Especially the rural population, people living in slums and people with disabilities are affected by the parasite infestation. They lack clean water, sanitation and clean housing, but also the means for shoes and hygiene items such as soap and wash bowls to avoid jigger infestation. In addition, a lack of knowledge about daily hygiene and health care, as well as superstitions about jiggers as a curse, play a role. Those affected are often covered in inflamed sores and sometimes deep ulcers. If the infection is not treated in time, the inflammations will burrow deep into the body tissues and cause severe pain, ulcers and disability. The inflammations can lead to blood poisoning and death. "Many of those affected lose their fingers or toes and can no longer walk or write. They are plagued by pain and the movement of the parasites under their skin," explains health officer Olaf Hirschmann. Children drop out of school and adults can no longer go to work, are stigmatised and isolated.
Help that lasts
Together with the Christian Mission Ministry (CMM) of the Anglican Church, DIFÄM conducts training courses on the prevention and treatment of jiggers infections in the Bungoma region in western Kenya: Volunteer church members are trained to become trainers who can not only treat minor cases themselves, but also pass on their knowledge about hygiene measures and therapies to the people. They inform children and adults how the sand flea can get under the skin and how regular sweeping of the dusty hut floor as well as hand and foot washing helps to avoid infestation.
We provide medicines to treat jigger infections and the trained community members show how people can treat an infestation themselves. They distribute large plastic bowls, fill them with water and put a few spoons of potassium permanganate in. The water turns into a dark purple solution with which the affected areas are washed for a few minutes. Three to five passes are required at intervals of a few weeks. Then the sand fleas are completely dead. Afterwards, the skin areas are creamed with Vaseline, because the fatty ointment supports the healing process of the wounds. The cost per patient is just 5 euros. Severe cases are referred to the surrounding health stations. "We are also planning measures to prevent jiggers," says Olaf Hirschmann, "children are given shoes and the tamped clay floors in the huts where people sleep are treated with a mixture of cow dung and ash, a simple but effective home recipe." Because many people cannot afford a mattress and sleep on the bare floor, and the fleas live in the sand and dust.
"At last, the children who were previously tormented by pain can laugh again and play football and go to school happily on their now healthy feet," says Enock Okonji, CMM's bishop.
Water, Sanitation and Hygiene (WASH) for better health
It is not only the jiggers who are to be fought. The communities themselves are to be mobilised and motivated to take their health challenges into their own hands. Issues such as the transmission of diseases through contaminated water, the treatment of drinking water and the handling of wastewater, personal and general hygiene measures to prevent diseases, waste management in households as well as in the community, and toilet construction are to be discussed and tackled together. "Only with the active help of the local people will their hygiene and health situation improve fundamentally."
