This article was inspired by a personal story shared with us, highlighting the deep struggles faced by families living with lymphatic filariasis, a neglected tropical disease common in Kenya’s coastal region.
A Family Living in Pain
At Mfuleni village in Magarini, brothers Jefwa Kalama and Mganga Kalama have battled mafumbu for over three decades.
The swelling, caused by lymphatic filariasis, has made everyday life difficult and socially isolating.
“This illness has taken away our dignity,” says Mganga, 50, speaking softly.
“Sometimes, the pain is so intense that I cannot even move. Life has not been easy.”
The swelling grows worse during cold seasons, making walking, working, and sleeping unbearable. Mganga explains that surgery is the only permanent solution, but poverty has kept it out of reach.
“I have visited hospitals many times,” he says, “but they tell me to return when I have money for the operation. With no stable income, we have to choose between food and treatment.”
Medical camps occasionally visit Kilifi to offer free hydrocele surgeries, but spaces are limited. Mganga has attended several but has never been selected.
“I will keep trying,” he says with a glimmer of hope. “Maybe one day, my turn will come.”
His elder brother, Jefwa, 69, was luckier. In 2020, he was chosen for surgery at Kilifi Sub-County Hospital during a free medical camp supported by Amref.
Doctors operated on one side, bringing some relief, but the swelling on the other side has since worsened.
“It is too big now,” Jefwa says, holding his hands apart to demonstrate the size.
Before the disease, the brothers were skilled palm wine tappers, climbing tall coconut trees for a living. But mafumbu robbed them of their livelihood, forcing them to depend on their children for survival.
The Stigma That Hurts More Than the Pain
For many men, mafumbu affects more than their health — it destroys confidence, relationships, and self-worth. In Mavueni, 24-year-old Baraka Baya hides his condition beneath baggy trousers. He was diagnosed three years ago but has never sought treatment due to stigma and poverty.
“I avoid talking to women,” he says, his voice heavy with sadness.
“How do I explain my swollen testicles? What if they laugh at me or tell others?”
Baraka dreams of getting married and starting a family, but the fear of rejection keeps him isolated.
“I love children, but I cannot even start a relationship,” he admits. “I just pray one day I get a chance for surgery.”
A Story of Hope and Recovery
Not all stories end in despair. Justin Kiringi, a community health promoter in Kilifi, once suffered from the same condition. In 2019, he underwent a successful operation during an Amref-supported medical camp.
“At first, I was scared,” Justin recalls.
“People said the surgery would stop me from having children or that the wounds wouldn’t heal. But I took the risk, and it was the best decision of my life.”
A year after his surgery, Justin became a father, proving the myths wrong. Today, he uses his experience to encourage other men to seek treatment.
“Surgery works,” he says firmly.
“It gives you back your life, your confidence, and your dignity.”
Justin regularly mobilises his community whenever free medical camps are announced. He believes that with proper awareness, more men will come forward for treatment and avoid unnecessary suffering.
Lymphatic filariasis is caused by tiny parasitic worms transmitted by infected mosquito bites. Once inside the body, the worms damage the lymphatic system, leading to swelling in various parts of the body.
In men, the swelling often affects the scrotum, leading to hydrocele, which can grow so large that it makes walking, working, and even sitting difficult. In severe cases, the swelling can weigh several kilograms, causing both physical and emotional suffering.
According to local health data, Kilifi County had an estimated 3,000 cases of hydrocele in 2019. Despite government efforts to reduce infections through Mass Drug Administration (MDA) programs and mosquito control, thousands are still living with the long-term effects.
For many families, surgery remains out of reach. In Mtwapa, 70-year-old Masha Mramba endured swollen testicles for over 40 years. When his condition worsened in 2024, his family had no choice but to raise Sh160,000 for surgery at a private hospital.
“We had to borrow money from friends and relatives,” his son says.
“Even after the surgery, we are still repaying debts.”
Masha describes his recovery as extremely painful, especially since he couldn’t afford proper medication.
“They told me to soak in salty water, but I had no painkillers,” he recalls.
Despite the challenges, he is relieved to be free from the weight that burdened him for decades.
Health workers in Kilifi have raised concerns over unsafe self-treatment methods. Some young men, desperate to wear tight jeans or hide the swelling, use sharp wires to pierce the scrotum and drain the fluid themselves.
Justin warns against this dangerous practice: “The swelling always comes back, but the infections and permanent damage can make future surgery impossible.”
The Kenyan Ministry of Health launched its National Programme to Eliminate Lymphatic Filariasis in 2000. Since 2016, continuous Mass Drug Administration campaigns have reduced infections significantly in coastal counties like Kilifi, Kwale, Lamu, and Mombasa.
In 2018, Kenya adopted a new triple-drug therapy (Ivermectin, DEC, and Albendazole), which drastically reduced disease transmission within two years. Today, the country is on track to eliminate lymphatic filariasis as a public health problem by 2030.
However, many already affected men still need urgent support. Surgical backlogs remain, and stigma prevents many from seeking help. Experts are calling for free surgeries, better community education, and more partnerships with health organisations to speed up recovery.
For men like Mganga, Jefwa, and Baraka, hope lies in increased access to treatment, public awareness, and the end of stigma. The disease may no longer be spreading as fast, but its social and emotional scars remain deep.
“I dream of living a normal life again,” Mganga says quietly.
“I just want the pain to end.”
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