NPR

The Unexpected Cause Of This Awful Disease Lay Right Underfoot

Farmers in a remote Ugandan tropical forest suffered from an excruciatingly painful foot ailment. Usually parasitic worms are the cause — but not this time.
The typical asymmetrical lymphedema (lower limb swelling) seen in podoconiosis. The skin on the affected limbs is thickened with warty and mossy nodules. The toes are disfigured toes with joint fixation typical of advanced podoconiosis disease.

After you see a case of elephantiasis, you can never forget it.

People's legs, feet and toes swell up so much that they can't walk. Or move easily. The skin thickens and breaks open, creating ulcers and infections.

"It causes so much pain. So much pain," says epidemiologist Christine Kihembo, at Makerere University School of Public Health in Kampala, Uganda.

The trigger for the disease

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