Wednesday, July 10, 2013

A Tough Day

When the day starts like this, you don't anticipate a rough road ahead.

The kids in the village of Wakisi welcomed us with five songs, some in English. We came there with a group called Sole Hope whose mission is to wash the feet of children, remove jiggers and give them shoes. We were there to take part in a foot washing/jigger removal clinic.

The village of Wakisi was the poorest village I visited while in Uganda. You can tell in a couple of ways. The structure behind the kids appeared to be the main building of the school and the one chosen to do the clinic in. See how it's made from mud bricks crumbling away from the wooden frame? The floor was dirt and there were no windows or doors in the openings for them.

I'm assuming the kids who sang us the welcome songs were all part of the school since they knew the songs, but not not even half of them had the blue uniforms. Hardly any had shoes. I saw immediately why this village was chosen.

A jigger is like a small flea that burrows under the skin, usually the feet, and lays an egg sac. These egg sacs can be as small as a pinpoint or as large as a pea and can be painful to live with. Imagine walking on a BB. Not only are they painful, but if not treated, the egg sacs will start to rot and can cause gangrene. A poor child in the village with gangrene isn't at risk for losing a toe or foot. Their lives are at risk, as good medical care is not accessible. If you can't afford a pair of shoes, how will you afford a doctor? Sole Hope goes into villages, treats any kids that come, sprays the area for jiggers and hands out as many shoes as possible to prevent further infestation.

I was fascinated to watch the jigger removal process. I'd read about it in Katie Davis' book Kisses From Katie and was very curious. At my house I'm known as Queen Picker. I love digging out slivers or squeezing blackheads. I've enjoyed digging leftover shed skin out of our lizard's orifices. My kids run the other direction if I notice a blemish I deem worthy of attention.

So jigger removal seemed right up my alley. I was hoping I'd have the chance to dig some of those suckers out.

Sadly, there were enough experienced people that I was not needed for the task. My job became recording the children who came through. They were trying to develop some records to follow up with these kids which is tough in the village. My job quickly changed when the first child came to our station.

Adrian looked to be about 8-10 years old. He wore a dirty t-shirt that was too big for him, the neckline sagging to his sternum and sleeve slipping off his shoulder. His khaki shorts had a hole in the crotch, so large that when he sat down I saw he had no underwear. His clothes quickly seemed minor as we got a look at his feet. I don't know how the kid walked there. Dark bumps covered, and I mean COVERED his toes, his heels, the sides of his feet. Some had been there a while as thick callouses developed over them.

The tools for jigger removal are safety pins and razor blades. If the egg sacs are new and not very big or deep, you take a large safety pin and dig around it to try to pop it out of the skin. They try to keep the egg sac intact so no eggs are left behind to cause problems later. It is a painful process because though the skin on top of the egg sac may be tough, the skin UNDER it is not. It is raw flesh. If the egg sac has grown larger, it often has calloused skin over top and a razor blade is used to cut away the dead skin, then the safety pin works the egg sac loose. We could tell that Adrian had been through this process before as his feet were full of old callouses. The woman working on him told me new jiggers had settled in the craters left from removing old jiggers.

From the moment she started, Adrian was crying. The bigger the egg sac, the more it hurt and he started trying to grab her hands. Soon I found myself holding his hands down and trying to comfort him through the process. Methodically the woman worked while Adrian cried out and other children came, were treated and moved on. HOURS later, the other children were finished and another woman joined to help.

As time went on, Adrian waned. They tried to give him breaks, but said they couldn't save some jiggers to be removed for another day. You never know if you'll see a kid from the village again. I saw a few egg sacs come out of his feet that were already rotting. The woman working on him looked at me and said, "Do you see? He is walking dead." To let him go without getting them all could cost him his life. So they kept at it. More people joined in, helping me hold the poor kid down. He was brave and knew what had to be done, but after about three hours, three HOURS, he was so weak he could barely sit and started leaning into my chest. His body was wet with tears and sweat and he looked faint. It was so hard to watch, my heart ached for him. As the women kept at it and the razor blade would shave away more dead skin I prayed for there to be nothing underneath, but with every swipe, two or three more egg sacs appeared. I'm pretty tough when it comes to handling injuries and gory stuff, but hanging onto that kid for three hours and seeing him become more and more limp really got to me. I quit watching his feet and just held him, looking the other way, praying for God's mercy, unsuccessfully holding back the tears.

One of the young Ugandan men who'd been traveling with us noticed me struggling and tapped my shoulder. "I take over," he said and I gladly let him. I walked outside and lost it.

By the time it was all over, they counted 57 jiggers removed from Adrian's feet. Each egg sac taken out left a hole in his foot. They slathered his feet in Neosporin and wrapped them in gauze. A pair of shoes was found for him. He was too weak to walk home. The Sole Hope people fed him and were going to drive him home and spray his house, hoping to prevent future infestation.

I asked how long it would take for his feet to heal and was told if they were taken care of properly, he could be better in a week. That too, is questionable for village children. We weren't sure who Adrian lived with. He told us his father and mother were dead and we couldn't decipher if he lived with a sister or grandmother. I felt better knowing the Sole Hope people would be checking out his living situation.

As we left that day, I wondered how many other children didn't come to the clinic that day. How many others have the same problems as Adrian but would not get treated? I know the line diminished throughout the day as children left when they heard the cries of their friends. Had our few hours there made a difference in the lives of those kids? It's hard to say, but I know one little boy who has a chance now.

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