Eliminating River Blindness

they're inevitable to a certain degree. But but but when you when you really started looking around at some of the the problems that that are dealt with in some of the more developing parts of the world, UM, it really is a wake up call to just how thankful we should be. Not to get to you know, Gucci here,

but but we are. In this episode, we're going to talk about, um, something that is both on on one hand, a very gross and a very fascinating organism, a parasitic organism that is of interest just because it is an organism that carries out it's uh, it's it's genetic mission in a very peculiar and engaging way. It's a very stealthy parasite, very stealthy, and we can admire it's uh it's purity, you know. But but on the other hand,

it is also a huge um world health issue. It is, it is something that is of a great concern to organizations like the World Health Organization and particularly the Carter Center based here in Atlanta, who we've been chatting with, you especially, have been chatting with UH this week to get geared up for this episode on river blindness. Yeah.

I mean, usually we will talk about parasites, and as you say, we'll talk about them as as destructive forces, but we don't always go into these um these larger public health arenas. So I think it'll be really interesting to today talk about um again. Like you say, the parasite itself, but what sort of destruction actually happens when a parasite really infiltrates a community. UM. So, we are talking about something called oncos or hiasis. This is also

known as river blindness. It's a parasitic disease caused by tiny worms or nematodes Uncle serica volvulus worm in particular, and it is transmitted by flies, black fly specifically, which are these nasty little things. When when I lived up in Canada and Newfoundland as a kid, we had we had black flies, and they were vicious like that. Like, yeah, now I'm not certain it's exactly the same. You know,

maybe it's just a cousin of the black fly. But but just the word black fly even now inspires itching and slapping on my part. All right, so it kind of strikes fear into your heart already. Um, well, imagine if it was carrying this this parasite, um, and you were then infected by one of these bites. Yeah, And and the thing about when we're talking about one of these bites, and certainly, like when I was in Canada dealing with a black fly, you get a couple of bites.

But in some of these these these areas like Uganda or or or certain parts of South America. Um, you're talking about like bytes or more per hour when you're out and about, right, So you're just getting bombarded with these bites and then these these are infected bites. And that's really key to the transmission as well. I mean, you're you're not probably going to get this parasite unless

you get multiple, multiple bites here. But let's just talk about before we start talking about the Carter Center, we talked about the parasite itself, let's talk a little bit about the symptoms. Um we're talking about intense itching, Yeah, itching.

The accounts that I was reading and listening to about this, we're talking a lot level of itching that most of us can't really fathom, like like constant, NonStop, extreme itching that that does not cease, can prevent, can can really prevent sleeping, and and and and still insomnia for years and uh. And it's not uncommon for people to commit suicide to just just over the itching alone. Right. You've got skin discoloration, of course, and you've got rashes, eye diseases,

and most notably this can lead to permanent blindness. And we'll talk a little bit more about the blindness aspect of this and how the worm accomplishes this. But as you can already tell, this is UM an incredibly tormenting, devastating disease, particularly if you are in one of these developing nations and you already are poverty stricken, are already dealing with a host of other issues just trying to

live your life on a day to day basis. Yeah, and there are other particularly harmful diseases that are that are often a problem in these areas as well. I mean these are areas where we're dealing with HIV AIDS in many cases, and there's a huge effort to to tackle that public health concern, and it's in in the past especially, it's been easy for stuff like river blindness

to fall to the wayside. Another thing to keep in mind is that this tends to and you'll have communities where you have like ninety percent infection rate, like most of the village, most of the community is infected with this UH, with this organism and essentially have river blindness. But it's generally in your thirties and forties where it really becomes debilitating where you see blindness set in. So it's taking people out during that what should be some

of the most active decades of their life. You have so people that are otherwise you know, the of of sound mind and body. But now that first they're robbed of to a certain extent, their sanity by by the this itching, this constant itching. They can't sleep constantly having to deal with this, and then they're obbed to their

side as well well. They can't so then they can't hold down a job right um, they can't take care of their children, they can't harvest crops, um, you know, they can't receive an education, so it's basically stripping them of their livelihoods and compounding these cycles of poverty for generations. Um.

