WARA, Ethiopia The district of Dawro in southern Ethiopia is farming country, its fertile soils brimming with life.

On steep hills, farmers eke out a living from corn and teff, yam and banana. When the thin air thickens with mist and rain, the copper-colored ground turns to mud.

But this fecund earth, a blessing for Dawros farmers, can also be a curse. Something in the soil triggers a disfiguring disease that may hobble even the hardiest folk.

I am quite young but now I look old, said Wosani Wolanchu, a 40-year-old mother of five waiting for an appointment at a clinic in the village of Wara.

She eases off an oversized plastic sandal to reveal a bloated, swollen foot riddled with scabs and moss-like warts. It took her two hours to hobble from her home to the clinic, a journey that once took little more than 30 minutes.

Wosani is living with podoconiosis , a non-infectious skin disease experts say is entirely preventable, were she able to afford proper footwear.

Here in Ethiopias remote highland villages, where farmers plow the soil barefoot while wives and children at home pad across dusty, uncovered floors, shoes are still a luxury. So in places like Wara the disease sometimes known as mossy foot endures, while the world remains largely ignorant of its ravaging effects.

Unlike the similar but much more common lymphatic filariasis (commonly called elephantiasis ), which humans contract when mosquito bites transmit a parasitic worm, podoconiosis stems from prolonged exposure to red-clay minerals in volcanic soils.