Fighting Noma

 The disease eats away at facial issue, leaving a gaping hole in the face.

In an ideal world, feeding the hungry and malnourished is the overall answer. This, however, is a task of immeasurable magnitude and is a matter for politicians. Education is another important factor.

Given the scant epidemiological information and statistics on Noma, the extent of the problem and its current trends are difficult to assess. The main obstacles are its presence in the poorest communities of the poorest societies with little or no access to front-line health care centres, let alone hospitals; the acceleration of Noma from its initial form to death is so rapid that few victims reach treatment facilities in time; unawareness of families and health workers who fail to identify the condition in time, and the tendency of families or communities to hide their Noma victims.

There is an immediate need for every country affected to set up a Noma control plan giving priority to early detection and immediate treatment. These countries need drugs and food supplements for patients and help in organising the training of primary health care personnel. Mothers and pregnant women as well as village leaders need to be informed and educated. Vaccination campaigns against measles and other childhood infections which wreak havoc in poor communities must be intensified.

Where Do We Start?

 A patient recovers from facial reconstruction surgery.

As indicated above, there are probably some 14,000 survivors each year, most of whom will be grotesquely disfigured for the rest of their lives. Their facial deformities are mostly extensive and confronting which in turn invariably causes social isolation and immense distress. A small boy of 8 was recently asked why he was so happy and smiled all the time soon after facial reconstruction had been completed. His answer was short and simple "I will now be able to play with my friends". Another child answered "because I will now be able to drink my milk through a straw". These heart-warming answers may seem trite to the average person living a normal life in the western world, but they have a profound sensitivity in a small and remote village in sub-Sahara Africa.

 Men from the Omo Valley in Ethiopia look at the charity's information pamphlets.

Reconstructive facial surgery is one thing when carried out in a well-equipped and well-staffed hospital with adequate financial resources. The facial reconstruction of a Noma victim is both complex and time consuming and requires very special skills. Such surgery is neither available nor accessible in the countries where Noma is prevalent. The cost of bringing one Noma victim to Europe for facial reconstruction costs about £40,000 whereas similar treatment in a local hospital costs about £800. Imagine, a new face and a new life for £800 !

However, a new face and a new life are entirely dependent on the goodwill and skills of volunteer medical teams and the kindness and generosity of the more fortunate whom we hope will make donations to finance our medical expeditions to Nigeria and Ethiopia.

Kurt Bos and Klaas Marck, founder and President of Dutch Noma Foundation, have written The Surgical Treatment of Noma, a publication aimed at surgeons and anaesthetists working with Noma as part of a surgical aid programme. The book offers a very in-depth description of the procedures used in the reconstructive surgery.

© 2012 Facing Africa - Noma Ltd. All Rights Reserved. UK Registered Charity No: 1072505