Fighting Noma
 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,
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?
 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 village in Northern Nigeria.
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 of volunteer medical teams and the goodwill
and sponsorship of the more fortunate whom we hope will make donations
to finance medical expeditions.
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