A human right to shoes? Establishing rights and duties in the prevention and treatment of podoconiosis.

Podoconiosis is a debilitating chronic swelling of the foot and lower leg caused by long-term exposure to irritant red volcanic clay soil in the highland regions of Africa, Central America, and India. In this paper, we consider the human rights violations that cause, and are caused by, podoconiosis in Ethiopia. Specifically, we discuss the way in which the right to an adequate basic standard of living is not met in endemic regions, where the following basic necessities are not readily available: appropriate footwear, health education, and affordable, accessible health care. Those living with podoconiosis experience disablement, stigma and discrimination, and mental distress, contributing to greater impoverishment and a reduced quality of life. We suggest that while identifying rights violations is key to characterizing the scale and nature of the problem, identifying duties is critical to eliminating podoconiosis. To this end, we describe the duties of the Ethiopian government, the international community, and those sourcing Ethiopian agricultural products in relation to promoting shoe-wearing, providing adequate health care, and improving health literacy.