Noma

Noma is a disease of poverty. You will not find it in a developed country. It is a bacterial infection run rampant. Many times it occurs when a malnourished child has one of the common childhood diseases such as measles. With the additional insult to their immune system, the normal oral flora overwhelms the body's natural defenses and eats away at the flesh. It has a predilection for facial tissue. It will kill most of it's victims, those that survive will be scarred for life. I just goggled it and the world health organization fears that it is on the rise. While it could not be eradicated, a 10 cent vaccine for measles would greatly diminish the number of children afflicted by it. Unfortunately, the poor cannot even afford that much. The local people call it the melting disease. On Monday, you have a beautiful child, on Wednesday, his face has been destroyed, he no longer has lips, sometimes the nose is gone as well...that is, if he is still alive. A nurse with antibiotics could cure it if caught within the first 24 to 48 hours. Goggle it if you want to see the devastation it can cause. Most children die, those that survive live on the outskirts of society. They hide as much as they can. They are ashamed of their appearance.

Christine is the only Noma patient I have taken care of, and I had her the day she went to surgery. Please don't think I am heartless, but I want you to get a feeling for what these people live with every day. She truly defined the word "hideous". She had a hole in her cheek the size of a lemon. Saliva seeped out from it and from between her lips which she could not close because of her swollen gums. Her facial skin was drawn so that it caused her to not be able to shut her eye which was red and weeping. Without the push back of her lips and cheeks, her teeth were pointing randomly, some through the hole in her cheek, some out the front of her mouth. She would not look you in the eye. I first saw her as she lay in bed, facing the wall, covering her face with a sheet, a dirty rag clutched in her hand. As I would work with her, she would uncover herself (I learned that she used the rag to wipe at the drool), and whenever I was done, back went the sheet as she tried to hide herself. Over 20 years of rejection, pain, and suffering where reflected in her eyes. I saw no hope in them even as I prepared her for surgery. I think I wrote earlier how the surgeons took the temporalis muscle and made her a cheek and then grafted skin on top, many teeth had to be removed. I just spoke with the nurse caring for her tonight and she said that she was just looking at herself in the mirror. I wonder, how does it feels to her to want to look in the mirror? Slowly she is emotionally recovering. Dr Gary says that she is getting a little sparkle in her eyes, the eyes that had been so hopeless.

Mercy Ships saw a lot of Noma in Liberia, a country that has had most of it's infrastructure destroyed by many years of civil war. Thanks goodness, Dr Gary says that he has not seen nearly the number of Noma patients here in Benin. He says this is a reflection of improving health care. Let's pray that it continues to improve... that no more children will suffer as Christine has.

I am at work again tonight. It is my second night of 4. We always start out our handover with a prayer but tonight we had a special treat. Two of the translators had brought guitars and they, with several others, sang. Although, we may not have understood all the words, it was obvious that they where praising God. It was an awesome way to start the shift.

God is good all the time, all the time, God is good.