I’ve hesitated to write medical blogs so far, mainly due to the fear of inadequate portrayal of the patient’s story or the conditions of this place. However, I really want to share this child’s story because her condition is not well known. She has a forgotten disease. Something that’s not taught in American medical schools. A disease that I only heard about half way through my surgical training. A disease that only affects very poor and malnourished children. DISCLAIMER: the picture below may be a bit disturbing to some people (used with permission from patient's mother).
Rejoice is a 3 year old girl. She weighs 17 pounds. She came to us severely malnourished a few months ago. She was profoundly anemic, with a huge wound of the nose and palate. We diagnosed her with noma, also known as cancrum oris. Noma only exists in very poor, malnourished children, usually aged 2-6. The child’s malnourished state leads to immunocompromise. After this, the normal flora of the mouth and/or nasal cavity cause an invasive, necrotizing infection. The children that survive noma are left with horrific facial deformities. This girl has a large defect in the palate with very little of her nasal septum left. She’s currently receiving care aimed at improving her overall nutrition, and we will address the reconstruction of her wound at a later date.
Noma is called ‘the face of poverty’. This disease particularly strikes me because despite it’s toll on many children, it is not mentioned a single time in my 3,000 page ENT textbook. I reflect on my own perception of the poor. Kelly and I often tell each other that it’s easy to forget the poor. It’s true. They often don’t have a voice to represent them, and they seemingly have little to offer society. For most of us, the poor don’t just show up on our doorstep, and they may be easy to avoid. Of course, when we consider the example of Christ, we see the exact opposite. He knew where the poor were. He did not avoid them. He knew what they needed most (Himself) and he provided for their physical needs. He loved them well. He saw the eternal value of the poor when he declared that the woman who donated two copper coins had given more than the wealthy that give out of their abundance. As I continue to treat the poor here, I’m hoping for this type of attitude.
Please pray that Rejoice would gain weight and be healed!
