Piques and Children

Wednesday September 10, 2008

I have mentioned before about piques – a flea that burrows under the skin, lays eggs that hatch. The newly hatched piques burrow in the same wound, lay eggs that hatch and…..the cycle continues creating a deeper and larger wound. We get them all the time. They first show as a small black dot under the skin. In the next stage you can see a white bubble surrounding the dot. The infected area is tender and you can feel them burrowing (especially at night when you lay down in bed). If caught early they are easy to remove, just lance the spot and pull out the egg sack.
Last week in the clinic Jeff saw a pregnant 13 year old and her three siblings (2, 4 and 5 years of age) who had hundreds of piques on their feet. Jeff picked countless piques out of the heel of the 13 year old, leaving a raw area 3 inches wide. The clinic cleaning lady who tediously worked on the feet of the children was in tears over the neglect of these kids.

Monday Jeff and I went to follow up with this family. They live in a poor area of town and have no water or electricity. The three small roomed “house” is bare. I saw no furniture, no toys, and no clothes. Ursulina, the 13 year old is extremely shy. She never looked us in the eyes, or invited us in or answered when we asked her questions. The kids huddled in the shadows of a corner, staring at us and giggling among themselves. Ursulina has only a 3rd grade education and cannot read. She had to drop out of school in order to care for her brother and sisters while the mom works.

The kids feet were swollen, caked with brown dirt and were covered with black, necrotic-looking skin. The 2 year old walked on his heels and the 4 year old walked on the side of her feet due to the soreness caused by the piques. Jeff sprayed the yard for piques and I changed the dressing on Ursulina’s heel (actually she had already taken her dressing off and the wound was covered with dirt!)

As we left the house I was in tears. I wanted to come back when the mother was there and see what kind of a person could allow her children to suffer like that. Everyone around here knows about piques and how to take them out. I went home and vented to my house help, Nilsa. It turns out that she knows the family. The mother is a maid for her boyfriend’s mother. Nilsa agreed that since the mother was done with work by 2pm, there should be no reason for the neglect she was showing. The mother has 3 other children who live with a relative outside of town. Nilsa mentioned that the mother is a bit “slow”.

It brings tears to my eyes even now to think that Nilsa went yesterday on her own accord and spend 2 ½ hours picking piques out of the kids feet. Nilsa asked the mother why she doesn’t take care of her kid’s feet. Her only explanation was that Ursulina was the “Senora” now (a derogatory comment probably because Ursulina will soon have a baby of her own) so she can watch the little ones. She also mentioned that the kids cry when she tries to get them out so she stops (Paraguayans do not like to see their kids cry so they give in to them).

Jean and I went today to apply antibiotic cream to the feet and cover them with gauze. We also gave them new shoes and perhaps the first shoes they have ever worn. Remember when the crippled beggar asked Peter and John for money as they were heading into the temple? But they said, “Silver and gold I have none but what I have I give to you.” The man began to jump and praise God. When we gave the 5 year old the shoes she jumped, she ran, she stomped, and all the while her head was down staring at the shoes. It was priceless!


Bandaging pique infected feet


Bandaging pique infected feet


Learning to walk in shoes


A big smile after receiving her new shoes