Preaching text: Numbers 21:4-9
Hi, my name is Victoria, and I listen to podcasts about disease for fun. Today, I want you to come with me on an epidemiological journey. Our way shall be fraught with both joy and disgust as we nerd out about how this story about poisonous snakes might actually be about guinea worm disease (GWD).
What are guinea worms?
I am so. Glad. You asked.
Guinea worms are a species of parasite. (**Stop. Take it in. If you can’t watch the movie Alien, you should consider skipping the next several paragraphs.**)
Still here? YAY LET’S DO THIS! Guinea worms begin their life cycles as teeny tiny little larvae floating in freshwater environments who get eaten by plankton. The plankton are then drunk by people. The plankton die. The larvae don’t. Instead, they press through our stomach and intestinal lining to find their mate in the connective tissues of your abdomen. During the next 10-14 months, the males die. But the females? The females keep going. And growing. And slowly making their way through your body, usually toward your legs and feet. Their eventual goal will drive them through your flesh—which causes terrible burning pain—until one tiny end of the worm, which may be up to three feet long at this point, pokes through into the outside world, after having lived inside you for a year.
Gah it’s so gross and yet somehow I can’t stop typing…
To relieve this burning pain, you will want to stick your foot in the nearest body of cool water. This is just what the guinea worm is waiting for. Upon contact with the water, she will excrete a milky liquid that contains millions of larvae, which begin the cycle again.
There’s no drug for or vaccine against guinea worm, and having it once is no protection against getting it again. The treatment now is the same as the treatment would have been in Moses’ time: to get a stick or a bit of gauze, and every day, wind a few more centimeters of the worm around it—don’t break it don’t break it no really don’t break it—until you’ve pulled the entire worm out of the body. This can take weeks.
Guinea worm disease itself isn’t fatal, but complications from it can be. And it’s a disease that’s especially bad news to those who depend on mobility for their survival. Like, say, a nomadic tribe of ancient Israelites.
GROSS FACTS END HERE.
Some interesting facts about the biblical narrative this week:
- While the NRSV gives us poisonous serpents, this is just as accurately fiery serpents. (Did I mention that guinea worms are properly named dracunculus, or little dragons, after the burning pain they cause?)
- The Israelites are traveling through an area where GWD was endemic.
- The snake onna stick thing sounds an awful lot like the treatment for GWD….and, incidentally, a lot like the Rod of Asclepius from Greek mythology.
Now, you may be wondering about the reason I made you learn about GWD, and it is this: thinking of this biblical account as a parasitological problem is very different than thinking of it as a God-sent plague, and it leads us to a different line of inquiry about how we understand God’s promise in this text.
But before we unpack all that, let’s identify the promise itself.
“Make a poisonous serpent, and set it on a pole; and everyone who is bitten shall look at it and live.”Numbers 21:28
Well, that was easy.
Why the Israelites need this promise
This is both the most and least straightforward promise of the bunch we hear this Lent: the people need this promise because they have a fiery serpent problem and without some antidote, they will die.
But the Israelites in this story read another “why” into their predicament: the serpents are sent as a divine punishment for the complaining that the Israelites do. This is not a pronouncement that Moses or God provides: the Israelites themselves draw this conclusion to account for their own suffering.
People—myself included—do that all the time. It feels so much more reassuring to imagine that suffering happens to us for a reason, and if we can just figure out what the reason is and fix it, then the suffering will be relieved. It’s a lot easier to imagine (particularly in an age before modern medicine) that a horrible outbreak of fiery serpents among your people is a result of their bad behavior, rather than believing that maybe your people wandered into an area rife with parasites and shit unfolded predictably. We do the same awful rationalizing when a hurricane or an earthquake hits, when the biopsy comes back positive for cancer, when a young person dies tragically and too soon. “Everything happens for a reason,” we murmur, finding comfort in a logical universe rather than a curse in the callous God such reasoning implies.
Why God needs this promise
But God won’t play along with the cause-and-effect narrative the Israelites build. God’s “solution” doesn’t remove the fiery serpents, or even relieve suffering. God’s only action here is to take death off the table: “everyone who is bitten shall look [at the bronze serpent] and live.” It’s no small potatoes, but it certainly wasn’t the promise that the Israelites were hoping for.
It’s easy to lose ourselves in what God doesn’t do, but worth looking for what God does do: God offers a vision for survival. God literally gives the Israelites something else to focus on when all they want to do is gaze at their own suffering and try to account for it. The vision God offers is not a quick solution, and it’s not a painless one, but it does promise a future. A future where God is showing up not in the miraculous cure, but in the messy middle.
This Lenten series is inviting us to consider God’s promises as a reflection of both a God and a people who are evolving and learning through relationship with one another. In this relationship milestone, God is confronted with Their people asking for one thing, and God deliberately chooses to give them something else.
It’s a painful moment when you realize that you can’t or won’t give your love exactly what they’re asking for, but the difficult truth of good relationships is that they aren’t built on wish fulfilment. They’re built on difficult conversation and hard compromises and especially on the commitment to keep showing up for one another.
In a moment of crisis, the Israelites cry out to God to be a particular thing: a problem-solver. But instead, God chooses to be a promise-maker. A God who we’ve seen choosing the easy way, most notably in the flood story, now chooses the hard way: commitment instead of cure.
Why we need this promise
All right friends, the guinea worms got us into this, and now they’re going to get us OUT.
In 1986, the World Health Assembly decided it was going to try and eliminate GWD. In that year, there were 21 countries with GWD, and about 3.5 million cases per year.
In 2019, only 4 countries reported GWD: a total of 54 human cases.
Three and a half million to fifty-four in a just over three decades!!
The story of how it was done is incredible and too long to delve into here, but briefly: organizations like the Carter Center liaised with ministries of health and helped maintain political will, and that went a long way toward sustaining efforts. But getting things done on the ground has taken community-based interventions. Talking with people. Teaching them about how people get infected. Instilling the importance of drinking filtered water, and keeping emerging worms away from water. Giving them the resources they need to get clean water. Incentivizing reporting, and allocating resources so that reports can be investigated quickly.
Guinea worm eradication is on the horizon, and it’s not because of a quick fix, a vaccine, a sudden cure. It’s because of a shared vision of a future without pain and death, and the myriad ways that vision roused us to act, together.
I’m writing this at the end of 2020, a year of pandemic. Here in the U.S., I watched my government fixate on the idea of a vaccine as the primary goal, to the point where our president refused to promote effective methods of containment and mitigation, like wearing a damn mask. Now there’s a vaccine—which is a medical marvel in its own right—but it turns out that the quick fix we’ve been longing for isn’t going to be quick. And it’s going to be complicated by the division and disunity sown by leaders that were unwilling to do the difficult, costly work of telling a people in crisis the truth: there is no easy solution.
Pandemics aren’t the only things that don’t have quick fixes. Systemic injustices, corrupt power structures, lingering prejudices—all of these burning pains can only be drawn out of our collective Body by the slow, sure turning of God’s vision, a vision that inexorably winds us around the untold love of the cross-bound Christ.
Places where I learned about Guinea Worm (and you can too!):
“Guinea Worm: (Almost) Ancient History.” Episode 58 of This Podcast Will Kill You, released September 15, 2020.
“Guinea Worm Eradication Program.” At the Carter Center website. Accessed 12/28/2020.
“Guinea Worm” article at the Center for Disease Control website. Accessed 12/28/2020.
Late-night wine-soaked talks with my occasional roommate, Dr. Janna Schurer, parasitologist specializing in One Health approaches to zoonotic parasite surveillance and disease mitigation, and really cool person.