TOMS Blog

TOMS gives new shoes to children in need around the world in remote villages and in bustling cities, to very young children and to teenagers alike. In some areas, shoes help provide access to education. Without a proper school uniform, which often includes black shoes, children in some areas are not allowed to attend school.

Shoes can also serve as a preventative barrier to cuts, infections and parasites like jiggers and hookworm. 

And in certain areas of the world, shoes also provide protection from a debilitating disease called podoconiosis. Podo, for short, is a non-infectious type of elephantiasis that affects an estimated 4 million people worldwide. 

In 2008, Blake (TOMS founder and Chief Shoe Giver) encountered podo during a visit to Ethiopia. He was moved to learn that podo is preventable with basic foot hygiene and shoes. Since that trip, TOMS has joined other passionate people from the health, research, treatment, advocacy, government and commercial sectors to work toward eliminating podo. We have met some amazing supporters along the way, like Dr. Gail Davey.

Dr. Gail Davey is a MD and Global Health professor at Brighton and Sussex Medical School and one of the few experts in the world on this neglected disease. She has been an incredible resource for us to work with and learn from. Here’s more about podo, right from Dr. Davey.

TOMS: How are you involved in the study of podoconiosis? 
Dr. Davey: In 2002, I realized that, despite many podoconiosis questions remaining unanswered, no one was doing systematic research into the problem anywhere in the world. 

I was in contact with an organization that had strong infrastructure, and knew there were scores of bright, interested students at Addis Ababa University. It became a case of trying to find funding to pull these things together. I now work full time in podoconiosis research and advocacy.

TOMS: What is podoconiosis?
Dr. Davey: Podoconiosis is one of the lesser-known types of leg swelling or elephantiasis. It’s caused by an inflammatory reaction within the leg to mineral particles in some red clay soils. It takes about 10 years of living and working barefoot on irritant soil to develop the earliest symptoms and signs of podoconiosis.

TOMS: How is podoconiosis prevented? How is it treated?
Dr. Davey: In order to prevent podo, feet must be safeguarded from irritant soil. By wearing shoes regularly and consistently, and washing the soil from feet, people protect themselves from contracting the disease.


Washing is an important part of treatment. Remarkable improvements in the feet can be achieved through regular washing, use of simple emollients (moisturizing products that soften and treat dry skin), toe-to-knee bandaging, foot and calf exercises and the use of socks and shoes.
 

TOMS: What makes podo an urgent health issue that needs to be addressed globally? 
Dr. Davey: There are at least 4 million people today that are living with podoconiosis. It’s urgent because this is one of the few diseases that could be eradicated within our lifetime. 

TOMS: In what areas of the world is podoconiosis most prevalent? 
Dr. Davey: It primarily affects tropical areas with volcanic histories. The irritant soils seem to originate from volcanic rocks that have been heavily weathered at high altitude through tropical conditions of heavy rainfall.

Very poor subsistence farming populations are at the greatest risk [of contracting podo] because they have daily contact with irritant soils. Without shoes or access to water to regularly wash their feet as protection against podoconiosis, people living in those conditions are extremely susceptible.

TOMS: In our 2009 interview, you called podoconiosis a “disease of the voiceless.” Can you elaborate on that? How does podo affect people personally?
Dr. Davey: [Almost as difficult as the physical aspects of podoconiosis are the emotional ones. So much of the problem for podo patients is the stigma attached to the disease.]

Teens who develop podo often find it difficult to continue at school, young adults have great difficulty finding a marriage partner and older adults may be unable to join in social and community activities like weddings, church or mosque.

Podo patients are some of the most outcast in the world, and treating them so they can resume their role in society is a very moving thing to be part of.

TOMS: What have been some of the biggest advances and milestones in the fight against podoconioisis?
Dr. Davey: Though there haven’t been huge recent breakthroughs, there have been incremental changes in treatment. For example, we now realize how helpful bandages can be in the early stages of the disease for many patients, whereas we had previously thought this useful for only those with pronounced swelling. 

And, there are some extremely exciting things going on now in the advocacy arena: Ethiopia is establishing a National Podoconiosis Action Network, and an International Podoconiosis Initiative is soon to be launched. These will form partnerships between organizations and people working on podo, and should be really instrumental in raising the profile of podoconiosis globally.

Learn more about the hazards of living without shoes, and see how you can help spread the word! Even more about podo from the International Podoconiosis Initiative at www.podo.org.