Jigger eradication programme
What’s the itchiest you have ever been in your life? Multiply that by at least 100 and imagine how sore and uncomfortable you would feel.
Tunga Penetrans or jigger, is a flea that burrows into the skin, mostly around the toenails and fingernails and is a parasitic feeder on its host. They are extremely itchy and painful if not treated. The female flea penetrates the skin and makes her home beneath the surface. She remains under the skin to feed and produce eggs. Once the female flea is settled under the skin she starts to grow. And grow. And grow. If not treated and removed, she will then pop! All her eggs are then spread under the skin and the whole process will start all over again, but multiplied by many times. Heavy infestations can lead to severe swelling, ulceration, toenail loss and in extreme cases, gangrene and digit loss.
Most lesions occur on the feet, often on the soles, the toe webs, and around or under the toenails. This lesion can range from asymptomatic to pruritic to extremely painful.
With minimal investment we can help eliminate jiggers in schools. The female sand flea burrows into the skin of its host and embeds itself under the toenails and fingernails of man – These burrowing fleas are extraordinarily itchy, and when the kids scratch, with dirty hands the resultant sores may fill with pus and become infected.
With a dip wash twice a week over a period of time jiggers can be controlled and lesions heal without further complications.
We recently did a dip at one of the schools. The next day Duncan, one of our project leaders, was standing at the school supervising the second dip when a tiny little boy came up to him, pulled the tails of his shirt and said :
“Mwalimu, (teacher) last night was the first night in my life I have slept without itching. Asante Sana (thank you very much).”
Kids with severe infestations are stigmatized. Peter and I noticed, at a couple of schools we visited, little groups of kids, far away from the main hub of happiness, sat out in the hot sun. When we asked the Head Teachers why the kids were sat out there, we were told they were dirty kids because they had jiggers and they could not participate in classes. This is when we decided that we would have to do a jigger eradication program.
Intestinal de-worming program
Celestine was appalled to learn that if kids have a major infestation of intestinal worms, the worms manifest themselves as ‘shillingi’s’ on their heads. These are like little discs that appear in the kids’ hair and if there are lots and lots and lots of internal worms they eventually crawl out of the top of the kids’ heads. What does that do to the brain, I wonder?
Today I treated two little ones, one no more than 2 and the other about 4 years old who have the most awful, smelly, suppurating sores all over their heads and the side of their faces. I got some liquid anti-biotics and some anti-biotic cream for them and the major part of the game was some ginger biscuits. They learn young don’t they? There is always a little bribe in there somewhere!! Apparently the 2 year old has not had his sleeping area changed since he started sleeping there.
When kids have a massive dose of intestinal worms they get what we call shillingis on their heads. These shillingis are the outward manifestation of internal worms. Children are particularly susceptible and typically have the largest number of worms, which cause a number of health problems; making them unwell, affecting their physical and mental development, and affecting their attendance and performance at school.
These worms live in the intestines and their numbers build up through repeated infection. Children may often be infected with more than one kind of worm.
What problems do they cause?
As numbers of worms build up over time, many of the health problems caused by these worms are chronic and can be long lasting.
The worms can cause:
- malnutrition, as they rob the body of food through loss of appetite so the children eat less, or through stopping the food being absorbed properly once it has been eaten
- children to be stunted and underweight
- bowel obstruction
- anaemia (especially hookworm, which causes bleeding in the intestines and loss of blood)
The larger the number of worms, the more likely they are to make the children ill, which can also lead to the children missing school, and doing less well when they are at school.
“Chronic infections can even lead to long term retardation of mental and physical development, and in very severe infections, even death.”
The benefits of treatments
Benefits of treatment to individual children are:
- generally feeling better
- an improved appetite
- loss of many of the symptoms of worm infection described above
- have improved nutrition
- better school attendance and be able to concentrate better when they are attending school
Treatment of school age children will also benefit the local community, since children not only carry the greatest burdens of worms, but can also be a major source of infection.
For most of us, having our eyes tested if we can’t see the blackboard is taken for granted. When Celestine was teaching as a volunteer she came to me and said ‘we have a problem here’. We arranged for five kids from the Primary School to have their eyes tested. One young fellow had -11 and -12 and nobody had noticed. Not his teacher. Nobody. When he did get a set of glasses he sobbed with joy and happiness. ‘I can see, I can see!” he shouted. We will make it a priority to have all the kids tested when they are in Class 1. We will also make it our priority that they have spectacles, should they need them.
In the Mishiu Primary School – for boys and girls – the head teacher indicated that 100 girls are already menstruating. Most of them don’t have access to sanitary pads so they miss out 25% of education time. We found a partner in The Netherlands. The RIVED foundation, founded by Rinske van Erp, who unfortunately died in 2016 of malaria at the age of 28, is sponsoring the reusable sanitary pads. We are very grateful that Dianne and Harry van Erp, Rinske’s parents, found our initiative in line with Rinske’s desire to help young women with an uncertain future.
KENYA KESHO TRUST
PO Box 86952