Doctors Without Borders estimates that noma affects 140,000 children each year. Without treatment, 90% of victims die within the first two weeks. The disease is rapid and painful, and it leaves those who survive with traumatic and often life-impacting injuries. It is also easily preventable and treatable. Here is everything to know about noma, the disease that should not exist.

What is Noma?

Noma, also known as gangrenous stomatitis, is a rapidly progressive bacterial disease that affects the mouth, nose and lips. It is most commonly found in sub-Saharan Africa and mainly affects children, with most cases occurring under the age of 10. If detected at an early stage, noma is easily treatable through basic hygiene, antibiotics and nutrition.

The Symptoms

The word noma stems from the Greek word “nomē,” meaning “to devour,” and looking at the disease, it is easy to see why. The disease starts in the mouth, with gingivitis developing in the gums over one to two days. In three to four days, ulcers develop within the mouth, along with swelling in the gums and cheeks. These ulcers spread rapidly and before the end of the week, the disease begins to eat away at the soft tissue within the mouth and cheeks, leading to a hole developing in the face. The infection continues to spread over the following days and gangrene sets in in the affected areas, causing devastating damage to facial tissue and bones. Depending on where the infection began, the jaw, lips, cheeks, nose or eyes are quickly destroyed, leading to severe disfigurement and life-threatening impairments.

The Causes

The exact cause of noma is unknown, but certain factors can influence the development of it within patients.

• Malnutrition: Malnutrition, particularly severe protein malnutrition, often occurs in the victims of noma.
• Hygiene: Like most diseases, the chance of noma drastically increases for people who do not have access to clean living conditions and adequate sanitation.
• Previous illness: The risk of developing noma also increases with the presence of prior diseases that cause immunodeficiency, such as HIV, tuberculosis, measles or scarlet fever. A compromised immune system is a common precursor to developing noma.
• Living in a developing country: Many of the risks listed above are factors that impact people living in a developing country every day. Add to this the lack of medical infrastructure and treatment available, and the risk of noma developing becomes much more likely.

The Fight Against Noma, a Disease That Should Not Exist

Noma, a disease that should not exist, has left a devastating mark on many children and adults in developing countries, both mentally and physically. There are, however, those out there who are fighting to lessen the impact of the disease. Medecins Sans Frontieres (MSF), supports one of the world’s only dedicated noma hospitals. Based in Sokoto in Northern Nigeria, the hospital is a haven for victims and survivors of noma.

Founded in 2009, the hospital offers four main components of care. They offer intensive care, such as wound treatment, medication and oral hygiene. It also offers continuous care, such as surgical interventions and post-operative care for survivors. Finally, it offers integrated hospital and community-based services that provide support for patients and lessen the stigma that often comes with the facial disfigurements left by the disease. The hospital admitted nearly 500 patients between 2014 and 2019 and continues to help those in need today.

Through continuous efforts, hopefully, noma will disappear completely. Until then, MSF is making a significant difference.

– Jodie Donovan
Photo: Unsplash