It was a cool afternoon at the end of July – much like any other day at the Sole Hope compound. But then the Sole Hope van arrived at the Outreach House carrying 12 wounded feet severely infested with *jiggers, the likes of which the team had never seen before

These six brave souls traveled 45 minutes to the nearest hospital in search of care, only to be refused treatment.  They were then brought to Sole Hope by a referral from the local law enforcement. The six stepped out of the van, fear and pain plaguing their faces, uncertain of where they were or what their future would look like. 

It was soon discovered that the father believed that their struggle with jiggers was because of a curse passed down from his father. His father suffered from jiggers and it was thought that the curse was passed to his family because he was not in good standings with his father when he died. Sadly, this is not an uncommon story. Many locals believe that curses and bloodlines determine who is to be plagued by jiggers. This lack of education creates a stigma and all-too-often fatal outcome for a very preventable disease. Like many Ugandans, they had avoided the issue of jiggers because they were ashamed and did not want to bring negative attention to themselves.

But this was not the end of the story.

As they sat on the mat outside of the Outreach House, Sole Hope founder Asher Collie approached them, offering words of encouragement and hope. And with that, a moment that threatened to be an end for this hurting family was transformed into a beginning – a beginning to their future.

This family is thriving today. The children are healthy and well cared for. Father, mother, four children, and two grandchildren were treated for jiggers, fit with #solehopeshoes, and taught about the importance of hygiene, shoes, and the truth about jiggers, where they come from, and how you get them. 

With a simple act of care and compassion, an entire family received medical treatment, education and shoes to protect their feet. The sun rises each day, and with it comes renewed life, joy and hope for the future, thanks to the work of Sole Hope. 

The road to Jinja is a dusty one. On the horizon is open sky; cows graze in the fields; houses and huts form a small village; and the Nile and Lake Victoria contribute landscape beauty and physical boundaries.

Before 1906, Jinja was a fishing village that benefited from its location on long-distance trade routes. The origin of the name Jinja comes from the language of the two peoples (the Bagandaand the Basoga) that lived on either side of the River Nile in the area. In both languages ‘Jinja’ means ‘Rock.’ 

In most of Africa, rivers like the Nile hindered migration. However the area around Jinja was one place where the river could be breached due to the large rocks near the Ripon Falls. On either bank of the river were large flat rocks where small boats could be launched to cross the river. These rock formations were also accredited with providing a natural moderator for the water flow out of Lake Victoria. For the original local inhabitants, the location was a crossing point, for trade, migration and as a fishing post.

Most of the ‘Flat Rocks’ that gave the area its name disappeared under water, but the name and legacy remain (Official Jinja District). 

The other reality 

Because of its key location at the source of the Nile River, Jinja emerged as the ‘adrenaline capital of East Africa.’ White-water rafting, kayaking, quad biking, mountain biking, horseback riding and bungee jumping are all among the tourist attractions available in this outdoor excursionists’ dream town. 

But there is another reality for residents of Jinja. A small parasite known as jiggers has wreaked havoc on many locals. These small pests have become a major problem in northeast Africa.

Small pests, big health complications

Jiggers are parasites that burrow into hands and feet, lay eggs and multiply.  Found in sub-Saharan climates, these sand fleas cling to and infest livestock, which serve as a carrier of the parasite. Jiggers transfer to humans, living in the dirt and then burrowing into human feet. Children are particularly vulnerable as they often play barefoot in the dirt. Once burrowed, jiggers lay eggs and multiply if not removed.

The problem of jiggers is easily preventable (with shoes!), and the initial infestation is treatable (cut the jigger out of the foot), but when allowed to fester and spread, the problem becomes a very large and serious one, leading to swelling and inflammation and creating wounds prone to infection and serious disease, like gangrene or tetanus. Such diseases can result in amputation, permanent deformity or even death. 

Stigma and shame

Where there is lack of knowledge, there is also often ignorance and stigma. For too many children in Uganda, jiggers is akin to a modern day leprosy.  

Those who are infected may be made fun of or bullied. This is a sad reality in itself, but contributes to an even greater problem – a rise in school drop-outs. In some cases, children are not allowed to attend school for fear of spreading their infection. Other times, a child opts to stay home in order to avoid harassment from peers because of the widespread ignorance about jiggers.

Mulyabintu Muzaham, a local science teacher at Busende Primary School, discussed the issue from first-hand experience:

The approximately 950 students at Busende Primary have been harshly affected by jiggers for some time. Kids regularly arrive to school limping, scratching, and complaining of pain caused by these parasites. Most alarmingly, approximately 20 students have dropped out of school in a single year due to jiggers. It is not necessarily the pain and discomfort jiggers cause that led these children to drop out, but rather the stigma associated with having them. These kids would rather discontinue their education than face the harassment from peers that they feel is inevitable because they have jiggers. Unfortunately, this stigma and the shame that accompanies it can cause the problem to be much worse than it otherwise might be. This shame leads to the lack of treatment, furthering the problem of jiggers altogether.

