Jigger in My Toe- Time Government Woke Up To The Itch

By Jossi Tinga

The first time a chigoe flea burrowed into my foot, I kind of liked it. Come night, the tingling itch was quite nice to scratch. I simply scratched until sleep got the better of me. It was the little bug’s way of lulling me to sleep. Unknown to me, the enjoyable itch spelt doom for my foot. The pregnant bug was busy laying eggs in my flesh. In essence the little monster was on a mission to colonise my foot. She wickedly sought to convert my soft tissue into a maternity. I was not going to cooperate with her. 

 

Image: Courtesy of Wikipedia

By day I applied copious quantities of anti-fungal and anti-inflammatory cream. I believed it to be a fungal infection. Surprisingly it did not go away. It appeared to recur every time I stopped medication. Over time, the skin around my toe softened. The fungicide did not kill the mother flea but appears to have suffocated the life around the infected area. A whole patch of skin peeled off as a result revealing the tiny bulge with a black ‘eye’.

 A friend correctly diagnosed the bulge as a jigger. With a pin and deft hand she literally pricked it out. It was still breathing when she plucked it out. Bug, needle and gauze all ended in a ball of fire. We were not to risk a single egg coming back as a flea. I have since discarded the bad habit of wearing leather sandals during my many field visits as petty official.

Reports elsewhere suggest the chigoe flea is no laughing matter. No less than a former Miss Kenya has deployed her beautiful deportment to the fight against jiggers. When Cecilia Mwangi, the Miss World Kenya 2005, put her charm behind the anti-jigger campaign; many thought it was just a prank. Politicians from her native Murang’a County dismissed her claims that jigger infestation was a serious problem.

The fair lady was not to be deterred. She drew the camera’s focus towards the smitten toes and legs. The female Tunga penetrans flea is wreaking havoc across the country. According to the Ahadi Trust which runs the main anti-jigger campaign in Kenya, some 2.6 million are infested with the pest. It turns out the problem is not limited to Murang’a. It is not, as veteran Maasai politician William ole Ntimama derogatively suggested, an affliction of the Kikuyu poor.

Recently, the Kenya Red Cross donated one hundred thousand pairs of canvas shoes to school children in Kilifi County in a quest to fight the jigger. In July Mama Sarah Obama, the 91 year old grandmother of US President Barack Obama, launched an anti-jigger campaign in her native Siaya County. First Daughter Ngina nee Uhuru Kenyatta, has also put her good offices into use against the female pest. The jigger infestation is a major public health issue in Kenya. 

Why then is a little sand flea an issue of public health concern in this age? Simple- the vast majority of Kenyan live in mud huts with just enough water to get by. They have no proper shoes, probably sleep on the floor and do not have the luxury of washing or changing beddings regularly. The daily bath is an expense many cannot afford. In jigger-infested areas one needs a good helping of water to wash-off possible infestation at least twice a day. A regular change of socks, shoes and clothing can go a long way in fighting infection. Many rural children endure childhood without ever donning closed shoes. They are easy prey for the burrowing monster.

There is no known cure for jigger infestation except prevention, surgical removal and disinfection. Splashing dusty surfaces with water destroys the flea’s preferred habitat. Regular use of insecticide repels the pest. After infection surgical removal is the usual option. Village 'surgeons' typically used all manner of pins, needles and razors to remove the unwelcome parasite. Therein enters a fresh risk- that of secondary infection. Villagers sharing needles easily spread other infections including the dreaded HIV or hepatitis. The misery of festering toes and feet is nothing compared to the risk of secondary infections. 

Often, acute infestation forces children to abandon school and adults to drift into anti-social behaviour. Going to school with feet full of festering wounds is not very pleasant. Yet, the jigger epidemic passes by quietly. It does not arouse as much interest as other public health issues. Infection is usually blamed on the victim. 

Jigger infestation is derided as a symptom of poverty. However true this may be, it is no reason for stigmatisation. The government is complicit by not coming to the aid of the millions afflicted. There is no concerted effort to fight jigger infestation in the same way malaria prevention is approached. It is foolhardy for the government to run a high profile hand washing campaign in schools while ignoring the feet.

While it is true the chigoe flea is not anywhere as deadly as the mosquito, the two often afflict the same person. Fighting malaria among the rural poor without addressing the jigger is akin to treating one illness while ignoring another condition. The government had better wake up to the niggling itch in Kenya’s underfoot. No amount of denial, stereotyping and buck-passing will diminish the pain and scale of jigger infestation in the country.