40 children undergo reconstructive surgery in Sokoto as agency warns against preventable facial disfigurement and deaths
Médecins Sans Frontières (MSF), an international medical humanitarian organisation, has urged the Federal Government and state authorities to integrate noma prevention, early diagnosis and treatment into Nigeria’s primary healthcare system, warning that delayed intervention continues to expose children to devastating and potentially fatal complications.
The appeal came as the Sokoto State Ministry of Health’s Noma Hospital commenced its final surgical intervention for 2026, with 40 children scheduled to undergo reconstructive procedures to repair facial damage caused by the disease.
MSF said the surgical programme underscored the importance of specialised treatment but also exposed persistent gaps in Nigeria’s healthcare system, where children often reach referral facilities only after noma has caused extensive and irreversible damage.
Noma is a rapidly progressing, non-contagious disease that attacks the mouth and face, destroying soft tissue and bone within days. The disease is largely preventable and treatable when detected early, but is strongly associated with extreme poverty, malnutrition, poor oral hygiene, inadequate immunisation and limited access to essential healthcare.
According to MSF, untreated noma has a mortality rate estimated at between 70 and 90 per cent. Survivors may suffer severe facial disfigurement, difficulties with eating, speaking and breathing, as well as lasting psychological trauma and social exclusion.
The disease primarily affects children under seven, particularly those living in disadvantaged communities with limited access to nutritious food, clean water and basic medical services.
For the 40 children undergoing surgery in Sokoto, the procedures represent an opportunity to restore facial movement, improve essential functions and rebuild confidence after living with the physical and social consequences of the disease.
However, MSF stressed that reconstructive surgery alone cannot address the underlying problem unless Nigeria strengthens prevention, early detection and access to treatment at the community level.
The MSF Nursing Activity Manager at the Sokoto Noma Hospital, Samuel Ajamah, said noma could be prevented and successfully treated if children were identified early and promptly referred for medical care.
“Noma is preventable and treatable. No child should suffer or die from a disease that can be detected early and effectively managed,” Ajamah said.
He explained that early-stage treatment could involve antibiotics, wound care, nutritional support and the management of underlying illnesses, interventions that could halt the disease before it progressed to extensive facial destruction.
“Recognition of noma as a Neglected Tropical Disease was an important step, but recognition alone is not enough. We now need practical investment in prevention, early diagnosis, and access to care,” he added.
The World Health Organisation classified noma as a neglected tropical disease in 2023, raising expectations that the condition would attract greater international attention, research funding and coordinated public health interventions.
MSF, however, maintained that the recognition had yet to translate into adequate action in Nigeria, where noma remains insufficiently integrated into routine child health services, disease surveillance and primary healthcare programmes.
Ajamah described noma as a “marker of inequality”, explaining that its continued prevalence reflected wider deficiencies in nutrition, immunisation, oral healthcare and access to essential medical services.
He noted that many affected children passed through several health facilities before reaching specialised noma centres, with some cases going unrecognised because frontline health workers were unfamiliar with the disease’s early symptoms.
In other cases, families lacked the information needed to recognise the warning signs and seek urgent medical attention.
By the time some patients arrive at the Sokoto facility, the disease may have destroyed substantial portions of their faces, making treatment more complicated and leaving survivors with permanent disabilities.
MSF therefore called for stronger training for frontline health workers to improve early recognition and ensure that suspected cases are promptly referred for appropriate treatment.
The organisation also advocated functional referral systems connecting rural communities and primary healthcare centres with specialised hospitals, alongside improved public awareness of the disease.
MSF reports over 1,600 reconstructive surgeries
MSF has partnered with the Sokoto Noma Hospital since 2014, supporting surgical interventions, rehabilitation and other comprehensive services for people affected by the disease.
The organisation disclosed that its teams performed 1,645 reconstructive surgeries on 1,078 patients at the hospital between 2014 and 2025.
In 2025 alone, 1,034 patients received comprehensive care, including surgery, nutritional rehabilitation, physiotherapy and psychosocial support.
The hospital also conducted a surgical intervention from April 17 to May 1, 2026, during which 55 reconstructive procedures were performed.
The latest programme involving 40 patients is expected to further improve survivors’ facial functions, physical well-being and quality of life.
The figures highlight the importance of the Sokoto facility as a specialised treatment centre for noma survivors, while underscoring the need to prevent more children from developing advanced forms of the disease.
MSF argued that Nigeria must move beyond periodic surgical campaigns and establish a nationwide system that identifies and treats noma before it causes extensive damage.
Call for nationwide healthcare integration
The organisation urged federal and state health authorities to incorporate noma services into primary healthcare delivery, particularly routine child health, nutrition, immunisation and oral health programmes.
It identified several priority measures, including regular training for frontline health workers on the early signs of noma, the inclusion of the disease in national surveillance systems and the establishment of effective referral pathways from rural communities to specialised treatment centres.
MSF also called for reliable supplies of antibiotics, wound-care materials and nutritional support, as well as stronger public awareness campaigns to encourage families to seek immediate medical attention when symptoms appear.
The organisation emphasised that sustained investment in nutrition, immunisation, sanitation and basic healthcare was essential to reducing the risk factors associated with the disease.
According to MSF, integrating noma prevention and treatment into existing healthcare services would improve early diagnosis, reduce complications and help ensure that children in underserved communities receive timely care.
It warned that without decisive intervention, Nigeria would continue to expend scarce healthcare resources on repairing damage that could often have been prevented through early diagnosis and relatively simple treatment.
As the 40 children undergo reconstructive surgery in Sokoto, MSF’s central message is that noma should not be allowed to progress unchecked in a country where effective preventive and early-treatment interventions are available.
The organisation maintained that tackling the disease requires a sustained national response addressing poverty, malnutrition, limited healthcare access and gaps in frontline medical services, alongside specialised surgery and rehabilitation for survivors.
