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Pa tar neng ye: Noma in Ouagadougou

Briana Evans
Class Year:

Early intervention with proper nutrition and antibiotics can stop this life-altering disease in its tracks—but only if nurses and doctors know what to do when they see the first signs.

This summer, I spent three months in Ouagadougou, Burkina Faso. The first part of my summer was spent learning a language, Mooré, while the second half focused on work with an NGO. A French-speaking country, Burkina Faso is home to 63 ethnic groups—each with its own distinct language. In Ouaga (as the capital is affectionately known), almost everyone speaks French, Mooré, and their own ethnic group’s language.

I quickly found that my French training had not prepared me for real life in a francophone country. While learning Mooré in French was an adventure, simple things–like trying to buy a can opener–proved to be the most difficult. However, with the help of new friends, I learned to find my way around–and to buy cans with pull tabs.

While I had been warned that no one in Ouaga speaks English, I encountered quite a few budding Anglophones–enough that I frequently had to remind people to speak to me in French or Mooré. Because few Americans visit the country, there is little current information available about it in English. This made the first night–arriving that evening at an unfamiliar airport, barely able to understand the accented French–particularly nerve-wracking. But it also made the first few weeks of exploration particularly exciting. 

The second part of my summer, with the NGO, was part of research for a senior thesis. This answers the question of why Mooré, why Burkina (my mom asks this question often: “Why so far away? Couldn’t you have at least chosen somewhere with nice beaches?”). My research centers around a disease called noma, a gangrene that rots away bone and muscle in the faces of malnourished children, usually under the age of six. In a matter of weeks, a small child’s toothache progresses to sloughing tissue and soon after to loss of entire areas of the face. In the months after the acute phase, infection can kill the child. Otherwise, scarred jaws can affect breathing and feeding ability, leaving the child to die from hunger. Even if the child survives these initial months, they face years of stigma as a “faceless” person.

You may be asking yourself why you’ve never heard of such a wicked serious disease. That’s part of what I want to know too. Practically, the issue is that (by conservative estimate) it affects only about 140,000 children in the world. These children are the poorest of the poor—malnutrition and poor oral hygiene are the two most common pre-existing conditions associated with the disease. Aside from the obvious basic solutions (eradicating malnutrition and ensuring good oral hygiene), awareness campaigns among healthcare professionals have proved effective in preventing noma. Early intervention with proper nutrition and antibiotics can stop this life-altering disease in its tracks—but only if nurses and doctors know what to do when they see the first signs.

Burkina is home to a host of NGOs fighting noma—and as far as we can tell, they’re winning.

In Burkina, most of the malnourished children come from the eastern region, where Mooré is widely spoken. Because these children come from families that live in rural regions and frequently don’t speak French, the children themselves are often more comfortable in Mooré. My basic training in Mooré was hardly sufficient for deep conversations, but it was enough to bond with my new little friends at the NGO as they taught me new words and laughed with (and at) the adult that spoke like a kid.

In Mooré, the phrase “pa tar neng ye” translates to “worthless,” but its literal meaning is “without a face.” Surrounded by children that have known hunger and pain in proportions of which I can barely conceive, I frequently thought of the rejection they suffered outside of the gated NGO compound. Outside of the NGO, many saw them as worthless–or worse, as dangerous. It was hard for me to imagine seeing these happy, playful kids as monsters—but that has long been the public vision of noma-affected kids. In the city, they are pitied. In the villages, they are feared.

As I left my friends at the end of the summer, I told them all “Wena ko d nindaare,” a farewell that means “God give us a future time.” I certainly hope that we do meet again. Burkina was a place a joy and learning for me and I look forward to the day when I can return.

child with noma