Jiggers : (
'Jiggers', or more commonly known in Kenya as “Jigga, Jigga, Jiggas!”.
When I heard this word for the first time I thought of
dancing and pictured a couple doing the salsa, however 2 months later I hear it
and my stomach churns. This is a word quite often used in rural areas of Kenya
and the impact it’s having is to say the least; quite devastating.
A picture drawing of a fully developed Jigger (Copyright
from the net)
Jiggers are otherwise known as a sand flea. They live and thrive in the mud in wet rural
areas close to the equator in Kenya. Both the male and female flea feed on the
flesh of a warm blooded host, however it is only the impregnated female that
burrows deep into the skin and lays her eggs in the soles of human feet or
hands. The female must claw and hack vigorously into the skin to enter as she
has no special burrowing shape or technique.
Once she enters her host, she will continue to grow and develop an
enormous abdomen. The end result will be a round sack, the same shape and size
of a pea, with the flea inside. She will also leave a small hole in the sack
that will look like a tiny black dot. This hole provides her with an exit for
laying eggs and depositing feces. 100 eggs will be released through the tiny
hole over the period of 2 weeks.
The symptoms of having Jiggers start to take affect once the
flea is almost a fully-grown adult. Once an infestation has developed it will
start to irritate and itch the skin. Quite often, if reproduction is successful
it can result in clusters of infestation all over the feet or hands of its
host. The process of the flea’s development can progress from itchy to
extremely painful within a matter of weeks. It’s been known to lead to ulcers, inflammation,
secondary infection, gangrene (which has been associated with death), tetanus
and the loss of toes. The infestation
leaves its host with walking difficulties and the inability to carry out their day-to-day
jobs.
HIV has also been related to Jiggers. When the Jiggers are
treated a small surgical blade is shared between victims to remove the flea,
resulting in the possible spread of aids through the passing of blood on the
blade.
I was very shocked to hear recently of a Jiggers related
death. Apparently the jiggers will burrow their way as far as the brain and
cause severe mental illness. If they reach the brain they can send the host
crazy and if untreated it will eventually result in the inability to walk or
even death.
The main causes for Jiggers are:
- Dusty / muddy floors in houses and schools (not having cemented floors)
- Poor personal hygiene
- Poor housing
- Lack of public education
- No prevention against infestation – e.g.: fumigating homes
- Lack of cleaning and washing - sheets, pillows, blankets, all bedding
- Not wearing shoes (majority of victims can not afford shoes)
Most people in rural areas of Kenya are too poor to practice
prevention techniques, and are equipped of adequate protection against Jiggers.
They also cannot afford the treatment needed to eliminate the infestation.
It has been reported that over 1.4 million Kenyans are
infested with Jiggers.
For the last 2 months I have been funding and participating
in a local Jiggers project. We have been walking from village to village, the visiting
families door to door. When we meet the family we check everyone for Jiggers,
Ringworm and Scabies.
If a member of the family has Jiggers, the health workers
will firstly cut the Jiggers out of their feet and the hands with a small steralised
razor blade. Quite often the Jiggers will lay eggs in the feet so these have to
been cut out too. Once the Jiggers and eggs have been cut out there is a large
hole left leaving the flesh exposed to dirt and infection. Both hands and feet
must then be soaked in a solution for about 15 minutes. The solution kills any
left over infestation and prevents more Jiggers for a short time after. If the
wounds are quite severe we will clean them with betadine and coat them with
dressing. Generally, after the treatment has been completed, the person will
put on their shoes (or not), and walk away. The severe cases are recorded and
will be eligible for a follow up treatment at a later date.
As most Jiggers are affecting people in their own home, I
have decided to branch out the project and start fumigating people’s homes.
This is to prevent treated victims from getting them all over again. The
majority of people I have treated will walk home to a Jigger infested bed. We
will start spraying peoples Mud homes with solution next week to prevent the
need for on going treatment.
Through my experience I have seen many extreme cases of Jiggers
and it is not something I would wish on anybody, not even my worst enemy. I have on occasion had to hold back children
and restrict them from interfering with the health workers at the time of
removing the Jiggers. The process is so painful for them I have literally had
to cover their eyes and hold them tightly. Such an awful thought I know, but it
is extremely important that the health worker cuts out every flea, does not
slip and wound the victim badly. I have witnessed children screaming and crying
in pain, as young as the age of 6 months.
Explaining Jiggers through words just isn’t enough to
justify the horrific, stomach churning feeling you get from witnessing the
infestation for yourself. So for those of you that have a strong stomach,
please keep scrolling down and have a good look at the pictures below.
Our ride to Jiggers camp
Jiggers are not the only pest infecting the poor in rural
Kenya. Many children have also fallen victim to ringworm and Scabies. Many of
the children I treated had the whole trifecta; scabies, ringworm and Jiggers!!!
Ringworm is a fungal infection on the skin. It can be
identified very easily and is most commonly found in HIV affected children. The
infection results in circular sores all over the body and the head. The sores
on the head are very dry and scaly and cause major hair loss. The sores on the
body are also circular and become quite itchy. Children will often itch the
sores and pick the scabs resulting in large welts and wounds all over the body.
This can also lead to infections due to the flesh being exposed and further
spreading of HIV.
Through my involvement with the program, I have purchased de
worming tablets and a cream to help fight the symptoms of ringworms. I have
been playing nurse by giving children their tablets and dressing their wounds.
a boy with ringworm sores on his head
a ringworm wound I cleaned and dressed
Scabies is also a common skin condition in rural areas. A
scabies mite has eight legs and also burrows into the skin. Scabies is
extremely contagious and spreads easily through contact with affected skin.
Scabies look like tiny bumps and blisters that cover the skin and cause intense
itching and pain. I have seen children with these symptoms covered from head to
toe in bumps, in every nook and cranny. It also causes secondary infections due
to itching and skin breakage. I have also been applying cream to children
affected by scabies
A picture of a Scabies Mite (copyright from the net)
Once again I need to reiterate just how tough these children
are, they do not complain and they carry on with their lives. They do their
chores and they look after their siblings. Its not until I looked closely at
these kids that I noticed their suffering, had I walked past them any other day
I would have been completely fooled!!!!
I really appreciate you taking the time to read this!!!!!!!
