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Foot note: Millions suffer simply for lack of shoes

Flickr, poppalina

Millions of bare feet prove we still aren’t reaching the very poorest of the poor.

The international community is doing a lot to help the world’s poor — spending billions of dollars (not enough, but still billions) to combat AIDS, TB and malaria, doing research, figuring out clever new uses of cell phones to help subsistence farmers increase productivity and getting microfinance loans to poor women.

And yet, millions of people worldwide suffer disfigurement and disability simply for a lack of shoes?

Foot with podoconiosis
Gail Davey

The disease I’m talking about is called podoconiosis and, chances are, you haven’t heard of it. It is a much lesser-known cause of elephantiasis (see right, a condition also caused by mosquito-borne parasitic worms) that one researcher believes may nevertheless afflict more than 4 million people worldwide.

“This is a problem that could be entirely eliminated now, simply and at low expense,” says Dr. Gail Davey, a British researcher who first encountered this much-neglected disease while working in Ethiopia nearly a decade ago.

The World Health Organization just issued a report on neglected tropical diseases that did not include mention of podoconiosis, which I guess makes this doubly neglected. For a more readable presentation on the WHO report, go here.

Podoconiosis, despite the large number of people likely afflicted, simply doesn’t fit into the standard disease categories.

“I was trained in tropical medicine but I had never heard of it,” Davey told me by telephone. I caught up with her as she was headed to Buenos Aires to meet with physicians and scientists there. Davey, who seems to be the world’s leading (only?) expert on podoconiosis, is trying to draw more attention to this problem.

While in Seattle last spring, teaching a course on public health genomics at the University of Washington, Davey approached the Gates Foundation to see if they would be interested in throwing some money at this.

“This is pretty low hanging fruit,” she says. It’s cheap and easy to prevent and treat.

But Davey says the philanthropy had no interest, probably because the ailment didn’t fit into their global health mission. Part of the problem with podoconiosis, Davey says, is that it’s a disease caused by simply going barefoot and by chronic exposure to irritating alkali clay soils. It’s not your typical infectious disease, or one that’s known by many except those living in the very poorest and isolated communities.

Yet Davey says her research in Ethiopia, where she believes there are a million cases in this country alone, indicated this disease likely numbers in the millions worldwide. That’s why she’s in Buenos Aires this week, to expand surveillance and document just how big a problem this is worldwide.

“This is a disease that is directly caused by extreme poverty, by people too poor to buy shoes,” stressed Davey. How can we hope to help the poor by solving much more complex problems, she says, if there appears so little interest in just getting shoes to people to prevent this disease?

Davey does appear to have one high-profile ally in her fight for attention to podoconiasis —  Blake Mycoskie, founder of TOMS Shoes. Here’s a video of Mycoskie and Davey in Ethiopia and below is a more recent one celebrating the one-millionth donated TOMS shoe:


About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.