So yeah, there's a huge economic impact here. We're talking about it affecting eighteen million people around the world with the cases in Africa, and it is the leading cause of preventable blindness in the world and is endemic to thirty seven countries in Africa and in Latin America. All Right, so let's uh, let's talk about this disease cycle that happens this with this parasite and how it's being um carried around and the mandibles of these black flies. Yeah,

I guess we'll start with the black flies. They're flying around there and they're they're carrying uh this uh this infection the larva. Right, so yeah, let's set the scene here, and we were talking about swiftly flowing rivers and streams. Yeah, which is which that alone through me when I was first looking into this, because you you know, when you're dealing with stagnant waters are still waters, there's always this

potential for for something horrible to brew there. But but fast flowing, clean waters and that's that should be safe, right, Well not. So you have the black fly that's infected by the larva, all right, it's got it in its mandibles, and the black fly seeks out prey. It wants to feed on some blood. So it finds these various villages who are hanging out around the water, bathing in the water, collecting drinking water. I mean, this is the sin of

their life. So they're there. There's no avoiding contact with the water. Other community is often you know, adjacent to the water. So black fly bites you and then you get the larva in your skin, yes, and and then things begin to proliferate. Yep, that's right. So the parasite is entering through that the skin that's been pierced by the fly, and they migrate inform nodules and the skin and then they mature. Yeah, basically they were talking about nodules.

We're talking about like little little spheres in the skin, like little round colonies, little it's almost like the nodules of your spine that you can feel in your back. Right. This this is something that's going to become that apparent on your skin when you see that kind of bump

um forming. Yeah, they look like little like little tumors or little just little balloons of worms basically, and these things reproducing an astonishing rate and and a really long lived like you tend not to think of things like a nematode living for nine twelve upwards of you know, over twelve years up to fifteen years of life in this worm that is living inside of this tiny little round the globe in your skin. Yeah, I mean, I kind of think of it as like tense city, Like

your body becomes tense city for them. These nodules are these places that they migrate back and forth too, because they are either moving back and forth to join other worms, are mating with other worms. So there's all this activity going on um in your body, and of course that's why you're getting some of these horrible symptoms. These worms are mating, uh in they're they're laying eggs. Said A

thousand larvae a day. Yeah, these, Yeah, a thousand of these microfilarre per day are being laid inside your skin. So it just it's it's exponential, It just it just builds up like crazy. So the body progressively it becomes more and more ravaged by this. You have these uh, these non nodules are popping up everywhere. They're they're they're itching, and then if it spreads to your eyes, that's where

you encounter some real problems. Yeah. Okay, so, and that sounds weird because you think about a worm, you probably are thinking about a nerveform or something along those lines. Are not thinking about a worm. That is the size of the period at the end of a sentence. But the fact of the matter is that's the size of these horms and they can travel to the eye where they create severe lesions and this is what it can lead to blindness. Um. So that is a huge concern obviously,

because again this is debilitating for the person. And the idea is that you want to try to get or intervene with medication before this happens. And we'll talk a little bit more about the medication later. Um, but let's talk about when you are infected. You you are the host that's infected. You are then contributing to the rest of the life cycle of this parasite because you're infected, you're bitten again, and then another fly becomes infected with

the larvae from your body in the cycle just continue. Yeah, you're like a resupply camp. You know, we talked about parasitic life cycles before and and that's generally how it goes. The organism is not living its entire life cycle inside your body. You are just a stopover in the same way that a human will occupy won't occupy a single job that their entire life, or live in one house for an entire life. You know, it's it's it's a cycle, except the cycle in this case always comes back around

at the same place. Yeah. That reminds me of when we did an episode on toxoplasmosis and how it uses rats and cats to continue its life cycle and even changes the behavior of those those animals and perhaps even people, which makes me think about this parasite and how it also can change the body's immune response. It can tinker with how things are working inside of us. And you're talking for us about the Wallbachia bacteria. Yeah, yeah, so okay, this this worm is not a single parasite or a

single organism parasite. It actually contains the Wolbachia bacteria, which is in and of itself unusual. But the reason him why that bacteria is hitching a ride with Anco sacs um psarchiasis is because it actually does a job for that worm. Um. What happens is that when it infiltrates the human body, and our white blood cells go, oh, there's there's something going on here. Um. Those white blood cells, specifically neutrophiles, which are specialized white blood cells. They surround

the the infection point. But what happens here is that that bacteria has already created a ring around the worm and is basically cloaking that worm from the white blood cells. So the white blood cells a cloaking device, the bacterial cloaking device used by the bacteria to infiltrate our bodies defense systems. Yeah. Yeah, So the white blood cells are then creating another ring around the bacterial ring and trying to attack that. But it's specialized, right, so it can't

