Forth Phase

After about one week, the affected tissue dies off and falls off the face during the fourth and final phase of the disease. Attempt by the body to heal the open wounds via scars often leads to a locking of the jaws. This makes it very difficult or impossible to eat and many children starve during this phase. They cannot take in enough nutrition by themselves or are no longer allowed to share meals with others because of their disfigurements. Locked jaws are also dangerous because children can suffocate if they vomit. Only surgery can help at this point. Even if no external damage is visible, bones dissolve and lead to muscle damage.

At first, the locked jaws have to be opened again through an extremely difficult operation because of the closed mouth. Bone transplants are necessary in most cases and this can only be done in extensive operations in Europe. At the same time, tissue has to be transplanted as well to cover up damages in the face. If the remaining tissue in the face is sufficient to cover up voids, it is possible to conduct such operations in Niger.

We are very glad that in the meantime it is possible to operate patients in our clinics in Niger and Guinea-Bissau where tissue has to be transferred from the back or other body parts to cover defects in the face. By now achieved high standards in our hospitals and the good education of our doctors, these operations no longer have to be done in Europe. This saves costs and the Noma children don´t have to leave their country.

Fourth phase

Fourth phase