The disease denies the children a chance to be productive as they cannot do anything for themselves, be it holding a knife to make a meal for the girls, and holding a hoe to plant a single seed for the boys. 
Ugonjwa huu unawafanya watoto kushindwa kufanya shughuli yoyote ya uzalishaji; wasichana hawawezi hata kushika kisu ili kuandaa chakula, na kwa wavulana, hawawezi hata kushika jembe na kuotesha walau mbegu moja ya mmea.