BUNGOMA, CENTRAL DISTRICT, KENYA — Agnes Nafula, 55, was born healthy. She married at 18 and raised three children. But in 1995, Nafula began suffering from mental illness. Relatives say she “lost her mind” and despite efforts to recover, her mental health has not improved over the last 15 years. As a result, Nafula was forced out of her home by her husband and his family. Today, Nafula lives alone in unhygienic conditions. And she suffers from jiggers.
A jigger is a type of parasitic flea that attacks soft areas of the skin, such as the web of toes and fingers, and spreads to other parts of the body if it remains untreated. The jigger initially causes only an itchy irritation, but as it sucks blood from the person, the bug grows bigger and multiplies, causing severe inflammation and ulceration in the person’s skin. The wounds left after a jigger is removed can become painful cracks, which attract more jiggers if they are not properly disinfected. Heavy infestations can lead to gangrene, sepsis, the loss of toenails, amputation of digits, and even death.
“Where did we go wrong that jiggers can still torment people in the 21st century?” asked Kenya’s former president Daniel Arap Moi at a recent event.
The same question is on the minds of million of Kenyans who are at risk of jigger infestation. Jiggers affect women, children and the elderly in the highest numbers. Poverty is a major cause, as unsanitary living conditions are believed to be the major source of jiggers. Many Kenyans believe that jiggers are a curse, which causes strong local stigma that keeps people isolated and unable to participate in their communities. A new report suggests that jigger infestations kept more than 800,000 people from participating in a recent voter registration drive. And advocates fear people with jiggers are at a higher risk of HIV transmissions since many share pins while attempting to remove their jiggers.
Like many who suffer from jiggers, Nafula lives in extreme poverty. Her home, a one-room, grass-thatched, mud house is dirty. Her clothes are filthy too. Her crooked toes and fingernails tell the story of her pain. Jigger wounds, the result of constant infestations, have left her weak and in pain. She has difficulty walking. She admits she can no longer take care of herself and relies on community members for much of her daily care.
“What do you want me to do? They all fled, they left me alone,” says Nafula. Makarios Wakoko, Nafula’s relative, says efforts to rid her of jiggers have proved fruitless due to her unsanitary living conditions, which are not uncommon for many area residents.
“At one point, I tried to fumigate her house with some disinfectant without success. Locals mostly apply a solution used to rid cattle of ticks, but it seems that it does not work for jiggers, because the infection keeps on recurring,” says Wakoko.
According to Beth Mugo, minister of public health, over 10 million Kenyans are currently at risk for exposure to jiggers. Mugo says that number will likely increase in the near future if proper health measures are not taken. Those with jigger infestations face a negative stigma from the community since many regard people with jiggers as cursed.
“The problem is that many see [jiggers] as a curse and the society does not recognize it as a medical condition,” says Stanley Kamau Maina, the CEO and founder of Ahadi Kenya Trust, AKT, an organization working to help Kenyans with jiggers.
Ahadi Kenya Trust, the sole organization in Kenya fighting this problem, estimates that over 800,000 people were unable to take part in countrywide voter registration that occurred in May of 2010 because of jigger-related injuries. The voter registration campaign in May registered more than 10 million voters to take part in the referendum on the draft constitution that is slated for Aug. 4. Despite concern that a large number of the voting population were unable to get to the registration centers for health reasons, the Interim Independent Electoral Commission reported that their registration goals were met.
While many were unable to walk to the registration centers, others with jigger wounds were able to register to vote, even with some difficulty. Maina of AKT, says he observed many with jiggers who had a hard time giving finger prints due to their crooked fingers and nails. Maina says AKT partnered with other charitable organizations to hire buses which drove individuals with severe health conditions to registration centers.
John Kuria, 70, from Kangira village in the Kandara district of the Central province, the area with the highest number of infestation cases in the country, got a ride to the voter registration center. Kuria says he could barely walk into the center to exercise his democratic right.
Maina is optimistic that if the government takes up their recommended awareness campaign to undo the myths surrounding jiggers it will lead to a healthier and more productive population. The former Miss World Kenya 2005, Cecilia Mwangi, AKT’s campaign ambassador, agrees.
“We are trying to undo the stigma surrounding jiggers, although lack of political goodwill is a major hindrance,” she said at the opening of an AKT center in Tanzania. Ahadi has also opened a center in Uganda. “It is the only way to restore the image of our continent Africa and reap it of the shame of this flea. We plan to spread to the rest of Africa by 2015,” says Mwangi.
Maina says many politicians here are opposed to increasing jigger awareness campaigns because it creates a negative image about Kenya that may deter tourism. Without coordinated public health outreach, ending the stigma may prove challenging, Maina says.
Still, AKT says there are ways to help minimize jigger attacks. People are advised to keep their homes and bodies clean. Constant fumigation is advisable and parents should ensure that their children wear shoes, particularly in areas prone to high infestations.
