She remembers the pain well.

Agnes Kossia managed an occasional smile as she talked about the parasite that, years ago, began to force its way through the skin of her lower left leg. She can't remember how long it lasted, but it seemed to be weeks before the parasite was gone and she was free of the agony it had caused.

Though unheard of in the West and eradicated in Asia, dracunculiasis, or Guinea worm, is a water-borne parasite still found in nine African countries, among them Ivory Coast, where Kossia lives with her 10 children in the village of Palla. The worm may grow to lengths of four feet inside a victim before working itself out over a course of one to two months through the person's lower extremities.

Guinea worm spreads through contaminated drinking water, and so Ivory Coast cases decreased dramatically in the early 1980s - from more than 67,000 cases in 1966 to less than 2,000 cases in 1985 - when more than 12,000 new water purification pumps were installed in villages like Palla. As pumps broke and villagers returned to untreated water supplies, however, incidents began rising, and in 1991 nearly 13,000 cases were reported.

"There is really nothing to do if we don't have clean water," Kossia said through an interpreter. "When our pump broke, we had no way to fix it. We had no way to get clean water. And we had no way to avoid diseases like Guinea worm."

Medical Assistance Programs (MAP) International is part of a country-wide effort to provide Ivory Coast villages with water filtration systems and to repair pumps that are no longer operable. Thanks to a grant of more than $52,000 from Rotary International Foundation and Rotary Clubs of Brunswick and Glynn County, Ga., Atlanta West End, Atlanta Airport and District 6920 (in cooperation with Rotary Club of Abidjan Golf in Ivory Coast), MAP has been able to repair an additional 57 water pumps and construct 800 water purification filters in villages like Palla.

"It is very important that we be able to avoid diseases from unclean water," Kossia said. "If we get sick, we often have no way to go to the hospital. Even if we can go, we cannot afford the medicines. What MAP is doing is very important because now we have clean water again."

MAP, which has been working for years to eradicate the disease in Ivory Coast, has helped decrease the number of cases significantly. In 2006, there were just 5 cases reported throughout the entire country - and none of them were in Palla.

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