What kind of people would live like this and not do anything to make things better ?
Ohhhh
Advice from Sam Kinison comes to mind.
Look up "Jiggers": aka the Chigoe flea, an invasive species to Africa. They burrow into their human victims, normally the feet (due to poor hygiene and lack of footwear) and lay eggs which have to be cut out with a knife.
There's lots of very graphic videos on YouTube of jigger removals. The most striking aspect is that their victims suffer while awaiting a healthcare worker to arrive with a knife. They make no effort to remove them themselves.
Even a dog will scratch his fleas.