actually attack the worm itself. It can't even get to the worm. Um. And then you have something called eosinophiles, and this sort of like the cleanup crew of our body. This is another type of white blood cell, and it usually could get to the worm and take it out. Okay, it's like, um, it's sort of like the crime scene clean up white blood cell of our body. But again because it's got the double ring around it. Now it can't get through the other white blood cells, it can't

get through the bacteria. It's not going to make its way to the worm. Which is amazing because what it's doing is it's gaming our immune system. This parasite. Yeah, it's like it's throwing up some some interference. It's like some sort of like a bank haist kind of a flick. It's it's like coming to mind, you know where where it's like the bank haist itself is just distraction. And then the the the guy who can say today can't get in to stop the bad guy because the police

response is surrounding the building. Uh. Kind of some more thing going on here with the with with with our nemesis here or misdirection like we talked about with magicians what they do to our brains to try to get us to focus on something else. Um. So this is how amazing this parasite is and and also how detrimental, as you can see, it can be because it's just

playing havoc with your body. Um. And we're gonna talk about the ways in which it has been combated and want to take a quick break, Yeah, we'll take you a quick break, and when we come back we will talk about how we're actually fighting this thing and and really thanks to uh, to the Carter Center and in

other efforts, were actually defeating the thing. All Right, we're back in reading about anco psarchiusis it also happens to fall in the same week where I'm I'm reading a lot about the xeno morph from Aliens, which also has a parasitic a fictional parasitic life cycle. And of course there's a there's a place, there's a part in the original film Alien where they're asking the android ash Um, how do we defeat it? How do we defeat this, uh, this organism? And he tells them you can't. So there's

there's no way you're gonna be able to kill it. Uh. He just tells them, you know, you have my sympathies, symp sympathies. And the interesting thing about uncle siasis is when we attempt to fight it, killing it is not really an option on the table. Is so our our means of defeating it is not going in there and wiping it out, rather waiting it out and keeping it from reproducing. That's right. So we're trying to control it and we're trying to um to lessen the symptoms, and

so the disease is really just treated here. Um, it's as you say, it's not eradicable at least at this point. So that is done through something called ibra mactin, which is an oral medicine. And this is part um. This is really part of this, really the great part of

this story which involves Carter Center and involves Murk. Yeah, I mean the parasite blinding people not the great part, no, No, but the things that we're doing to to to curb it and to control it and to and to address the public health side of it is amazing and pretty pretty much just an awesome story for everybody involved. Yeah. So in n this is the only part of the story here, Murk and company pledge donate mecdicine, which is ib macdin, for as long as necessary to all people

affected by the disease and endemic countries. This is a huge deal, right. Yeah, say what you will about the large pharmaceutical companies, but this is just there is an example of of of a company doing the right thing here and just just putting public health above all else. Yeah. And when we're talking, um, just so everybody gets an

idea of the scope of this. Since two thousand and ten, more than one hundred and fifty million medicine treatments have been distributed, and presumably many more until this is, you know, completely managed to the point to zero where there's zero infections across the world. And to put that the number of treatments in perspective to this is not something you

take every day. This is something you take annually. So you'll you'll dose up on medicine once a year, but you'll do it for about fifteen years because the idea is that every year you want to pump the stuff in there, keep the females from reproducing, the females that are already living inside your body, keep them from reproducing

for their entire life cycle. And again, these things live nine twelve m generally that the estimate I was saying was like nine to twelve years, call it fifteen and you're safe, right, Um, Basically, you want to wait it out, don't let it reproduce for the rest of its life, and then at the end of fifteen years, nothing else has been new has been born. You'll be clean. Yeah. Yeah, So again, you know, Mark has pledged to you know,

indemic countries to help keep this under control. The pill does kill immature worms in the body, and if they can't reproduce in the human body, we defeat it ultimately exactly because it breaks that cycle. Right. So if you get you know bit again and you know, anyway, the transmission, what we're talking about here is interruption and elimination, and we'll talk a little bit more about that. But um, but macdisene is is great. It relieves itching and in

whose vision and prevents blindness. UM. So hopefully you can get in there at the right time to help prevent that blindness because essentially, what you're doing is you're giving uh people their lives back, because if you can't work, if you can't take care of yourself, if you are in a family that has already stretched to live you know again, day to day living here, um, then most likely you're going to be kind of put to the wayside.

