The villain of this new documentary is a worm — but not just any worm.
"We have known monsters, all kinds of monsters," Waleed Eltayeb declares. "Then there's the dragon, this fiery serpent, this terror, this ill, this parasite, this worm."
He's talking about Guinea worm, which shares the title billing in the new film The President and the Dragon, premiering on Amazon Prime Video today, Oct. 1, which would have been the 101st birthday of "the President" — Jimmy Carter.
After leaving office, Carter's former drug czar Dr. Peter Bourne told him about the devastating effects of Guinea worm. Funding was hard to come by, so the former president made it his life's mission to eliminate the disease.
Guinea worm disease is caused when the worm itself is spread through contaminated water and undercooked fish. Once in the stomach, the larvae penetrate the intestinal wall and migrate to the skin. The adult female worm — which can grow up to 3 feet in length — commonly goes to the lower limbs, where it causes painful blisters. That pain can cause temporary or permanent impairment, disrupting daily life.
To relieve the burning pain, people plunge the affected limb in streams or ponds, triggering the release of thousands of larvae and contaminating the water source. When a person drinks from that source, the cycle repeats.
When Carter first decided to come face-to-face with the ancient parasite in 1986, the World Health Organization estimated 3.5 million cases of the parasitic infection in Asia and Africa. Thirty-eight years later — at the time of his death in 2024 — the late president's Guinea worm eradication program counted a mere 14 cases. The World Health Organization uses this data in its Guinea worm reporting.
While eradication is remarkably close, the Carter Center says they haven't achieved an end to Guinea worm disease. As of Sept. 18, the group reported four instances of the disease as a provisional count.
Those numbers are only part of the story, Eltayeb says. The documentary, directed by him and Ian D. Murphy, chronicles the late president's fight to eliminate Guinea worm disease — and the individuals who led the fight. It also weaves in the story of how Carter played a role in ending the civil wars between north and south Sudan, Eltayeb's homeland and one of the countries afflicted by Guinea worm.
NPR interviewed the 50-year-old director, who also wrote and produced the film. Eltayeb now lives in Dubai but traveled with the crew to Africa for the film. This conversation has been edited for length and clarity.
Your involvement with the film began with an exploration of the eradication effort in Sudan. But you found a deeper story to tell.
For me, this film is basically about one of the most important things that we as human beings cannot do without, and that's hope. It showcases very clearly the power of us when we come together. When we decide that we want to put differences aside and focus on doing things that are for our collective good and for the betterment of humanity. There is nothing that we can't achieve. I loved that idea about the film.
Now more than ever, with everything else that is basically going on right now, I think we all can do with some hope and something to inspire us and show us we can achieve great things if we can just put our differences aside.
I found it fascinating that the eradication effort was centered on clean water and education — not vaccines or medication. Why did this story captivate you and your colleagues?
You have a story of a formidable enemy — a very conniving and manipulative monster that has basically existed for millennia — born out of poverty and perpetuating poverty amongst people.
The notion that we as a species were about to reach the milestone of eradicating something like Guinea worm using nothing but education and discussion as a form of intervention — no vaccines, no direct medication or pills to swallow — I thought that we were part of a great milestone and achievement for humanity. I felt like this was a story that needed to be told.
There's this thunderous beat at the start of the film's soundtrack. Where does the sound come from?
It was based on a piece of spoken word that I did for the Guinea Worm Summit. For that specific event, we wanted to do something that galvanized everybody behind the objective and the goal of eradicating Guinea worm.
I wrote this piece called "Just 13," and the initial beats that you hear were used to say, "We are 13 cases away from eradication." The idea was to basically create this sense of urgency and to almost link it to our collective heartbeat and excitement to try to eradicate the remaining 13 cases as quickly as possible.
Throughout the film, I felt incredibly connected to the characters, like Makoy Samuel Yibi. How did you achieve that cinematic effect?
One of my key visions for the film is that I wanted this sense of people looking directly into the camera. Almost as if they're staring into your eyes, and you're staring into their eyes to let you know how this disease is affecting other human beings.
Another important aspect is the South Sudanese tribes that were filmed look like kings and queens in their colors and in their beads. They just look like ancient African warriors. There was such a degree of dignity in terms of their presence in the way that they stood.
Jimmy Carter is the titular hero of the film but you didn't just focus on his involvement.
The success of this eradication program does not happen without the people on the ground. It does not happen without the volunteers. It does not happen without the local doctors. It does not happen without partnership.
I didn't want to present this idea of a white man who has basically come to save the indigenous people of Africa. For me, it was really, really important that it never, ever looked like that or came across like that.
We weren't making a film about President Carter. There are enough great documentaries covering the full legacy of President Carter. This was very clearly, from the beginning, about the Guinea worm eradication program and everybody who played a role in that.
You include a quote of Carter saying, "I would like to see Guinea worm completely eradicated before I die." That didn't happen. Why did you choose to include that quote from him?
Because he refused to put this issue aside. He was extremely stubborn and driven around this issue.
Even when he went into hospice care, he kept on asking about the Guinea worm numbers. Even at that point when your life is slipping away from you and you are frail, his concern was not for himself. His concern was for the Guinea worm program.
Can you tell me about your upbringing in Sudan, and how it impacted the way you told the story?
I knew about Guinea worm, but I really didn't truly understand what it was. I didn't know much about Guinea worm, but I knew a lot about the conflict in Sudan.
It's a conflict that's been raging for over 50 years, and as with all of these conflicts that are happening, it is just completely driven by greed. I was aware of the loss on both sides. I was aware of the pain on both sides, so this was something that I felt like had to be a key aspect of the film.
Can you tell us about a story from the film that stuck with you?
We feature Garang Buk Buk Piol, who speaks about carrying an AK-47 when he was 12 years old. He was a child soldier learning how to kill and slaughter and slay another human being at that age. He was carrying an AK-47 that was taller than he was.
That child turned into a Guinea worm warrior, now turned into a philanthropist and an activist amongst his people, who is teaching underprivileged communities in South Sudan and building schools. These programs are fighting disease, waging peace and building hope. Look at the stories behind the numbers, and then you truly begin to see the impact of these health programs.
Sudan is still in conflict and other parts of the world are, too. What message do you hope viewers take away from the film?
It's very hard not to be pessimistic. What's going on in Gaza, I think, is a stain on our humanity. I hope people can see the spirit of hope that exists in this film. That they can see the fact that people can put aside differences and work for the greater and collective good of humanity.
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