MSF warns malnutrition exposes Nigerian children to Noma disease

Médecins Sans Frontières, also known as Doctors Without Borders, has warned that poverty, malnutrition and poor access to healthcare are leaving Nigerian children vulnerable to noma, a preventable disease that can destroy facial tissues and kill up to 90 per cent of untreated victims.

The international medical organisation urged the Federal Government to strengthen primary healthcare services, improve childhood nutrition and immunisation, and expand access to early diagnosis and treatment to prevent avoidable deaths and lifelong disabilities.

MSF Nursing Activity Manager, Samuel Ajamah, raised the concern while speaking with journalists in Sokoto on Monday, describing noma as a disease that exposes the deep inequalities in access to essential healthcare services.

He said the disease, which primarily affects young children in impoverished communities, often goes undetected until it has caused severe damage because of inadequate awareness, limited access to medical facilities and poor knowledge among some healthcare workers.

“Noma is a marker of inequality. Addressing it requires stronger primary healthcare, better nutrition, improved vaccination coverage and greater access to health services,” Ajamah said.

Noma is a severe, non-contagious disease that destroys tissues of the mouth and face. It often begins with bleeding gums before progressing rapidly to swelling, tissue destruction and severe facial disfigurement if treatment is delayed.

Ajamah explained that early detection could prevent the disease from advancing, stressing that children should receive medical attention as soon as the initial symptoms appear.

“If we can detect this disease early, for example, at the first stage when we notice bleeding, it is easy to prevent it without causing any damage,” he said.

He identified malnutrition, inadequate oral hygiene, low immunisation coverage, recurrent infections and limited access to healthcare as major factors associated with the disease.

According to him, children in remote communities are particularly vulnerable because their families often face difficulties accessing healthcare facilities, resulting in delays that could worsen their conditions.

The MSF official also expressed concern over the limited knowledge of noma among some healthcare professionals, saying the organisation’s study found that some health workers were unfamiliar with the disease.

“Even among health workers, awareness is still a problem. We did a study recently and found that some health workers were not aware of the disease,” he said.

He warned that inadequate knowledge could lead to misdiagnosis and delayed treatment, increasing the risk of permanent facial damage and other complications.

Ajamah, therefore, called for noma prevention, diagnosis and treatment to be integrated into primary healthcare services and medical training programmes, particularly to equip frontline health workers with the knowledge required to recognise early symptoms.

He also advocated the inclusion of noma in routine disease surveillance systems to improve case identification, reporting and referrals to specialised treatment centres.

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“Our advocacy now is for this disease to be integrated into the primary healthcare system so that someone in a remote village can walk into a nearby primary healthcare centre and get treatment,” he said.

Noma was recognised by the World Health Organisation as a neglected tropical disease in 2023.

However, MSF said sustained investment in prevention, awareness and treatment remained necessary to reduce its burden in Nigeria.

In Sokoto, the organisation has supported the state Ministry of Health in managing noma since 2014 through the Noma Children’s Hospital, a specialised facility providing medical treatment and reconstructive surgery for affected patients.

Ajamah said MSF provided free medical care, medication, nutritional support, physiotherapy, psychosocial assistance and reconstructive surgery, while also helping patients and their caregivers with transportation and feeding.

He disclosed that MSF performed 1,645 reconstructive surgeries on 1,078 patients between 2014 and 2025, while 1,034 patients received medical treatment and support in 2025 alone.

He added that 55 reconstructive surgeries were performed between April 17 and May 1, 2026, while another surgical intervention was targeting 40 patients at the hospital.

According to him, the effects of noma often extended beyond facial disfigurement, with some survivors struggling to open their mouths, eat properly and perform basic daily activities.

“Some patients cannot even open their mouths to eat. You will not appreciate the difficulty until you see them struggling to put food into their mouths,” he said.

Ajamah further explained that survivors frequently experience stigma and discrimination because of their appearance, with some children isolated from their peers and communities.

He said rehabilitation must therefore include psychological support and preparation for reintegration into society, in addition to medical treatment and surgery.

“It’s difficult for somebody who has been isolated for a very long time to be thrown back into society. A lot of work goes into preparing them before they are discharged,” he said.

The MSF official urged governments and communities to address the underlying conditions that expose children to noma, emphasising that early diagnosis, adequate nutrition, routine immunisation and accessible primary healthcare could prevent many of its devastating consequences.

“No child should suffer or die from a disease that can be detected early and effectively managed,” Ajamah said.