And for years some people have been living outside of their communities because they just don't have the resources to take care of people who um have river blindness. UM. So anyway, this really is sort of a life giving drug and a development that happened in conjunction with the Carter Center. So let's talk about the Carter Center, um, real quickly. These guys are a leader in disease eradication

and elimination. They target diseases that no one knew um or did little or nothing about before the diseases like something like river blindness were even recognized as a neglected disease. And they've been doing this since the eighties. Uh, so they are out there on the front field. But not only that, they work like in tandem with the countries and the program administrators, um, you know, the community based volunteers.

And this is a huge effort because not just like hey, we're this one organization and we're gonna bring this down on high. Everybody can have this. I mean this takes a huge UM commitment first of all, and the second well cooperation um different countries, um, you know, different levels of government to get this. You know, going yeah and think because once you get it going to where it's

such a long term process. You're talking because again you're talking about uh supplying this to two communities for a period of fifteen years, and you need everybody to take it because because again these communities are dealing you're dealing

with like infection. Right, So it's like everybody so and everybody has to take it because if if only some people take this medication, if some are abstaining because of of real or perceived side effects to taking it or some sort of I read some stuff too about you know, at times there have been like fears that oh, it will make me sterile, or or concerns that more traditional medical practices in a culture would treat would be actually

be better at treating this condition than outsider medicine. So you have to do a lot of real education and re education UM and keep that up for fifteen years as well. So it's a it's a huge commitment. And uh and the fact that the Carter Center has been so proactive and it is really amazing. Yeah, And I think one of the keys UM in learning about the program, particularly the river blind this program UM that that they do. It's not just okay, here's a strug from an outsider.

What they really have done is they've allowed these countries and these communities and these different levels of government to take this on this the education programs and UM the medication on themselves and distribute it to the communities that need it to the people that need it, so that people are understanding it as not an outsider agenda, but as an agenda that is important um inside the community. And so I think that has gotten everybody on board.

So in that sense, you know, the CAR Center is also helping them that you know, those communities to help themselves. UM. So that's really important. You've got the education component, you've got the medicine component, and you have the vector control. Right, so there's also spring that goes on. Yeah, So medicating UM infected individuals just one part of it. We also are getting in there with anti larval um like larval

sides actually that that put in the water. Well, first of all, figure out what portions of a river are really prime activity, So they'll go in, they'll they'll look at the rate of the water flowing through there, like measure it with like little propeller gadgets. And then once they figure out the areas to treat, treat it with this environmentally friendly anti larval yeah yeah, and then that

that will attempt to kill it off. And then you know, you'll look at how the larval populations have dropped off in those areas, like like looking at typically these larva will end up crawling all over like the crabs that live in there in the water. Pull out the crabs, examine the crabs and uh. And we're seeing some of these areas that were previously hotbeds for the larval infestations

that it's just just not there anymore. Yeah. So yeah, cutting down, medicating people, cutting down on where it grows. Um also just a lot of things like making sure people were wearing more clothes in areas where they're exposed to the black flies, protective clothing, protective gear. Uh. Just sort of any little additional, seemingly petty advantage you can take can make a huge difference when you add everything up. Yeah.

And UM, I wanted to touch on elimination versus interrupted transmission too, because these are two different terms obviously that mean very different things. UM. So for for interrupted transmissions, but this has been happening with a lot of um, the different countries that the car Center is involved with. UM. This interrupted transmission basically happens when treatment coverage of an area UH is attained and there are no new incidences.

Elimination is a term that that you cannot actually use until an area or a country has maintained no new cases during a three year period called the surveillance period, and that's zero infections, and that's when you know that that is eliminated. Of course, World Health Organization is also involved in UM in terming the country or an area eliminated of this disease. But I guess with the larger story here is that this is a huge wind for

these countries and for these areas. Colombia has interrupted transmission UM and has gone three years without any new cases and it's waiting to be certified as eliminated. Ecuador, which is another area that the Carter Center is focusing on, has interrupted transmission, has also gone nearly three years without any new cases and is also being prepared to be sort of fight is eliminated. Mexico and Guatemala have interrupted

transmission and they are in their surveillance period now. Venezuela and Brazil still have endemic areas UH, most notably the area that crosses their shared border. Sort of makes sense, right UM. And then the Carter Center assists five African countries where they've interrupted transmission in some areas but not entire countries. A little bit more complex UM. Some countries have elected to go from nationwide elimination or to go

