River Blindness Robbed Him Of His Sight But Not His Independence : Goats and Soda He lost his sight in his youth. But he's lived an independent life for decades — despite the best efforts of goats to raid his crops.

The Farmer And Fisherman Who Lost His Sight To River Blindness

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We're going to learn more about something the World Health Organization calls a neglected tropical disease. It's river blindness, and in parts of Africa, river blindness is not neglected as much as it is feared. The blindness is actually the final stage of a parasitic infection that involves intense itching. People often scratch for so long and so hard, they develop so-called lizard skin. NPR's Jason Beaubien recently traveled to Ghana and has the story of one man's struggle with his disease. And we should say, some people might find descriptions here difficult listen to.

JASON BEAUBIEN, BYLINE: Emmanuel Kwame taps a well-worn stick in front of him as he makes his was across existing the village of Asubende in central Ghana. He navigates past chickens, sleeping dogs and a cement sewage canal. Then he veers towards an open fire where a woman is cooking fufu in a charred metal pot.

UNIDENTIFIED BOY: (Yelling in foreign language).

BEAUBIEN: A boy yells at him to stop. The boy then grabs Kwame's stick and leads him around the fire. Kwame, who's now 60 years old, says he started to get sick with river blindness in his 20s.

EMMANUEL KWAME: (Through interpreter) I started having nodules and swelling all around my body. And then, I - it would appear. I'd see some worm on my eyes. I would see them moving across my eyes. And I realized my eyes were no good.

BEAUBIEN: This disease is caused by a roundworm infection. As the parasites reproduce, hundreds of thousands of larvae spread throughout the person's body. They cause blindness by repeatedly penetrating the eyeball. The worms knot up under the skin. Kwame says the itching from the parasites was unbearable.

KWAME: (Through interpreter) You scratch so much. And if it were now, I couldn't have even spoken to you because I would be scratching all over.

BEAUBIEN: This village of Asubende has been hard hit by river blindness, also known as onchocerciasis. Of Kwame's 12 siblings, six lost their eyesight. In the late 1980s, Ghana switched strategies in the battle against the disease. Up to that point, Ghana had been using insecticides to try to kill the black flies that carry the river blindness parasite. The new strategy that's still being used today goes after the parasites inside people. The government treats entire villages every year with a drug called ivermectin. This is meant treating roughly 4 million Ghanaians a year, or more than 15 percent of the population. And the strategy is paying off. Three decades ago, more than 80 percent of the residents of Asubende were infected with parasite. That number has dropped to just 3 percent today. Kwame says his generation appears to be the last stricken with the blindness.

KWAME: (Through interpreter) I cannot say that the disease is totally gone. But since they started distributing these new drugs, I have not seen anybody getting blind again in this community.

BEAUBIEN: The 2015 Nobel Prize for medicine went in part to two researchers who discovered ivermectin. Kwame is well aware that his life would have been very different if these drugs had come earlier. He still has some aches that he blames on river blindness. But his biggest complaint on this day is the goats. He's showing me his vegetable garden next to his hut.

KWAME: (Through interpreter) Have you seen this? This is pine nuts. It was growing, and some goats came to eat it.

BEAUBIEN: In addition to his garden, he has a grove of 70 cashew trees. And he tries to grow cassava and plantains. The goats, however constantly slip through or over his fences and eat his plants. I'm a bit surprised that he can grow anything given the nimble goats, the rapidly growing tropical weeds and the fact that he can't see. He shrugs and says the trick to gardening blind is straight lines, planting everything in straight lines. Kwame is proud that he can support himself. He wants to show me the Pru River. He has a complicated relationship with this river. Decades ago, it took away his eyesight. But throughout his life, it's also been a source of income. He says he can make more money fishing than he does from any of his crops. On land, Kwame walks hesitantly, constantly tapping and probing with his stick. But when he steps in the river, something changes. He seems to stand a bit straighter. He moves smoothly, confidently through the water. Waist-deep in the rapids, he pulls out a fishing net that's about the size of a bed sheet. He runs his fingers over the lines, searching for knots and that the weights aren't tangled. And then he flings the net out across a pool. Eventually, he strides back to the bank, where girls are washing laundry on smooth, dark rocks.

KWAME: (Through interpreter) I didn't get anything. I threw the net, but nothing came in. There's no fish now.

BEAUBIEN: Some days he catches fish, he says. Some days he doesn't. The worst thing about his blindness, Kwame says, was the timing of it. He went blind before he was able to get married. And he never got a chance to have a wife or children. Again, he shrugs. But those men who won the prize for discovering ivermectin, he says, they should be given many, many more prizes. Jason Beaubien, NPR News, Asubende, Ghana.

GREENE: And tomorrow, we'll hear why a wonder drug alone is not enough to wipe out river blindness.

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