On the mend

For 17 of her 20 years, Flora Doume has hidden from the world. She was three when she became a victim of noma, a gangrenous disease that starts with tiny ulcers around the mouth and then spreads, often devouring lips, flesh and muscle. In Flora’s case, a growth covered her eye, then spread to the left-hand side of her face, forcing her to hide. Noma gets its name from the Greek word nomein, “to devour,” and is a bacterial disease that kills nine out of 10 patients, according to the World Health Organisation. The disease, with the Latin name cancrum oris, occurs mainly in young children with weak immune systems and destroys the mucous membranes of the mouth and other tissues, causing survivors to be severely disfigured, often with gaping holes in their faces. There are an estimated half a million cases around the world, most of them in Africa, says WHO. It can be successfully treated if identified in time, and if drugs and the right nutrition are available. “It’s a disease of poverty, of malnutrition, of people who live in poor hygiene conditions,” says a Spanish surgeon, Angel Emparanza, who specialises in facial surgery and who often travels across Africa to operate on patients with little or no access to health care. Picture shows Flora at a private clinic in Abidjan, Ivory Coast, after undergoing reconstructive surgery. AFP