for nationwide elimination, and others have not. And I think that is important, UM, that that aspect right there, that you have to have the country on board with us as well or the area on board with us to really decide, Hey, are we gonna as a community go for complete elimination. Yea. So now one of the big challenges is just keeping the fight going, just continuing to

to keep it in people's minds. This is an issue that we need to continue to to fight, to u to eradicate, continue to treat, and just not let the guard down until UM, until it's it's adequately dealt with in the all of these affected areas. Yeah, because as you said before, like to stop that disease cycle, you have to have at least eighty of eligible people in the endemic area taking the medicine each year until the parasite disappears. And I read I believe it was in

Guatemala Um. I may be wrong on that location, but in the Carter Center they were talking about the Carter Center website, they have this great story about how they're trying to really keep the education component of this UM in people's minds for for all generations. And they were talking about school aged kids who in their courtyard have um black fly pinatas and that's again part of the

conversation of keeping it in their minds. If this is a very real danger, this is something that we need to think about so that those generations will continue to part of the culture. Yeah, yeah, yeah, absolutely, um. And I should also mention too that there is um and independently produced film called Dark Forest Black Fly that is tracking the efforts of the Carter Center and its partners to wipe out river blindness in Uganda, and that should be out later this year. But you can check out

a clip on the Carter Center's website. Yeah, do you do. Go to the Carter Center's website. You can just do a Google search for Carter Center. If you want to be a little more specific, do Carter Center River Blindness, or just do a search for river blindness and you'll find the Carter Centers website on this you also visiting that website, you'll find an easy way to donate if you would like to donate to to that particular cause. It's a great cause and I highly recommend supporting it.

And uh oh and also if you want, if you're just a little more curious about the organism itself, well, they have plenty of information about it, but the results. There's also a little discovery show that came out a couple of years ago called Monsters Inside Me. And if you're just fascinated by grotesque, harmful parasites, um, this is the show for you. It's it's it's it's kind of

a disturbing and dark show. It's a documentary but with a lot of dramatized scenes of individuals encountering parasites, becoming infected by parasit. It's all based on unreal stories. But they have a segment in one of the episodes it deals with with river blindness. Um. What has to do with an American chimpanzee Um? Yeah, and um specialist who comes back to the States infected and has to deal

with the ramifications. But but check that out if you're you're interesting in learning just more about the the strangeness of this creature. Yeah, and I hope you guys enjoyed learning about this. More of the Carter Center part of this, and not just the Carter Center part, but the sort of humanitarian efforts that are going on. We can often we talk about parasites who talk about how deadly they

are or how fascinating they are. But this is so incredible to know or to remember that there's this whole shadow effort and it's not even really shadow, but it's not something that we don't talked about all the time. There's a huge effort going on to to help people and to um to get them educated, in to to get that sort of health care that they need, and to stop the cycles of this that are making a huge difference in their quality of life. So it's pretty

cool stuff. All right, Well, let's call the ropeot over here and do a couple of listener mails before we sign out. First of all, I want to say that we heard from Adam again UM, the Chief Happiness Officer who's traveling around the world and sentis the cool hats, which we still need to get a photo of. I know one of these days, like this week is blown by UM. But anyway, he wrote in to tell us what he was up to now. He was in Hope, Hi men City. Uh and he also managed to pick

up and he sent some pictures of the money. But he also says also Robert, I suppose this is the Asian red Bull that you talked about many times in the show. It was available here in Singapore. I didn't try it and included a picture of it. Uh. We had a listeners in a picture of this this beverage in before and it's hard for me to place because

it looks like it's in cans now. And when I had it a few years ago in um Um in Thailand, it was it was in like a little medicine looking bottle, but but it was a red bluel product and it was like really crazy intense. So I've I've yeah, So I put the call out. It's like for any of our listeners who are traveling through East Asia or live in East Asia, uh, to to give me their feedback on it and see if it's really such a a such such an intense beverage compared to its American counterpart um.

