The disease is caused by walking or working barefoot in silica-heavy volcanic soil, a common practice in rural farming regions of developing countries. This creates a large public health problem in at least ten countries in tropical Africa, Central America and northern India. In Ethiopia alone, it is estimated that 11 million people are at risk, with between 500,000 and 1,000,000 people already affected. In the densely populated southern Ethiopian region of Wolaita, Podoconiosis is more common than HIV infection. Deformity Intense pain Ulcers Social stigma and exclusion Podoconiosis is preventable by wearing durable shoes and simple foot hygiene. Podoconiosis can even be reversed by simple treatment and proper use of footwear. TOMS Shoes is working to prevent Podo by giving durable footwear to all early-stage and at-risk children in the hazardous areas of Ethiopia. Our non-profit partner Friends of TOMS is working with organizations to provide treatment to existing patients.