How jiggers have bred pain and death in Busoga

When Daily Monitor visited Mzee Augustine Okoth’s home in Mufumi Village in Nabijingo Sub-county, Bugiri District on Wednesday, the old man had to be summoned from a nearby drinking joint for an interview.
As he staggers to meet the journalists, the spring in his walk is not a swagger, it is the walk of a man whose soles until recently were home to jiggers. It is even worse for his wife Justine, she cannot carry her own weight. The pain is excruciating. She has to be lifted.

Just the other day, the couple lost their three-month old baby, Mary, to jigger infestation. In their tiny, ricket house, Mzee Okoth takes a seat to tell his story.

It is just not his story; it is a tale of a region plagued by poverty, ignorance, negligence and-jiggers. Jiggers have proved to be an interminable menace in Busoga with reports of deaths in almost all the districts of the sub-region.

For Mzee Okoth’s family, living with these blood-sucking parasites is a reality that they know all too well. They have hosted the flea for as long as they can remember.

Just last week, Mzee Okoth buried his three-month baby, Maria Nyaburu following a jigger infestation that left her anaemic. The three-month-old baby had developed resultant ulcers on most parts of the body including the feet, hands and elbows.

A nurse at Nabinjingo Islamic Health Centre, Mr Abdulatiff Ogera, who attended to the family, said little Nyaburu had become anaemic, a complication that got out of hand after the family, believing that they had bewitched, chose to seek local herbs for treatment.

He perceives this as the biggest obstacle to eradication of the epidemic. “The problem is the belief that sorcery has a hand in the infestation. So instead of coming to hospital all they do is go to herbalists,” he says.

“If we had not intervened after hearing of this problem in the parish then may be more people would have lost their lives to secondary complications just like the baby.”

The nurse says Ms Okoth had been having problems breastfeeding the baby, making her more susceptible. This according to the nurse was due to her own infestation that left her anaemic. The jigger flea sucks blood from its host to survive and later multiply.

Visit to hospital
Before the baby’s death, Mzee Okoth’s family had also been admitted to Nabinjingo Islamic Health Centre for treatment.
However, the most tortured is his wife, Mary-Justine Akoth, who has to be lifted from her kitchen as she cannot walk without support. She still bears sinewy cysts especially on her feet.

She seems to be in excruciating pain when left to carry her own weight under her feet. Her hands are scoured and her fingers have been gnawed half way through the first knuckles. It is a surprise then that she still has nails that have grown unexpectedly long.

“She is the most affected. When I remove the jigger, the area develops into a wound. It dries, then after a few days it swells and is infested all over again,” Mzee Okoth says.

The family shares one tiny rickety hut. Inside, a bed made out of co-jointed logs with a mat made out of reeds acting as the matrimonial bed.

A look around the home reveals that this room is also shared by their three children Scovia Adikinyi, 12, Ayogoli, five, and Paul Okoth,10. Another mat on the bare floor just next to the ‘bed’ acts as the children’s sleeping area.

But Mzee Okoth’s only school going child, Paul Okoth, 10, probably suffers the most harrowing effects of the plague, a thing for which he is often taunted by his schoolmates. He says his mates have refused to sit or play with him as he is accused of taking the parasite to his school, Nabijingo Primary School, which is also badly affected by the problem. The other two are unable to walk so cannot go to school.
Mzee Okoth, a peasant farmer, says he has been using a single safety pin which he admits he does not even sterilise to extract the fleas from the infected areas to no avail.

“We keep removing but they keep increasing. The more we remove the more aggressive they seem to become. We had almost given up,” he says.
They were once treated before, a few years ago, he says.

Ignorance?
He believes the problem is inherent. “This problem started with my grandmother and her son, my father, who also died of the infestation. It is a family thing,” Mr Okoth says.
He says his grandmother used herbs to treat them, but still the problem persisted.

The problem seems to be endemic in this parish. Just one homestead away in a lone house, Daily Monitor caught up with 84-year-old Simon Obonyo as he sprinkled ash on his wounds.

He says he is in constant pain after his daughter removed the parasites about two weeks ago. Two years ago jiggers burrowed all through his legs up to the knee.

Unending anguish
His legs were saved after a visit to the health centre. Although his legs have healed, his scaly skin bears witness to his agony. He however lost both his small toes to the attack while all that is left of one of his big toes is just a stump. Now the parasite has stricken again.

In Nansaga, just a few kilometres away, 73-year old Kwaturila Namukose’s family is no different. His wife, Esther Namukose, 61, says since she got married to the home, she has never seen her husband without jiggers.

The home is also infested with bedbugs and chicken fleas.
“The problem has gotten worse with time but he can’t keep at home. He now crawls to go and drink (the local potent gin),” she says with a contemptuous expression on her face.

The man has been nursing jiggers for the last so many years without proper medical care and he is becoming a menace to the household.
“I have never seen that man without jiggers. They say he is bewitched,” Mr Hassan Isabirye a neighbour of the Namukoses, says. Most of his neighbours have moved.

At lunch time, Daily Monitor watches as Ms Namukose feeds her ailing nine-month-old grandson using her bare fingers. Despite them being very dirty she continues pressing the baby’s food between her fingers and then pushing it into its mouth.

Perturbed, we ask the area woman district councillor, Robinah Namukose with whom we visit the homes why they (community leaders) had failed to sensitise the community on simple hygiene that could abate the problem.
To which she retorts, “When you tell them they need to bathe and maintain cleanliness around their homes, they say you are abusing them and that they will not give you their vote the next time round.”

The issue last elicited such magnitude of debate in June 2008 when a family of five was admitted to Kakira Health Centre in Jinja.
Then, parliamentarians considered the possibility of arresting people infested with jigger-fleas, arguing that the affected were flouting public health laws.