Free Noma Surgeries Offer Hope to Children in Northern Nigeria

In Sokoto, northern Nigeria, eight-year-old Ibrahim Dalhatu has undergone seven facial reconstructive operations since contracting noma at the age of three. His first surgery was performed in 2021 at the Noma Children Hospital in Sokoto state, and he has since had six more. After nasal fistula surgery, he can now eat and speak normally.

Noma is a fast-moving infection of the face and mouth. It typically begins as gum inflammation in malnourished children living in polluted conditions and can destroy soft tissue and bone within two weeks if left untreated. It mainly affects children aged two to six in poor communities. Early care involves antibiotics, wound treatment and improved nutrition; once the disease advances, surgery becomes necessary.

The World Health Organization classifies noma as a neglected tropical disease, meaning it attracts little global attention or funding. The agency has not updated its data since 1998, when it estimated 140,000 cases a year with a 90% fatality rate. A study published in July in The Lancet Global Health, drawing on data from the Sokoto hospital, recorded more than 50,000 cases across 12 northern Nigerian states between 1999 and 2024. A "noma belt" is known to stretch across Africa from Senegal and Mauritania in the west to Ethiopia in the east.

Doctors Without Borders, known by its French abbreviation MSF, carries out multi-stage operations free of charge as part of its work on neglected diseases. Parents say the surgeries have given their children a chance at a normal life. "I was very excited because I thought there was no solution to the disease," said Muhammad Dalhatu, Ibrahim's father, an Islamic teacher. "Before, I was worried about the cost of the treatment, but when I was told it was free of charge, I was so happy."

Health workers in Nigeria report seeing more noma patients. Bukola Oluyide, MSF's Nigeria medical coordinator, said the organisation is seeing more acute cases and is focusing on community awareness so families bring children in earlier, before tissue loss requires reconstructive surgery. Yuka Makino, a technical officer for oral health at WHO's Africa office, said research has identified 117 different microorganisms behind the disease, describing it as an opportunistic, polymicrobial infection. Experts say the main risk factors are extreme poverty and severe malnutrition; WHO calls noma a marker of absolute poverty, and the United Nations Human Rights Council says the conditions that lead to it amount to a human rights violation for affected children.

According to Makino, Nigeria reports more cases than other countries because of its specialist hospitals, large population and a government-led response that likely ensures more cases are recorded. Neither the federal Ministry of Health nor the Sokoto state ministry responded to a request for comment on plans to combat the disease.

At the Sokoto specialist hospital, more than 500 children from across northern Nigeria were treated between 2023 and 2025, according to data seen by the wire service. Others remain on waiting lists for the three surgical sessions MSF runs each year for children whose bodies can withstand the procedures. Dr. Abubakar Abdullahi Bello, the hospital's chief medical director, described the situation as worrisome, noting that the disease damages mouth tissue within a short period.

Not every child can access care. Nigeria has only two noma hospitals, including one in Abuja built in 2023. Maryam Sabiu's four-year-old son, infected in 2024, is on the waiting list. The disease has left a hole in his left cheek extending toward his left eye, but he is too young for surgery. He is in constant pain and cries frequently, and his mother breastfeeds him often to soothe him, which she said has brought her pain and stigmatisation. "I feel like the way people would stop and look at my child is one of the worst experiences in my entire life," she said.