Noma - A Neglected Disease

Noma is a largely forgotten and hidden disease. Noma remains little known because it affects the most marginalised children in the world and kills quickly. Noma is most prevalent in sub-Saharan Africa, though cases have been detected in the US, south-east Asia and South America. It has been recognised for more than 1,000 years and emerged in Europe in concentration camps during the second world war.

Noma starts as a sore on the gums and progresses rapidly, destroying the soft tissues, bones, hard tissues and skin of the face. Without treatment, noma is fatal in 90% of cases, according to the World Health Organization.

Children aged two to six living in extreme poverty with weakened immune systems from malnutrition are most at risk and can die within weeks of the first sore appearing. If they make it to a health facility and survive, they can be left with severe facial disfigurements that hinder eating, drinking and speaking. Where noma is detected early it can be simply treated with antibiotics.

Noma is entirely preventable. When a child has enough food and clean water, the disease is unable to thrive, and is therefore often called “the face of poverty”. That it exists at all is a sign of how society has failed, says Dr David Shaye, of Massachusetts Eye and Ear, who has operated on hundreds of noma survivors in Nigeria. He says: “Noma is a canary in the coalmine indicator of where there are systemic problems with society. It’s a disease of poverty.”

Dr Bukola Oluyide, deputy medical coordinator Nigeria for Médecins Sans Frontières (MSF), says: “It is assumed to be no longer in existence. Where we see it is where we have poverty and no health centres. It’s only when children are almost on their deathbed with another illness that they [are taken] to a healthcare facility … People do not know they can receive care in the early stages.” Healthcare professionals often miss it completely, she adds.

The WHO estimated in 1998 that there may be up to 140,000 cases a year, and 770,000 survivors of the disease.

Noma: the hidden childhood disease known as the ‘face of poverty’ | Global development | The Guardian