Recently we had a group of Swiss surgeons come to our hospital for a week-long camp, and we brought in a bunch of patients for operations. Most of the patients came for cleft lip or cleft palate repairs, and that is something that we regularly treat here. But a few of the patients came because they needed plastic surgery of a different kind – something much more extensive. They had faces that were disfigured by a disease called Noma.
I had never heard of Noma before coming to Niger, so don’t be feel bad if you haven’t either. Thankfully (surprise!) Wikipedia has got you covered. Since I had never heard of Noma before coming here, I was surprised to discover that it is so widespread. I shouldn’t have been surprised, of course, but it seems that I persist in believing that my knowing about something is what makes it important. Obviously, this is not true. My knowing about something is what makes it important to me.
Here in Niger, people know about Noma, not from Wikipedia, but from seeing it face to face. That is probably the best way to encounter it since words cannot really do it justice. Here is a short video from BBC that gives a good idea of what it looks like. It is really interesting and explains the causes of Noma and the treatment possibilities. Warning – it is not pretty.
One of the patients that came for the camp was Abdoul Karim, a 29 year-old man from a village near Zinder. Abdoul Karim and the rest of the patients came through a Swiss NGO called Sentinelles that does a lot of work with Noma patients. Some of the more extreme cases are flown out to Switzerland for surgery, but if the work can be done here, they often bring them to the CURE hospital, and we have developed a very fruitful partnership with them. They do excellent work.
Abdoul Karim developed Noma when he was only two years old, and although it was treated a long time ago, it affects were not. So he has basically spent his whole life with a face ravaged by infection. He told us that his life has been hard. He never went to school. He was rejected by everyone. Nobody would eat with him. His parents tried to arrange a marriage for him, but when they brought the girl to see him, she took one look at his face and ran away. He left home and went to Libya to try to find work, and eventually he did work as a gardener. He stayed there for two years, learned Arabic, and started to save up a bit of money, but then the civil war broke out. He came back to Niger and has been here ever since.
We spoke with Abdoul Karim before his operation, and he told us that he couldn’t wait for his surgery. He was very upbeat. He saw the other patients going into the O.R. and coming out a bit bloodied and sometimes swollen, but transformed. He was genuinely excited. After his operation, we came by to see him and ask how he felt, but he couldn’t answer us. The repair that was done on him was so extensive that his entire mouth has been sutured shut. His mouth stayed shut for about two weeks. He couldn’t talk, but I am sure he had a lot to say, and even though his mouth was closed, his face spoke for itself. He was happy and excited to go home. He indicated to us his excitement by giving us enthusiastic thumbs up every time we saw him.
Thumbs up is pretty universal.
It is hard to imagine that something as damaging as Noma can come from hunger. It is almost as though the body is so hungry that it starts eating itself. The fact that Noma can come from malnutrition and hunger is a real cause for concern, especially since there are signs of drought and famine on the way to Niger. But there is cause for hope as well. There is nothing more inspiring than seeing someone’s life radically changed for the better, and giving someone a new face is a huge change. We don’t see our own face very often, but it is the part of our body that defines who we are for most other people. Our face is our identity as far as others are concerned, and nobody knows that better than someone who has had Noma.
Abdoul Karim was a beautiful person before he came to CURE. You could tell even by spending a few minutes with him that he was kind and caring. But he spent his whole life being judged because of his face. I am so glad that now others will be able to see who he really is.