Known medically as Cancrum Oris, Noma is a brutal bacterial infection that attacks the faces of children, often within days of onset. Without swift intervention, it kills 90 per cent of its victims , most of whom come from the poorest corners of Nigeria and neighbouring countries. Those who survive are left with gaping facial wounds, unable to speak, eat properly, or accepted by society.
Yet, amidst the devastation, Sokoto State has become a quiet sanctuary of healing for the vicims. In collaboration with Médecins Sans Frontières (Doctors Without Borders), the state government has made Noma Children’s Hospital a regional hub for complex reconstructive surgeries.
Twice a year, teams of highly skilled plastic and maxillofacial surgeons fly in from Europe , not for fame or fortune, but to rebuild what disease has stolen: dignity, functionality, and a child’s chance at normalcy.
Dr. Isah Shafiyu of the NOMA Children’s Hospital in Sokoto describes the disease as a severe facial infection that typically begins in the gums and spreads to the soft tissues of the face. “It destroys not just the flesh, but also the bone and surrounding structures.
He said the disease mainly affects children between the ages of two and seven, and can strike anywhere on the face, whether the cheeks or the central parts of the upper and lower lips.
Beyond the physical damage, Dr. Shafiyu highlights the intense social stigma survivors endure. He said, “Many struggle with basic functions like eating, having to maneuver food into their mouths to swallow. Others face speech difficulties. But despite their facial deformities, their minds and thinking abilities remain intact.”
Some medical expert from the Sokoto facility who spoke to LEADERSHIP weekend said, “Nose reconstruction is generally not advised for children between the ages of two and four, because the reconstructed nose may not grow proportionally with the rest of the body.”
They said children in this age group are usually asked to return for corrective surgery between the ages of eight and ten.
LEADERSHIP Weekend further gathered that although NOMA is a treatable disease, it has long been made deadly by the dual challenges of poverty , malnutrition and ignorance. For the few who survive, the battle doesn’t end well , as they are often left with deep, lifelong scars.
Father of a NOMA survivor,
Malam Namanso Abubakar, expressed deep gratitude to the Sokoto State Government and the Médecins Sans Frontières (MSF) medical team for the life-changing surgery that saved his son.
Recalling the ordeal, Malam Namanso said, “At first, we thought it was just a regular fever when my son developed a high temperature and swelling on his left cheek. Seeking medical help early was what truly saved him.”
He explained that they were referred from a primary healthcare center to a general hospital, and eventually to the NOMA Children’s Hospital. “We thank Allah the surgery was successful. Though the disease left a scar, my son is alive, eating well, living normally, and now learning a trade,” he said with relief.
“In gratitude to Allah, the Sokoto State Government, and the MSF medical team, I’ve become an advocate, spreading the message that NOMA is preventable, treatable, and not contagious,” said Malam Sani Ilella, a father who has turned his pain into purpose.
Malam Sani Illegal, who lost his seven-year-old daughter to the disease, shared his regret over not knowing earlier that NOMA could be treated. “By the time we noticed a hole forming in her upper lip, I was too discouraged to seek medical help he recalled. Everyone around us believed it was a strange spiritual affliction. They advised us to seek spiritual, not even traditional, healing.”
He said, “To avoid the stigma of being seen as parents of a child with a strange, spiritual affliction, my wife and daughter had to relocate to another village. They kept to themselves, away from the prying eyes of neighbours, and resorted to traditional remedies.
Tragically, he said, the condition worsened. “Not long after, my daughter died in excruciating pain because chewing and swallowing became nearly impossible. It was only after her death that I learned the disease was not spiritual, but treatable. I met a survivor who opened my eyes.”
“Had I known there was medical help and free a free one at that, maybe my daughter would still be alive today,” he added, his voice heavy with regret.
On her part, a NOMA survivor, Mulikat Okanlawon, now dedicates her life to spreading awareness beyond Nigeria’s borders. In a somber tone, she told LEADERSHIP Weekend, “People are still in the dark about what NOMA really is. Many still believe it’s a curse or a punishment, and that ignorance continues to kill.”
She explained that , “The disease thrives because of negligence and a lack of awareness about what it truly is. With more education and focused attention on NOMA, it is a disease that can be eradicated,” Mulikat emphasised.
“I was once a victim. But after the corrective surgery, I now socialise and live like any other person. Anyone suffering from NOMA should never lose hope. They should come to the NOMA Hospital in Sokoto, and they will leave better than when they arrived.”
The project manager of Medicines Sans Frontiers (MSF), John Canty , identified the high rate of malnutrition as a major factor driving NOMA in Nigeria.
Carry explained that , “NOMA is a neglected disease that primarily affects those living in poverty. It is infectious but not contagious, starting as an inflammation of the gums.
The infection destroy the bone and tissue very quickly, affecting the jaw, lips, cheeks, nose or eyes, depending on where the infection started. Up to ninety percent of people die of NOMA in the first two weeks, if they don’t receive treatment on time.
“For those who survive, they are left with facial disfigurement, rendering it difficult to eat, speak, see or breathe. Survivor are also frequently stigmatized and left to face stigmatization and social isolation.
“NOMA mostly affects children under six years old. It cause is unknown but risk factors are malnutrition and poor oral hygiene, compounded by co-morbidities such as measles and malaria.”
The project manager further said, “NOMA is treatable and preventable, it should not exist. If detected and managed during the first weeks of the disease, with basic oral hygiene, antibiotics and and wound dressing, a patient can recover from NOMA within a few weeks. However, preventing NOMA demands knowledge about the disease and its treatment.
“Moreover, good nutrition, oral hygiene, access to healthcare and vaccination against childhood diseases are all needed to prevent NOMA.”
He noted that specialised care for NOMA is now available in Nigeria at the NOMA Children’s Hospital in Sokoto, one of the few dedicated facilities for the disease globally.
LEADERSHIP Weekend findings further revealed that since 2014, Médecins Sans Frontières (MSF), also known as Doctors Without Borders, has supported the hospital with specialised surgeries.
Records have it that between 2014 and now, MSF has conducted 1,481 reconstructive surgeries on 953 NOMA patients at the Sokoto facility. Active in Nigeria since 1996, MSF currently provides free medical care across 11 states. In a significant milestone, NOMA was added to the World Health Organization’s (WHO) list of Neglected Tropical Diseases (NTDs) in 2023, following years of advocacy.
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