I spent a week at Oak Hill College in north London in the summer learning about some tropical diseases, courtesy the Christian Medical Fellowship (CMF). When you check the stats, Ethiopia is the place to go if you want to catch most of them. I’m all prepared for onchocerciasis, schistosomiasis, tape worms, malaria, TB, typhoid; the list goes on. however I wasn’t prepared for furuncular myiasis – I should ask Dr Vicky Lavy, the CMF international director, to add it to the course.

I promised anonymity to the person who introduced me to this disease, so we’ll call him “A”. “A” came from the countryside to Addis on his way to Germany for a holiday (sorry, vacation). We had a lovely lunch together in the subtly named “Garden Paradise” restaurant (it’s good; but “paradise”? For more subtle names, see below). “A” came to see our new penthouse suite at Bingham – we love showing off our brand spanking new flat (sorry, apartment. By the way, Google defines “penthouse” as either “a flat on the top floor of a tall building, typically one that is luxuriously fitted”, or “an outhouse or shelter with a sloping roof, built on to the side of a building”. On that basis there are a lot of penthouses around Bingham…) After a cup of tea and a tour of the penthouse (it doesn’t take long) “A” tried to take his shirt off to show me some skin spots. Ensuring he kept most of his shirt on (he’s not young) I inspected four or five small pustules; one of which for all the world looked like chicken pox, although the others were too big, with surrounding redness. Not knowing what these were but fairly sure they were infected I recommended an antibiotic and left it at that. The next day “A” was due to fly off to Germany late in the evening. Off he went with my prescription and we thought no more of it.

Strange things often happen when Haile is driving me to or from work. Recently around the huge city market (“Merkato” – spot the Italian influence) there has been a surfeit of young men carrying new refrigerators, still in their packaging, on their heads through busy traffic. Only one at a time though, unlike tellies (sorry, TVs) which can number four or five on one head. On this occasion the strange thing was a phone call from “A” on my mobile phone (sorry, cell) to tell me that I wouldn’t believe what just happened to him. Knowing “A” fairly well I’d believe pretty much anything, but the description of how he was busily squeezing live maggots out of his pus spots stretched even my already strong trust in his stories. “A”’s earnestness convinced me this must be true, and a short while later I had educated myself on the glories of furuncular myiasis. Here's what happens. A fly of the species Cordylobia anthropophaga (also known as the mango fly, tumbu fly or, far more entertainingly, the skin maggot fly) lays eggs on your clothes while they are hanging out to dry. You put the clothes on; the egg hatches to a larva which painlessly penetrates the skin, starts to grow and causes exactly what “A” described. He even said he felt something wriggling inside but I had dismissed that as fantasy (sorry “A”!)

The only way to treat cutaneous myiasis is to get the little blighters out. A subsequent email revealed that “A” finished the process of maggot extraction at 9000 metres (sorry, 30,000 feet) up in the air in the toilet (sorry, rest room) of a plane on the way to Germany. Is that a first I wonder?

If you want to enjoy “A”’s suffering as much as I did, this Wikipedia article is entertaining, in a slightly gruesome way.

In one of those extraordinary coincidences that sometimes happen, a colleague came to the clinic a couple of days after “A” had landed maggot-free in Germany and said “you’ll never guess what I squeezed out of my husband’s back last night!”. “A maggot?” I surmised smugly. With a startled look she presented me a specimen tube with the little wriggler in, alive and, err, wriggling. Here he is:

Finally, having been to a restaurant from paradise, I thought I’d show you that we eat strawberries that have clearly come a very long way to get here, and a packet of fruit juice that if the label is correct couldn’t possible be improved on. We also buy fresh milk in 500 ml plastic bags with a rather unfortunate and slightly creepy name.