By Halima Athumani
KAMPALA, Uganda
Theresa Josephine Nakazzi, a frail, 79-year-old woman, lives with her son, Stephano Kakooza, 62, in a small, two-room mud house in Kasubi village in central Uganda's Masaka municipality.
What attracts immediate attention is the litter of dirty clothes and the remains of what used to be blankets and bed sheets on the small compound floor, along with dried bushes in front of the house.
Their modest home, surrounded by others not much different, has a pit latrine just a meter away.
Hearing voices outside, Kakooza, who was pounding maize flour (commonly known as "posho"), gets up to welcome The Anadolu Agency team.
"Am weak, but also very hungry," he says.
His hands and bare feet have dark spots and some of his toenails are already gone because of the blood- and flesh-sucking jiggers – parasitic arthropods also known as the Chigoe flea.
Passing on three digestive biscuits offered him, Kakooza finally got up.
"I need to feed my mother," he said, opening the second entrance to the house and calling out to his mother.
"Mama, please wake up and eat something," Kakooza said.
Nakazzi sleeps on a layer of dirty clothes spread on the dusty floor, covering herself with a dirty black blanket, oblivious to the heat and scorching sun outside.
Kakooza then enters and gently shakes his frail mother, who is dressed in a dark blue dress.
She finally responds begrudgingly to her son's prodding.
He passes her the biscuits, which she bites on and struggles to swallow.
"Mama has not eaten for two weeks now," Kakooza said.
"Ever since she was infected with these jiggers, all she wants is bread – and I can't afford it," he said.
"She speaks with difficulty and only shakes her head in response to what I tell her if she is not moaning in pain," added the son. "Yet she chokes on food and water."
Unable to continue eating the biscuit, the frail woman goes back to sleep.
The mother and son are among thousands of Ugandans living with jiggers – small parasitic fleas that enter their victims through their feet.
"Our people don't mind where they sleep or stay. Some share their rooms with animals, which carry these fleas," State Minister for Primary Health Care Sarah Opendi told AA.
"Our people must stop sleeping in dusty rooms," said Opendi. "Many of our rural schools are also so dusty."
It is common in Ugandan rural families for people to share their rooms with animals, including pigs, goats, cats, dogs and chicken.
An infected person normally has black dots on their skin where the jigger has buried its head.
As the flea feeds, the black dot increases in size, eventually reaching up to a centimeter wide. If it's a female jigger, it lays between 100 and 200 eggs, which are pushed out by the flea to incubate once exposed to dirt and sand.
"But for now, we advise infected people to smear their homes with cow dung or clay soil," said the minister.
According to Opendi, this method has proven successful in the country's eastern Teso region.
"In Teso, most people smear their mud and wattle huts with cow dung, which covers up the cracks on the walls where these fleas hide and breed before spreading to humans," she said.
"This must be done regularly, if we are to stop the jiggers," she insisted.
The minister noted that, since jigger infestations had forced many children to drop out of school in different parts of the country, schools, too, should be smeared with cow dung at least once a week.
-Stigma-
Kakooza, dressed in a grey striped shirt that showed his bare bones and grey chest hair, says he and his mother "are now an embarrassment to the community."
"No one has come to visit us since they heard we had jiggers," he told AA. "No one wants to associate or be with us."
Kakooza said the mud house had been built by some good Samaritans.
"I used to sleep under a makeshift polythene shed," he recalled. "So whenever it rained, the sticks holding the structure started rotting – that is how I got infected."
Upon hearing of Kakooza's dilemma, local leaders sprayed the two rooms of their home and surrounding structures.
But Kakooza says this only worsened their relations with their neighbors.
"Jiggers should not shame us; we have to get rid of them," he said tearfully.
"Only those who don't know the pain of being eaten up by a jigger would refuse to have their houses sprayed," he added.
Mathias Nsubuga, an MP representing the Masaka municipality, describes the jigger infestation in his district and country as "an unfortunate development."
He expressed disappointment that while other countries were planning to send spacecraft to the moon, Uganda was still fighting jiggers.
"For me, it's ridiculous and unacceptable," Nsubuga told AA.
Dr. Stuart Musisi, district medical officer, said even if they had to support the family, they didn't have anyone to look after the elderly woman and her ailing son.
"They are old; their hygiene and care is lacking," he told AA.
Musisi said district officials had Kakooza's house sprayed with medicine and had dipped his and his mother's feet in antiseptic material.
"I think the infection will be controlled," he contended. "But, of course, if they don't improve the general environment, it's very likely the jiggers will rebreed."
MP Nsubuga, for his part, faults the government for failing to come up with a viable protection mechanism.
"The question is how many social amenities are available to these poor people, such as water to facilitate bathing, instead of them living in an environment that can only facilitate these unfortunate living conditions," he told AA.
"We need to be more pragmatic and have clear provisions in the [state] budget to take care of special cases," the lawmaker added.
In 2014, Minister Opendi asked for 2 billion Uganda shillings (roughly $691,340) to procure pesticides for jigger-infested communities.
"We could not get the money because members of parliament said we wanted to divert funds for nodding syndrome," she told AA.
"They only gave us 500,000 Uganda shillings," the minister said. "It couldn't work."
Minister Opendi said her ministry would continue to look for funding with which to fight chronic jigger infestations.
"In some places, people have their buttocks all eaten up; there are people who are so badly off," she lamented. "We have to go help them."
