Meet Aster Lemma. Aster was only 15 when she started to have trouble with her feet (3). She was not suffering from blisters or bunions. Instead, she began to feel sick and red sores appeared on her feet and calves. Shortly after, mossy growths began to appear and her leg swelled to three times its normal size. Aster had developed a condition called mossy foot, as known as podoconiosis or non-filarial elephantiasis (1).
Podoconiosis is an ailment that most people in the United States have never seen or heard because it is extremely rare in highly modernized countries (1). However, for people in rural and impoverished communities across the globe, mossy foot is a serious threat. It has a prevalence of more than 4 million cases every year with all of them occurring in the highlands of Africa, Central and South America, and northwest India (5). Nearly one million occurred in Ethiopia alone, and half of that occurred in Cameroon (5). In some places, it is so bad that one in 10-20 people suffer from mossy foot (5). Despite its high rates in these nations, according to the World Health Organization, it is the one of the most neglected tropical disease (4). Yet, mossy foot is a very serious problem especially in rural communities that can not access help.
The condition greatly hinders a person’s life and is seen in many places as a curse. A report by Scientific American shows just how devastating mossy foot can be: “Unaffected members of the community are less willing to marry an individual from a podo-affected family because people believe it runs in families and can’t be prevented. Children are ostracized and drop out of school.” (2) Furthermore, people with mossy foot are not allowed in marketplaces or churches because people believe it is contagious. Thus, people who suffer from the disease and their families become poor and are doomed to live a life of poverty.
Yet, mossy foot is not contagious and is not caused by parasitic worms or bacteria as many may expect first (1). Instead, mossy foot is an immune response to microscopic slivers of mineral in people who consistently walk barefoot on red clay soil that tops volcanic rock (2). In fact, the word podoconiosis means “foot” and “dust” in Greek. Therefore, it is completely preventable by wearing shoes (1). This means that mossy foot could be combated by simply ensuring people have access to shoes or coverings for their feet, and much of the stigma surrounding the ailment is unnecessary.
In addition, a study by Dr. Ayele conducted in the Ethiopian highlands found that there is a genetic component that can increase or decrease an individual’s susceptibility to having the immune response (2). Although this may appear to be negative, it is actually incredibly helpful. If communities are accepting, they can be genetically tested to target shoe distribution to the most at-risk populations. Ayele calls the strategy a “low tech, cost-effective, and locally and culturally feasible genomic tool.” (2) Over time, it is possible that the disease will be eradicated.
Mossy foot may be rare, but the communities that suffer are often the ones that most need help. Together, humanity can help to eliminate podoconiosis and bring hope to so many people. To join the fight against mossy foot, see Footwork from the International Podoconiosis Initiative and from Ethiopia The Mossy Foot Project. In addition, California-based TOMS Shoes has a collaborative project with local non-governmental organizations working on podo (2). You can make a difference today!