It’s challenging enough to be the new kid in school. It’s even harder when something scary happens and you don’t know why. Ten-year-old Gideon Abraham and his brother Odenaka, 12, and sister Blessing, 7, had come to live with their grandmother in Amagunze, Enugu State, Nigeria, in the middle of the school year. One morning, he was alarmed to discover that his urine had turned blood red. He didn’t tell anyone; he just got dressed and walked to school. This went on for a week. Finally, because it wasn’t going away, Gideon went to his teacher while all the other children were outside during recess. The wide-eyed boy leaned in and quietly told her, “I’m scared.” The teacher asked him why. “My urine is red,” he whispered.

The teacher gently took Gideon by the hand and walked him past a row of mango trees to the office of headmaster Paul Nnamchi who quickly realized what was causing Gideon’s problem: schistosomiasis. Schistosomiasis is a parasitic infection that can cause bleeding in the urinary tract. Left untreated, it can seriously damage internal organs, causing anemia, stunted growth, chronic pain, higher susceptibility to other infections (such as malaria), and sometimes premature death.

Nigeria is the most endemic country for schistosomiasis, with approximately 20 million people - mostly children - needing treatment. “We can treat schistosomiasis with a donated medicine called praziquantel, and keep it under control,” said Dr. Frank Richards, director of The Carter Center’s schistosomiasis, river blindness, and lymphatic filariasis programs, supported by IZUMI Foundation. An infected person’s parasite load can be knocked down with a single annual dose of praziquantel, Richards said.

Because schistosomiasis mainly affects children, the government’s strategy is to distribute the drug through schools. In addition to his educational duties, Gideon’s Headmaster Nnamchi is a community-directed drug distributor for the state Ministry of Health. The ministry partners with The Carter Center to train volunteers like Nnamchi to administer treatments for schistosomiasis and several other neglected tropical diseases.

Teachers discovered 10 more children - including Gideon’s brother and sister - who had missed treatment for various reasons. Nnamchi measured the heights of all 11 children, and carefully counted out the appropriate doses of praziquantel tablets for the children.

“The drug kills the parasites almost immediately,” said Adamu Sallau, a director in The Carter Center’s Enugu office. Gideon’s urine could be expected to clear up within 48 hours.

“The children are happy; the teachers are happy; I am happy and the parents too,” Nnamchi said. “The whole community is happy with this.”