The jigger is a sand flea which has become endemic in some regions of Kenya. The jigger embeds itself in the skin, especially under toenails and fingernails, but can infect any area of the body. It causes lesions which are extremely itchy and can become inflamed and infected. These infections often lead to the following secondary infections: gangrene, sepsis, loss of toenails, auto-amputation of toes or fingers. Tetanus, which is fatal, is also a common secondary infection.
To complicate the situation there is a very strong social stigma so people are hesitant to seek treatment. We have had parents send their children for treatment while they remained home out of shame. The leading cause of jiggers is lack of hygiene.
Some of the effects of jiggers are:
- Difficulty walking.
- Inability to work or carry out daily chores.
- Stigmatization by the community
- Infections such as HIV/AIDS passed from person to person.
During our May 2012 mission we piloted a jiggers eradication program. We were shocked by the devastation caused by this parasite. The 1,081 jiggers patients we treated while in Kenya represent only a small proportion of those still in need of treatment today. We have a trusted community worker in Kenya, Johnstone, who is partnering with us to further the growth of this program. He has treated another 200 persons since we returned to Canada and we are organizing to treat another 500. Treatment includes home visits to rid the home of jiggers and to educate patients on how to prevent reinfection.
February 2013: since the inception of the Jiggers Eradication Program in 2012, 5,727 men, women and children have been cured of jiggers. As well, their homes have been treated and education conducted regarding prevention. Thirty six schools have been inspected, treated and teachers educated on prevention. Thanks to our wonderful community worker, this program continues to work toward the goal of eliminating jiggers in this area of Kenya.
Parasitic worms are also endemic in the region of Kenya that we service. Worm infestations can cause many health issues, such as malnutrition and anemia, especially in children and affect school attendance.
When in Kenya, CNFA nurses provide a deworming program within the local schools. During our 2012 mission we treated a total of 5,361 children. In our absence, our Kenyan nurse partners will revisit all schools that received treatment for follow up care in six month intervals.
On September 7, 2012 CNFA had 5 wheelchairs and one pair of crutches delivered to 5 adults and one child.
While working in Kenya we at times see people at our clinics, or during a home visit, who have suffered a stroke or mishap that has left them with a loss of mobility. This can be complete or partial paralysis. We also occasionally see those with neurological disorders such as cerebral palsy. Upon returning to Canada we work with the Association of Physically Disabled of Kenya to provide appropriate assistive devices for these patients. With the assistance of a community worker, this organization will visit the patient in their home to assess the needs. The wheelchairs and crutches are all manufactured in Kenya using Kenyan labour. They are heavy duty and designed to withstand the rough terrain on which they will be used.
Having the opportunity to spend time in many schools in the area of Kenya that we work in has made us very aware of the inadequate infrastructure. Especially the lack of latrines which poses a risk for disease. Repeatedly, head masters cite latrines as being one of the most pressing challenges at their schools. Most schools have only a few latrines for as many as 500 students and boys and girls must share. This poses health issues for the students. It also poses challenges for girls of menstrual age and may cause them to miss school.
In 2011, one of our nurses Trish, took quilt squares and organized children at one of the poorest of schools to draw pictures on them. She returned with a fascinating array of drawings reflecting their view of the world. Trish then made the squares into a quilt which we raffled. With the proceeds we kicked off our public heath latrine project. To date we have latrines being built at two schools. Latrines may not sound like a big deal to us here in Canada with our indoor plumbing. If you have ever used a crumbling one in Kenya you would quickly understand why new ones generate so much excitement!
Sexual Health Education is an essential component of our mission work. With each clinic, groups of women gather with a sexual health nurse to discuss STI prevention and healthy relationships. Sexual health education is also provided in the schools for middle school boys and girls. With each discussion, reusable sanitary pads, which are made in Canada, are distributed to the girls. Also, male and female condoms are offered to men and women in groups at each clinic.