Wednesday, March 10, 2010

Adventures in tropical medicine: Removing jiggers

Between my first jigger post and this one, I've removed five from people's feet. The last two were from my big toe and prompted Wallace, who works at the campsite, to marvel that I was a "real Liberian woman." I was extremely proud. So proud that I want to share with you, faithful readers, how to do it. Just in case you come back from the bush with bugs in your toes. Also, I recommend you find a friend to do this for you.

What you will need:

Clear alcohol (wipes, rubbing alcohol, or even vodka)
Cotton
Sharp-nosed tweezers (if you don't have these, use tweezer and a needle)
Surgical gloves, if you feel better wearing them
Optional: Swiss Army knife scissors

1. Identify that your friend indeed has a jigger. It should look like a rather circular blister that is pea-sized or smaller. It will be slightly swollen, have tiny dark flecks on it (jigger body parts) and be kind of numb when you press on it. Usually they're on the foot, toe or a little under the toenail.

2. Wash your hands and the infested foot with soap and water. If you're wearing gloves, put them on now. Dry the toes thoroughly and sit lower than the foot (like on the ground with your friend in a chair). Encourage them not to look, as it will be gross--but strangely painless.

3. Wet a cotton ball with alcohol and sterilize your tweezers, the needle (if you're using one) and the scissors.

4. Using the sharp-noosed tweezers or a needle, start to poke a shallow circle around the infected area. Poke a little under the skin and pull up. Our aim is to remove the top layer of now-dead skin that the jigger will have burrowed under.

5. Once you've done this around the jigger, you should be able to tweeze the top circle of skin off slowly to reveal the jigger. At this point, it gets a little gross, as pieces of the insect will come off with your friend's skin. Wipe and clean the tweezers in alcohol.

6. At this point, you should see what looks like a larvae--it's the egg-laying jigger. Since you've exposed the area surrounding it, you're in a good position to grab the insect and slowly pull it away from the skin. You want get your tweezers as close to the head as possible so that in one slow, solid pull--you'll need to pull--you grab as much of the jigger as you can. Check with your friend that it's not hurting, but in my experience, this part doesn't--the jiggers have some kind of numbing agent that makes removing them pretty painless. Don't squeeze too hard--you don't want to burst it. Again, wipe and clean your tweezers but I probably don't need to remind you. This step is pretty gross.

7. There should be bleeding around the wound now, which might be pretty deep. Wipe it away with a cotton swabbed in alcohol--this part will sting--and take a good, close look. If you see anything pus-like or black, tweeze it out as firmly and deeply as you can without hurting your friend. A good test is pressing firmly with both thumbs on either side of the wound. It should bleed freely. If it doesn't, you'll need to have your friend press while you explore a bit with the tweezers--nothing drastic, just a little bit of poking. More jigger bits (or, if you're me, another jigger) may come out--try to expect it and not be grossed out.

8. In the end, the wound will probably be deep but clean, bleeding freely. Clean it again with alcohol, apologizing to you friend for the stinging, and then bandage the wound with a strong band-aid. Let them air it at night so a scab forms, but have them keep it nice a clean. Any sign of swelling or infection means you haven't gotten the jigger out, so be sure you have!

4 comments:

  1. Oh my... I'm glad I didn't get a jigger over there. I have to say, they sounds sort of like mythical creatures, like the nocturnal jackolopes we saw in Kenya. Are there jiggers in the US? Or will they think I'm just making this story up too? Definitely on the very gross side.

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  2. Hi
    I am now currently living in a farm close to Windhoek, Namibia. A girl who came from Kenya just found two fleas under two toes - filled with eggs. What are the probabilities that the eggs are now strewn across the farm and what can I do to avoid getting them?
    Thankyou

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  3. @Margherita24: Not sure about the probability of contamination, but wearing shoes--even flip-flops--reduces the risk of getting jiggers considerably. Good luck!

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