The stigma also serves as a barrier to treatment. Because medical facilities often lack an accurate medical understanding about the problem, clinics and hospitals regularly turn away jigger patients and refuse them treatment.  

Individuals suffering from jiggers may be isolated and separated from their families. In some cases, they are even locked in their homes, usually because of a belief that the infection is a result of witchcraft or evil spirits. At a time when they most need compassionate care, extremely vulnerable members of society – children, elderly, disabled – may be ostracized from their families and communities, with nowhere to turn for help.  

Restoring hope

Enter Sole Hope, a safe haven in the small rural town of Jinja, Uganda, that accepts everyone, treats anyone and turns away no one. Through education, treatment, rehabilitation, prevention and the simple gift of shoes, Sole Hope is restoring hope in Jinja.

The Sole Hope mission statement articulates a holistic approach – through education, jobs and medical relief. What started as an effort to provide shoes for vulnerable populations in a heavily jigger-infested region evolved into a larger vision to restore health and hope within the greater community.  

Treating the problem

The problem of jiggers is not a glamorous one. Jiggers produce ghastly sores and can lead to dangerous diseases. While one of these sand fleas is a small problem, if not treated, one jigger can lead to hundreds and hundreds. The images are not pretty. 

“It's not easy to advocate for something that is ugly and laughed at. There's nothing glamorous about what we do. It's a lot of hard work,” says Sole Hope founder Asher Collie.

But the good news is that jiggers are completely treatable. Removing jiggers is an unpleasant process, but the results are dramatic. Children who are covered with sores on their hands and feet, can barely walk and are unable to feed themselves are transformed into happy, healthy, smiling children again.

“[They] go from looking like they're in despair and sad and down to seeing they have a future and they can go to school and they can get back in the garden. It's those stories that keep me going.”

Sole Hope goes out into villages throughout the region to host clinics. Trained staff and volunteers set up stations where they remove jiggers, treat wounds, test for HIV, typhoid and malaria and provide sanitation and educational materials.     

In some cases, these services are literally hope for the hopeless. Because there is a lot of misinformation and misunderstanding surrounding jiggers, some of those infected are not even aware that the problem is treatable.  

"For so many, jiggers feel like a hopeless situation. It's just a curse, just something we were born with. [Sole Hope] is here to offer hope and say ‘you can lead a jigger free life and this is not the end for you.’"

A simple solution

Jiggers are not only treatable, but also entirely preventable. Severe infestations are often the result of unsanitary homes and practices and lack of a simple resource – shoes! Close-toed shoes help protect feet from jiggers. Providing locally crafted footwear to protect people’s feet is perhaps one of the most common-sense efforts of Sole Hope. 

Education is also a key component of prevention. Sole Hope staff work with local schools to teach prevention tools and educate children about how to stay jigger-free. They also provide these resources to everyone who is treated for jiggers to help them remain jigger-free.  

Jobs and dignity 

“We believe in supporting communities and teaching the trade of shoe making. We innovate and demonstrate solutions that combine the best of indigenous and contemporary practice to create sustainable skills and employment.”

This core value guides the work of Sole Hope. The process begins with a pair of old (donated) jeans, which are then cut into patterns provided by Sole Hope. The materials are then shipped to Jinja, where skilled Ugandans use the pattern-cut jeans and old rubber tires (for the soles) to create shoes. Tires are a long-lasting, inexpensive, recyclable, locally-sourced and readily-available good. They are also already a part of the Ugandan shoe culture.  

Asher designed the shoes and describes the goals behind it: “I was wanting something that is sustainable and would help the economy and the people get behind why they are wearing shoes.”

This process allows old jeans to be recycled into something useful, creates jobs for the Busoga region, stimulates the local economy and provides much-needed shoes for children in jigger-infested areas. 

Building hope

Sole Hope also provides extended medical services for those suffering from severe jigger infestations. In more serious cases, additional care is needed to ensure proper healing of the wounds and to fully educate patients about how to remain jigger free.  

The Sole Hope Outreach House currently provides a home and care for up to 30 children at a time suffering from debilitating cases of jiggers. The Sole Hope Team brings the worst children and families to the Outreach House for medical attention and lets them remain there for a period of time for healing, education, and reformation of unhealthy habits that kept them in the grips of jiggers.  

Once the children have recovered at the Outreach House, they are given a new pair of Sole Hope shoes, resettled into their villages and equipped with the tools and knowledge they need to remain jigger free and to teach others to do the same.

Sole Hope leased and opened its current Outreach House in summer 2014. However, space in the leased facility is limited and beds are consistently full, so Sole Hope purchased property where it will build a new Outreach House that will expand its capacity and allow them to welcome those in need of assistance and care.

A Safe Haven

This new land will be designed to serve as a safe haven for Sole Hope staff, patients and the Busoga community. It will create a space that welcomes anyone needing treatment for jiggers and will also allow all Sole Hope services to be consolidated in one location.

Erica Baker's photo essay takes us along on the journey towards becoming jigger free.