Monday, November 3, 2008

Jiggers


KCMC is never quiet. The bench outside of Labor and Delivery Triage always has family members waiting. The Casualty (the hospital's emergency room) waiting room chairs are frequently overflowing. Very similar to Duke Medical Center’s constant flow of human traffic, but without the traffic lights.

In this context of compelling medical need, I was waylaid by my toe. My fourth digit, in fact. The one that I forget exists. One morning I awoke with a throbbing pain in my distal toe, and seeing a black spot, presumed that I had a splinter. A day later, Jeff develops what we think is a wart on the bottom of his small toe. (Pictured here.) Coincidence? Not if it is a Jigger infestation, according to our resident Jigger expert and Dermatologist neighbor Richard. He took one look at my toe, having never made this diagnosis previously in Wales (which is NOT England, we were corrected), and informed me that I had a living parasite actively producing eggs under my toenail. My children run around without shoes all the time, despite all my attempts, and I am the one with Tungiasis. (or “more commonly known as the chigoebicho de pie (bug of the foot), jigger, nigua, pico, pigue, and sand flea. Chigoe flea is sometimes confused with chigger or harvest mite.” ….or sometimes confused with a splinter under the toenail. Visit http://www.healthinplainenglish.com/health/infectious_diseases/tungiasis/ for some good pictures. )

No one else we know has gotten Tungiasis while being here- it is quite safe to visit and to live. And given Jeff’s last blog about the state of Women’s Health globally, or the fact that teenagers get liver cirrhosis from Schistosomiasis that could be prevented with once-year treatment, or that last week in clinic there was a 7 year old boy who weighed 22 pounds (due to HIV, poverty, and his mother’s recent death), I realize that my infected toe is an insignificant matter. My brain recognizes this fact, but my gut is churning in disgust. So finally 2 days after the diagnosis is made, the infested sites are incised, drained, and thoroughly hidden in band-aids. I still have a black ring under my toenail though- is it a scar….. or is it a persistent infestation?