I’ve mentioned jiggers before in the context of discussing the struggles of compassionate sustainability and previous outreach activities I’ve participated in, but I’ve never gone into too much detail. They’ve been a rather important part of my work, so I think it’s time to rectify that.

“Jigger” is the local name for the chigoe flea, a tropical parasite found in sandy soil. They feast on warm mammalian blood to survive, so the way they usually come into contact with humans is by burrowing into whichever body part is touching the ground most – usually feet and legs, sometimes hands, sometimes even the backs of legs, lower buttocks, groin, or genitals. Once they’re settled in there, they lay eggs, hatching MORE chigoe fleas, which emerge briefly to mate then find a nice place to settle down and nest – often, in the same body into which they were born. You start with one, slowly gaining more and more over days and weeks until you have a full infestation. Left untreated, they can cause infection, weeping ulcers, disfigured limbs, gangrene, amputation, or death. No … I’m serious. An itchy little flea can kill you, especially if you’re young or immune-compromised (like folks who are HIV-positive.)

The results of untreated infestation. Click each to enlarge [I made it extra-small for the folks who REALLY didn’t want to look]. Left image: Advanced jigger infestation. Note the cracking skin (especially around the nailbeds) giving the toes a “cauliflower-like” appearance, swelling, skin discoloration, and ulceration on the tops of the feet as well as on the instep and lower shins. Right image: Ulcerated infestation point, causing skin necrosis and secondary infection.

Basic hygiene will prevent most of them: wear shoes, preferably closed-toed. Wash your feet and legs with soap and something for scrubbing (a brush, a washcloth, etc) at least once a day. I scrub my legs and feet with a nail brush splashed with soap or tea tree oil every time I come in the house, and in two years, I’ve never had one, despite wearing sandals almost exclusively. Sometimes, however, you simply draw the short straw and end up with one despite your best efforts. For those that can’t be prevented, the treatment is fairly simple.

Historically, once you discover a full-grown jigger (appearing as an itchy black dot or raised mound with a black dot in the middle), you’d wash the foot, dig it out with a needle or scalpel, and dump hydrogen peroxide over the whole mess. This was effective, but without follow-up care (keeping the wound clean and covered, etc) it could result in a deadly infection. The way we treat them now is much less invasive:

First, wash the feet.

Disinfect the wounds caused by jiggers with a dilute iodine solution, followed by a drenching of hydrogen peroxide.

Soak the feet in a potassium permanganate solution to kill the eggs.

Cover the feet in a layer of Vaseline to protect the treated skin from getting injured while it re-moisturizes itself and to smother any surviving jiggers that may still be lurking. (After they die, your body will expel them naturally over a few days, like a shallow splinter.)

A nearby school and my facility decided to work together on this pervasive and potentially dangerous issue. On the day these photographs were taken, teachers in each class checked their students’ hands and feet, then sent the children with infections to our no-cost Jigger Intensive Clinic (or, as I called it, Jiggerpalooza.) Several teachers came along to chaperone and provide some basic assistance.

Purity, our stern secretary, kept us all in line, while also tracking how many patients we saw during the special clinic. She is in fifth grade and wants to become a doctor when she grows up.

If you’re thinking “Huh, those uniforms look familiar …” then you are correct! These students are from one of the schools where I teach health class. In fact, the health class I started there has – totally without my prodding – been doing jigger education and outreach to encourage students to seek treatment. That faint light you see isn’t dawn creeping over the horizon, but the ten-zillion megawatts I’m generating today as I glow with pride. A teacher is only as useful as her students, and with these kids, I think I did pretty well.