What is Noma?

15 March 2016


Nomahappily most people in the world won’t know what that word means. That’s a credit to the health care systems across the world and the nutrition improvements that have happened in so many places.

But in the remaining very, very poor countries where malnutrition is a major issue as it is here in Madagascar, noma causes devastation to individuals, families and their tribes.

Noma is an opportunistic bacterial infection. It’s caused by the same bacteria that live in our mouths and noses but our immune system keeps those bacteria at bay, keeps them under control.

If you are weakened by malnutrition or a general systemic illness like measles, if you survive that when you recover and are already in a malnourished condition then the bacteria gets the upper hand. In a period of two or three days you have this rampant infection that spreads from around the teeth or around the nose into the tissues of the face.

It destroys the soft tissue. The destruction happens between 7 and 10 days and then after that whatever has died sluffs away. The bone underneath is exposed, it dies and it sluffs away. You’re left with these horrific defects.

Sometimes you’ve just lost your lips, which is bad enough. Other times you’ve lost your lip, your cheek, your nose, your eye. Big holes in your face that are terrible.

90 percent of the children die, 10 percent survive. Who we see are the survivors. Sometimes they’ve had noma when they were three or four and we meet them when they’re 40.

They’ve been living without their nose, without their mouth, without their cheek for all those years. Hiding away, coming out at night to get food because the stigma is so very severe.” – Dr. Gary Parker, Chief Medical Officer, Africa Mercy

Mercy Ships performs numerous reconstructive facial surgeries on noma victims, affording them a chance to lead normal lives. We contribute to the eradication of noma through community health education, dental programs and water and sanitation teaching. Poverty, malnutrition, poor oral hygiene, lack of sanitation, and diseases, particularly measles, all contribute to the risk of noma.