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Sunday, March 9, 2014
- Jowaali Dhikusoka sits on the side of the road, alone and bored. The twelve-year-old doesn’t play much with the other children in his village because he has trouble walking. His hands and feet are infested with sand fleas, in Uganda commonly called jiggers, which itch and cause him a lot of pain. Jiggers are also the reason why Jowaali dropped out of primary school in Mafubira village in Uganda’s eastern Busoga region. Apart from the pain and the constant itching, his hands are so badly infected with the fleas that he cannot even hold a pencil.
Jowaali is one of hundreds of children and adults in Uganda’s rural Busoga region who suffer from a jigger epidemic that has spread in the poverty-stricken area due to poor hygiene and sanitation.
Jiggers, also known as Chigoe fleas, thrive in unclean, sandy grounds, especially where people share their homesteads with domestic animals. The fleas mostly feed on warm-blooded animals, but pregnant, female fleas also burrow themselves into the skin of humans.
According the national Department of Education, only 20 percent of pupils who enroll for primary education end up completing Grade 7, the highest level in Uganda’s primary education. Although the department does not have statistics on how many children drop out of school due to jiggers, it acknowledges that the sand fleas are a key contributor to the problem in rural areas.
Despite the fact that jiggers are a widespread and recurring problem in Uganda’s rural areas, the country’s health ministry only sprang into action with a campaign to eradicate the fleas in mid-October. Cabinet directed the health, finance, gender and local government ministries to work together to promote education around hygiene and sanitation as well as treatment of affected individuals.
New measures in place
Primary health care minister James Kakooza says government has set aside $177,000 for the jigger campaign and the emergency treatment of more than 600 people in Busoga, after which more money will be released for treatment of more people infested with the parasites.
The campaign was launched after a public outcry when the epidemic caused deaths in Busoga and Burgiri in September. Jigger infections can lead to severe inflammation, ulceration, fibrosis, lymphangitis and gangrene. A three-month-old baby died in Mufumi village in Bugiri, another district in eastern Uganda, for example, while nine other village residents had to be admitted to hospital.
Nasitanzio Akisa, a local councillor from Nabijingo Parish in Burgiri district, blames health authorities for the severity of the epidemic. He says jigger prevention has been neglected despite the fact that is a seasonal problem that peaks during each hot, dry season, when there is plenty of dust.
“This problem can be addressed by spraying the homesteads with insecticides, but the health department has been reluctant to implement this,” she says.
Salaamu Musumba, a member of opposition party Forum for Democratic Change in Busoga, complained to IPS: “There is no excuse that we, the people of Busoga, can be hosts to jiggers. Jiggers have intensified during the current regime.”
Even government officials acknowledge that infestations can be prevented and cured relatively easily.
“The issue of jiggers is an issue of sanitation. We are telling people not to sleep on the floor, not to share houses with chicken, goats and pigs,” explains Rebecca Kadaga, deputy speaker of parliament and a Member of Parliament for the District Women’s Constituency in Kamuli, Busoga.
“We are also asking the local governments in the affected districts to institute by-laws on household hygiene to ensure weekly smearing of floors and walls with cow dung and ant hill soils, especially for houses without cement. And the local leaders should enforce it,” she adds.
To get the epidemic under control, government is also cooperating with global children’s aid organisation Plan International. Children are most affected by jiggers, because they play in dusty soils and their soft skin provides easy entry for the fleas.
Plan is distributing indoor spray to kill the fleas as well as a potassium permanganate solution, which kills jiggers, while at the same time treating the wounds. “We are determined to get rid of this problem, and we are already achieving some success because some of the children that we have treated are already back at school,” says Plan programme coordinator Sam Echodu.
The high school drop out rate is not only due to the pain and discomfort the sand fleas cause, but also because jigger infections are highly stigmatised.
Eight-year-old Derick Ntalo from Mayuge district in Uganda’s east is one of the many jigger-infected pupils who refuses to go to school because he feels discriminated by his peers. “The teacher and the other children are laughing at me,” he explains why he dropped out of Grade 3 eight months ago.
Local government councillor Charles Mukiibi confirms that absenteeism at schools is high because of the stigma attached to the epidemic: “The children are teased because they keep on itching their hands and feet in class and cannot concentrate.”
He believes many more children would be attending primary school in eastern Uganda, if the health department would bring the epidemic under control.