500 Kamwenge residents battle leg swelling disease

At least 500 Kamwenge District residents are at various stages of battling podoconiosis, a disease similar to, but clinically distinct, from elephantiasis. This data covers the past 10 years, health officials said.

Whereas elephantiasis, medically called lymphatic filariasis, is caused by infection with roundworms transmitted through bites of an infected mosquito, podoconiosis is, according to the World Health Organisation, a “result of a genetically determined abnormal inflammatory reaction to mineral particles in irritant red clay soils derived from volcanic deposits”.

The UN health watchdog says podoconiosis is more widespread in Africa, central America and north-west India.
 In Uganda, experts have now identified Kamwenge District as a hotspot, with 250 residents in Busiriba Sub-county confirmed over the past 10 years to be battling the disease.

Overall, the total number of residents grounded by the disease in four of Kamwenge’s sub-counties, including the town council, grosses 500, according to Dr William Mucunguzi, the district health officer.

Mr James Kamusiime, 79, a resident of Kyakatooma Village, by 9 am last Saturday queued up at Busiriba Health Centre II, waiting to be evaluated by scientists from the Ministry of Health headquarters in Kampala.

He was not alone. About 50 other individuals with podoconiosis too had lined up. A migrant from Kabale District in 1990, Mr Kamusiime said he contracted the disease in 2015 while already settled in Kamwenge, but does not know how.

“In my life, I had never seen this disease until I became the victim. It is now six years with this disease, it gives me sleepless nights because most of the time, the legs are itching,” he said.

None of the modern and traditional medicines he tried has helped and he said scientists, who paid him a home visit to take blood sample alongside local soil sample,  gave no feedback.

“This disease cannot allow me to do gardening because health workers advised me not to step in the soil again. I am always experiencing the pain and I feel like my legs are burning. When the pain intensifies, I leave all the activities I am doing and start scratching my legs,” he added.

Citing stigma, Mr Katusiime said health workers advised him and other people suffering from podoconiosis to always wear gumboots and or shoes to avoid getting contact with the soil because experts linked disease to the silicon mineral in the soil.    

Mr Abwooli Kabagenyi, another patient in queue at the health centre, covers festering wounds on her legs with a piece of blood-stained cloth.

Her feet are swollen and cannot fit in a gumboot or shoes and she improvised a linen wrap to prevent contact with mother earth.

The ordeals of the duo capture the pain and suffering of some 500 residents battling podoconiosis, 250 of them in Busiriba sub-county alone.

The patients report being stigmatised, discriminated against and shunned by kinsmen and friends discriminated over their smelly wounds.

Mr Kato Elisa, a youth also battling the disease, said it forced him to drop out of school due to bullying by fellow students.
“I dropped out of school and tried to study tailoring because it is the only job I can do better, but also I don’t have start-up capital. Since we have been told that disease cannot be cured, the government should support us financially,”  he said.Treatment for the disease at Busiriba Health Centre II is a tall order.  
Ms Saturday Florence, the nursing officer at the facility, said they have no clear treatment to give such patients.

“We are three health workers at the facility [and] overwhelmed by this big number of these podoconiosis patients …,” she said, pleading that government elevates the facility to a health centre III.

Mr Everest Beyanga, an advocate and focal person for people suffering from Elephantiasis in Kamwenge, said the cases of people with similar diseases were first reported in the district in 2011.

He said at that time, affected peopled numbered 60.

According to Kamwenge District health officer, Dr William Mucunguzi,  a joint 2015 Ministry of Health-WHO study found that the disease started in the district in 1980s.

“…we have discovered that it is caused by minerals in the soil, the only support we have given to these patients are gumboots to see that they don’t get into contact with soil,” he said.

Dr Patrick Tusiime, a Health ministry commissioner, said they discovered that the disease is caused by silicon minerals in the soil and that there is no treatment, except health workers managing the symptoms.

“The solution for the patients is to ensure that they don’t get into contact with the soil regularly … [the] wounds can get treated at health facilities,” he said.

If detected early, podoconiosis can be treated by soaking and washing the feet with salty water, he added.

However, the rising disease burden had not attracted the attention of the government at the highest level.
Last Saturday, Prime Minister Robinah Nabbaja led a team of health experts from the Ministry of Health and camped at Busiriba Sub-county for on-the-spot assessment of the condition of patients.

The government, she said, is aware of the situation. She doled out Shs40,000 to Shs100,000 to each patient for medicine and promised each two pairs of gumboots. Ms Nabbanja also committed that the government will upgrade Busiriba health facility II to a health centre III in the 2022/2023 Financial Year.

Dr Mucunguzi said the Minstry of Health’s Vector Control Division in conjunction with Foot Work Ethiopia, has trained health workers in Kamwenge on the preventive measures and case management of persons presenting with podoconiosis.
He said WHO also took soil samples from homes and gardens for analysis, but did not say if the results were released.