. I am aslo an Ashoka Fellow nominnee (but has not gone through the whole assessment process).