Médecins Sans Frontières (MSF) has urged the Nigerian government to prioritize the fight against noma disease and take decisive action to eliminate it within the country. The international medical organization is calling for a concerted push to improve early detection, treatment, and prevention efforts, emphasizing the importance of screening children in endemic regions as soon as symptoms appear.
Dr. Peter Ajanson, Deputy Medical Coordinator for MSF Nigeria, highlighted that noma is a preventable disease. “Good nutrition, oral hygiene, access to healthcare, and vaccinations against childhood diseases are key factors in preventing noma,” he said. The disease, he explained, often begins with gum inflammation, but if left untreated, it can rapidly escalate, causing severe destruction of facial tissue and bone, leading to death in approximately 90% of cases.
“Early detection is crucial, yet awareness is low, and many families lack access to essential antibiotics or cannot afford the treatment,” Dr. Ajanson explained. The disease predominantly affects children living in poverty-stricken, remote areas, where healthcare and dental services are scarce or non-existent.
He further noted that of the few survivors, 10% endure long-term suffering from disfigurement, pain, and social stigma. Noma primarily affects malnourished children or those with compromised immune systems. The World Health Organization (WHO) estimated that in 1994, 140,000 children were affected by the disease annually. Dr. Ajanson stressed that the lack of updated data for more than 25 years highlights the global neglect of the disease.
In 2020, MSF, in collaboration with other organizations, survivors, and Nigeria’s Ministry of Health, launched an international campaign to raise awareness about noma. After extensive advocacy, the disease was officially added to the WHO’s list of Neglected Tropical Diseases (NTDs) as the 21st disease. This achievement, Dr. Ajanson explained, should now prompt the global health community and donors to prioritize efforts in noma treatment and research.
Since 2014, MSF has been supporting the Sokoto Noma Hospital in northwest Nigeria, which is managed by the Federal Ministry of Health. MSF teams have been providing a range of services, including reconstructive surgery, nutritional support, mental health assistance, and community outreach.
To date, MSF’s surgical team has performed 1,481 surgeries on 953 patients over the past decade. These interventions, which include specialized reconstructive surgeries for noma survivors, aim to treat approximately 40 patients during each surgical session. Both international and national surgeons and anesthetists collaborate in these procedures.
Dr. Ajanson further explained that noma is an infectious, but non-contagious bacterial disease that begins with a small mouth ulcer or gum inflammation. The infection then spreads rapidly, destroying bone and tissue, particularly in the jaw, lips, cheeks, nose, or eyes. Poverty, malnutrition, poor oral hygiene, and diseases such as measles or malaria make children under the age of seven particularly vulnerable to the disease.
Survivors often face significant challenges, including difficulty speaking and eating, social isolation, and stigma from their communities. This, in turn, leads to developmental delays and mental health issues due to the trauma caused by both the physical and social consequences of the disease.
MSF’s efforts in treating noma are carried out in partnership with the Nigerian Ministry of Health, focusing on community outreach, active case identification, health promotion, and the provision of mental health support. Reconstructive surgeries are conducted by a team of local and international surgeons, anesthetists, and nurses who travel to Sokoto four times a year.
In addition to its ongoing efforts in Nigeria, MSF is committed to integrating noma screening and treatment into its projects globally. Dr. Ajanson also called for increased research into the causes and epidemiology of noma, as well as greater global attention to the disease’s impact.
As MSF continues its advocacy, the organization stresses that eliminating noma requires not only improved awareness and treatment but also comprehensive strategies to address the underlying issues of poverty and access to healthcare.
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