The changing face of a disfiguring disease (From York Press)

The changing face of a disfiguring disease

10:47am Monday 13th February 2012 in Health & Wellbeing By Richard Catton, richard.catton@thepress.co.uk

THE huge medical advances of the 20th century have done much to consign many terrible illnesses and afflictions to the history books in Europe and the West.

Diseases such as cholera or scurvy, whose very mention would have been enough to strike fear in to the hearts of our Victorian ancestors, now seem absurd to us as possible modern day complaints.

Noma, a cruel and disfiguring disease which was all but wiped out in Europe at the end of the 19th century, continues to plague those West African nations where, such as in the case of Ethiopia, there may be only two doctors for every 100,000 people.

One of the cruellest things about an illness like noma is that it strikes the very youngest, either killing them or leaving them with horrific facial disfigurements, leading to a life undercover hiding from society.

The Facing Africa organisation has been sending teams of surgeons and medical workers in to Africa since 2000, to seek out those worst affected by the disease and to offer the corrective facial surgery that those affected could never hope to undergo in the own country.

Anthea Etches, a 47-year-old theatre manager at York Nuffield Hospital, has been swapping the clean and sterile wards of her regular workplace to travel to Addis Ababa for five years.

She now pays regular visits with Facing Africa and her husband Mick, to help out and co-ordinate the life-changing work.

She said: “We were invited to join one of the trips in 2007 because a consultant we worked with in our previous post had gone to Nigeria where they were also treating this condition.

“There was no question about not going over there.

“The first time was an eye-opener. We had seen pictures before, but it was different when you see it live, so to speak.

“Our first trip was to Addis Ababa. You never see anyone with facial disfigurement in England like you do out there. And you tend to find the patients are hidden away in their villages.

“It’s mainly young children. They are living in poverty and what starts off as a tiny insect bite turns into effectively gangrene. Only one in ten survive the actual infection, and if they survive the initial infection, they are left horrendously scarred.”

According to Facing Africa, there are about 14,000 survivors each year, most of whom will be grotesquely disfigured for the rest of their lives. Their facial deformities can be extensive, which in turn invariably causes social isolation and immense distress.

The charity tells of one boy aged eight who was asked why he was so happy and smiled all the time following facial reconstruction.

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”.

Such 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 and remote village in sub-Sahara Africa.

However, the work which goes in to achieving such outcomes takes a lot of expertise and skill.

Anthea said: “It’s major major surgery. What they need to do is what they call a rotation flap from underneath their chin to repair the face.”

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 just £800.

It is hard, however, to put a price on how the surgery can change a person’s life.

Anthea said: “It’s amazing. I have been on five trips and sometimes patients come back for minor corrective surgery and they come back with smiles on their faces. They don’t have to walk about with scarves over their heads.

“Some of the girls have got married who would never have got married before. They are just mixing with people again.

“You can’t communicate with them because they speak a different language, but the look in their eyes tells you everything.”

According to the World Health Organisation (WHO), noma may be on the increase in various African countries. Struggling economies in West Africa are impairing the health and wellbeing of children through increasingly overcrowded conditions, deteriorating sanitation and inadequate nutrition.

Food supplies in some sub-Saharan countries have declined over the past decade and many people are afflicted by severe chronic malnutrition. The picture is further complicated by increasing numbers of armed conflicts, the AIDS epidemic and high-level corruption.

If you would like to help by donating money, or would like to apply to become part of a medical team for a two-week trip to Africa, go to facingafrica.org