At the Nomo Children’s Hospital at Sokoto in Nigeria (750 km from Lagos), Dr James Jesudasan, a Chennai-based maxillofacial surgeon, stood poised over the one-and-a-half-year-old boy with a scalpel in hand. It was a routine biopsy. The boy had a swelling on his face that looked like a tumour. On either side of the doctor were his colleagues Julia Amando of Brazil and David Shaye from the US. Suddenly James paused and tears rolled down his face.
Julia looked at James and said, “What’s wrong?” James shook his head, “I can’t. Will you do it?” Julia did the biopsy within two minutes. Looking back, James, 36, says, “The boy had a look of fear and anxiety. I suddenly remembered my five-year-old son. Maybe, that caused me to tear up.”
James was in Sokoto at the behest of Médecins Sans Frontieres (Doctors Without Borders), the international NGO that works in conflict zones and in countries affected by epidemics. He was there to deal with children who had been afflicted by a disease called Noma, a bacterial infection which occurs because of excessive malnutrition in poverty-stricken countries. It starts off with a blister in the mouth which develops into ulcers. Soon, the tissues degenerate and the surrounding tissue hardens. As a result, the jaw gets locked and eating becomes difficult. A huge opening is formed in the area of the nose and mouth.
James’s brief was simple: Repair faces, restore dignity, and unlock jaws so that the children could start eating again. “Along with the plastic surgeon, we can only reconstruct about 70 percent because we are working in a primitive area using basic equipment.” The healing process can take up to six weeks. “Since we come for three weeks at a time, another team will carry on the work,” says James.
It takes years before some semblance of normality can be brought back to the face. But what brings joy is to know that the children can start eating. Not surprisingly, they are extremely grateful. On his last visit, in October, they prepared a poster, titled ‘James’. It had stars, heart emojis, and butterflies. Pressed on each drawing was a child’s thumb impression in red and their names. “I was moved,” says James.
The doctor rues the fact that not many people know of Noma. In order to create awareness, on November 19, International Noma Day was organised in the federal capital of Abuja. “Hopefully, government funding will start flowing to the affected areas,” says James. For him, it has been a transformative experience. “I have learned to value life,” he says.