My feet itch so badly and when I use my hands to scratch it's not enough. I use rough stones. When I was in school, that alone would attract loud laughs and gestures from my classmates and I was ashamed.
Mohamed Hashim, 13, always had a ready smile.
He loved school and looked forward to moving to the next class.
That was until jiggers set in.
Hashim missed the just-ended term because walking became too painful. The jiggers have eaten away most of his feet.
To make matters worse, his classmates made fun of him and called him names.
He swears never to go back to school again.
“They called me duck feet because of the way my toes look. I told my mum I would never go back there and be mocked again,” Hashim says.
“My feet itch so badly and when I use my hands to scratch it's not enough. I use rough stones. When I was in school, that alone would attract loud laughs and gestures from my classmates and I was ashamed.”
His mother Yusura Hashim says the parasites have not just eaten away her son's feet but also his self-esteem.
She says Hashim refuses to go back to school, insisting he will only do so when he gets rid of the jiggers.
His feet are constantly itchy so he cannot sit still long enough to concentrate on the lessons, he argues.
“I have tried to tell him to assume the trolls and focus on education but he says it's hard for him to do that when the other kids laugh at him at the slightest chance. I have allowed him to stay home but we don’t when the jiggers will stop eating him,” Yusura said.
Hashim joins a long list of children in parts of Lamu county whose lives, education and health have been set back by jigger infestation.
Scope of Jiggers
The worst-affected areas include Hidabo, India, Makafuni, Milimani, Kandahar, Spotlight and Mararani in Lamu island.
Parts of Mpeketoni, Witu and Kiunga on the mainland are also affected.
Abdulaziz Sadiq of the Lamu Child Protection Initiative says jiggers are caused when a pregnant female sand flea burrows into parts of the body, such as under the fingernails, ankles, elbows, palms, toes, knees, lips, eyelids and buttocks.
As the flea feeds on a person's blood, it grows and lays eggs the shape of a pea that cause pus-filled sores.
I call it the poor man’s pandemic because only poor people suffer the worst effects. These people don’t have shoes because if you live in an area known to be infested, you need your feet covered all the time to prevent any chance of the parasites biting
Serious cases can lead to ulceration, fibrosis, gangrene, loss of toenails, amputation of fingers and even death.
Sadiq says the major cause of jigger infestation is poor hygiene.
He says the parasites have been found to also largely affect those who have set up homes on areas that were previously used as dumping sites for cow dung.
“The parasites in these areas didn’t completely die out and so many of those living in such areas are literally living with jiggers,” he says.
Sadiq says poverty is a major barrier to overcoming the infestation as many cannot afford shoes or the required treatment.
“I call it the poor man’s pandemic because only poor people suffer the worst effects. These people don’t have shoes because if you live in an area known to be infested, you need your feet covered all the time to prevent any chance of the parasites biting,” he says.
The exact number of people suffering from jiggers is unknown but Sadiq says it is in the hundreds going by the statistics the LCPI has collected over the years.
Children and men are the worst affected.
He explains that poor housing exposes many people to attacks by jiggers.
“Many live in dire conditions. Most houses have no floors or the floors are earthen and this provides the perfect environment for the jiggers to thrive,” Sadiq says.
Effects of jiggers
The effects of jiggers on affected persons range from physical, emotional to psychological and even economic.
Sadiq explains the physical effects are awful as the person has to live in constant discomfort and ill health as jiggers continue to feed on their blood.
For children, it is doubly painful as the jiggers invade more sensitive parts such as buttocks, armpits and private parts, making life a nightmare.
“If they are in the buttocks, that means one cannot sit, sleep or stand. It literally takes away that person’s life even though they are alive. They can feel the jiggers moving in the various parts of the body and causing them untold pain,” Sadiq says.
The itching keeps them awake all night, denying them sleep and stunting their development.
Psychological effects then set in as the victim suffers poor self-esteem and keep to themselves for fear of being picked on, like in the case of Hashim.
Sadiq says affected schoolchildren struggle to hide the wounds from their friends at school to be accepted and to fit in.
The education of such children is put on hold as most are unable to stay in school or concentrate in class due to the pain and stigma.
“Most kids are mocked in school and stigmatised because of the condition and that’s when some drop out and reject school altogether. Because the psychological trauma becomes unbearable,” Sadiq says.
The ongoing drought in Lamu and parts of Kenya has made the infestation worse as the parasites thrive in intense heat temperatures, meaning the number of new infections is high and the scope large.
Lessening the pain
Together with organisations such as Ahadi Kenya Trust, World Vision and the Lamu Women Alliance, the LCPI and the Lamu government has been moved in to help by buying drugs and pesticides.
County Public Health director Athman Dumila says jigger infestation is a communicable disease and falls on a long list of neglected tropical diseases that mostly affect poor people with poor hygiene and little knowledge, and neglected people such as the elderly.
He says children and men are more affected as they venture outside more.
Dumila says his office works with community volunteers who point out areas that need attention and officers are sent in to help.
He says jigger infestation is simple to treat. It only requires hydrogen peroxide, which the county has procured in plenty, after which the wounds are cleaned with iodine.
“The feet or affected area is soaked in the hydrogen peroxide for a few minutes after which the parasites are easily removed or they come out themselves,” Dumila says.
The treatment plan also includes spraying and disinfecting affected houses and areas around them to kill larvae and prevent further spread.
Dumila says his office has made a point to organise frequent outreach programmes to affected areas to ensure consistent treatment and total eradication of the parasite.
“The numbers have gone down because of the consistency of response whenever any alerts are raised in the red zone areas. We ask for the cooperation of the community to defeat this because it's possible,” Dumila says.
Edited by Josephine M. Mayuya