And by intense, it feels as though it alters your reality a little bit. Yeah, I just, I mean, it's like like it just felt like an enormous amount of energy, Like it was like multiple shots of espresso or or B twelve or something just really charging and sweeter somehow too. We also heard from a listener by the name of

Robert Roberts and it says Robert, Julie and Company. Uh, he's refining responding to our episode on fiction and reality, he says The famed comic writer Alan Moore's recent work has frequently centered around an investigation of the power of fictional reality, has discussed in your recent Fiction Reality Secret Master podcast. His Prometheo graphic novel UH novels are clearly a simplified exploration of the power of myth and symbolism

on the human experience. But even more relevant is this amazing, spooky, bizarre spoken word performance Snakes and Ladders, which ties in the biblical serpent, the discovery of DNA and obscure writer author Makin's mourning over the loss of his wife into a beautiful exploration of where ideas come from and what impact they can have on us. It's quite a dense performance, and some of the more complicated elements elude me. Eluded me until I read the illustrated adaptation, but it's really

worth investigating. Thanks for your continued excellent work in the field of thought provoking podcasts. Um Yeah, Alan Moore is awesome. I encouraged anyone to chuck at his stuff. I actually actually have not read or listened to the titles he mentioned here, and familiar with Promethea I was. I was

actually reading a little about it the other day. That's the one where we get the weeping gorilla from just like a weeping gorilla that shows up and he's, uh, he's always been moaning something like I can't get good. I thought you men about the weeping girl in the office. No, no one, no, Well, if you see a weeping girl in the office, and it's probably um some sort of crossover from fiction into reality via the metaphysics of Promethea

um as for snakes and ladders. I don't think I actually heard of this one before, though I have read some of the fiction of author mockin Um. Unless I have my name's crossed the belief he's the guy who wrote he wrote the Wind to Go and some really weird No, maybe he didn't write When to Go. I think he wrote I think you wrote some weird stories about Pan, like uh, like sort of early weird tales.

But but at the center of this is is Pan the the half man, half man, and have goat, and he's depicted in a very very interesting manner, like a dangerous manner. But it's it's really powerful stuff assuming and I didn't screw up my names there. But anyway, thanks UH, Robert. We always love to hear from people on the podcast and also about other bits of media Italian and what we're talking about. And finally we heard from Summer in

Salt Lake City, Utah. Summer rights in and UH. She's responding to our discussion of how stuff works versus HSW. She brought this up because we mentioned on the podcast in the past that that even though we say how stuff works, when we go to UH to refer to the website or website properties and internal emails will often put down UH, it just put on h SW to

simplify things, just three letters. But when you start looking at the syllables how stuff works, that's three syllables, H s W, that's five syllables, we end up say saying hs W though, because we're used to abbreviate it on reviating it on paper, so we up abbreviating it in our speech. And so she says, I would like to offer solution that was adopted at the place where I was employed through college. Kennis Warehouse is much longer and more drawn out than t W when written, but they

are the same number of syllables when spoken. Being college students, either options seemed to require way too much energy to say over and over, so we instead pronounced it t dub. It only solves the too many syllable in the letter W problem, but it also makes everyone feel slightly more street smart. So he recommendation would be for us to go with hs dub. Okay, so H s W with a four, right, then we can short g it back to three. It just all right, we need to send it.

We need to send a memo out today. Well, I think we would have to. We'd probably have to get rid of that S and we just change it to H dub or h W. I don't know, something, once you start down that road, it's a slippery slip. I understand I'm thinking of this. I don't know. I'm a traditionalist. I'm like an hs dub hs stub. All right, Well, we'll give it a trial weekend. We'll see how it goes. All right, Well, if you would like to talk about anything with us, be at abbreviations and UH be at

river blindness and its effects on the world. Other interesting parasites, parasitic lifestyles, lifestyles, parasitical life cycles, not so much the life stuff, but that's another podcast. Yeah. Yeah, if you have a parasitic lifestyle, let us know about that. We'd be interested to know what that can to the stuff. And do you have the Bolbock bacteria? Yeah? And how is that working out? So? You can find us on Facebook and you can find us on Twitter. On Facebook,

we are Stuff to Blow your Mind. On Twitter, our handle is blow the Mind. Look us up there, friend us, follow us, interact with us, share stuff with us. Um, anything's on the table. Yeah, and do make sure to check out the Carter Center's website. UM. River Blindness is just one of the many programs UM, but they work on and uh please do feel free to send us an email at Blow the Mind at Discovery dot com. Be sure to check out our new video podcast, Stuff

from the Future. Join How Stuff Work staff as we explore the most promising and perplexing possibilities of tomorrow. M H.