Eaten alive
The government of Kenya is finally addressing the major public
health problem created by a tiny parasite, almost invisible to the
eye, that is causing misery and even death.
OVER 2 MILLION KENYANS are being eaten alive by
the jigger (Tunga penetrans), also known as chigger
or sand flea, a little known parasite found in most
tropical and subtropical climates. For the last six years,
more than 300 people were eaten to death by this
barely 1 mm (0.04 inch) long flea, the smallest around,
although the figure may be higher, since most cases
go unreported.
A female flea can jump as high as 20 centimetres (8
inches), embedding itself on exposed human skin and
burrowing in. Once inside its host, the jigger feeds on
a blood-only diet and multiplies by laying hundreds
of eggs. No body part is spared, from the face to the
eyes, hands, feet and, in some cases, the whole body.
Kenya is the first African country to admit that jigger
infestation is a big problem in the twenty-first century,
this coming 50 years after independence, and after
eight years of intensive lobbying by an anti-jigger
organization. The lobbying has led to the launch of a
policy of jigger eradication by the Kenyan government,
the first of its kind without the help of an international
body such as the World Health Organization. The
policy requires various ministries to take part in the
prevention, control and treatment of jiggers, and to
build capacity to strengthen institutions. A national
Jigger Day will be marked annually on 3 March.
According to the Kenyan government, over 2 million
people, or about 4 per cent of the population, are
jigger-infested, with another 10 million at risk.
The anti-jigger lobby group Ahadi Kenya Trust,
says that 60 per cent of those affected are children,
with some 1.5 million missing school. They cannot
walk to school because their feet are eaten up or
Children with jigger infestation have trouble writing and
some cannot walk to school. S O U R C E : J U D Y K O S G E I
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severely inflamed with ulcerations; nor can some
even hold a pencil because of disfigurement caused
by the infestations. The 40 per cent of adults who are
afflicted may not be able to work or vote.
Jigger victims are stigmatized much like leprosy
victims are, and since most come from the poorest
households in endemic and high-transmission
counties, they will end up dying.
According to Dr Stanley Kamau, the founder of
Ahadi Kenya Trust, tetanus is a common secondary
infection, and the sharing of needles and pins that
jigger victims use to remove the parasite from their
body has led to transmission of the HIV/AIDS virus.
Twelve-year-old James Njehia Njabia finally went
to school in 2013—nursery school, where he is the
oldest in his class and taller than the rest of the
children. Painful sores on his feet, hands and knees
forced him to drop out when he was five. He could not
write with pus oozing out of his infected fingers, and
his feet and knees were eaten up by jiggers that had
burrowed into his tender skin, so painful that he could
not walk to school.
In class today, he wears a distant look as tries to
catch up. The pain is still visible in his eyes as he tells
me, “I want to be a doctor so that I can help those in
pain”. The scars in his before-and-after pictures tell it
all, and why the pain still traumatizes him.
There have been recorded cases of people who
have gone mad due to the misery caused by jiggers
and require mental health support.
Njabia became jigger-free, like thousands of
victims, by using readily available treatment and
medication. Through the lobby group, volunteers use
soap and water to clean the affected areas, then soak
the limbs in potassium permanganate solution for at
least fifteen minutes, after which petroleum jelly is
applied to soften the skin. The procedure is repeated
three times a day for two weeks, after which they
hope to be declared jigger-free.
Community workers then fumigate households to
avoid re-infection, and follow up on the recuperating
jigger victims. Where jigger infections have led
to paralysis and anemia, patients are referred to
hospitals.
With a jigger eradication policy now in place, the
Meet the Jigger
The jigger (Tunga penetrans) has an angular head, no
comb or spines, with narrow thoracic segments at
the top. This small pin-head-sized flea is found in the
sandy terrain of warm, dry climates. It prefers deserts,
beaches, stables and the soil and dust in and around
farms. It hides in the crevices and cracks found on
the floors, walls of dwellings and items like furniture. It
feeds on warm-blooded hosts, including humans, cats,
dogs, rats, pigs, cattle and sheep.
S O U R C E : A H A D I K E N YA T R U S T
Ministry of Environment will approve and monitor
chemical control of jigger infestation in schools and
households.
Because jiggers thrive in dirt, education on hygiene
is an ongoing effort.
For most jigger victims, however, poverty could
see them slide back into the vicious cycle. The Ahadi
Kenya Trust is campaigning to bridge the poverty gap
through empowerment and rehabilitation programs
that will help to create self-reliant farming and
business-generating projects.
Judy Kosgei
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