When 18-year-old Mamisy was a child, he lost his nose.. It was eaten away by a bacteria called “noma” and he has lived the majority of his life with a hole in its place.
When 20-year-old Hery was a child, he lost half of his nose and cheek to Noma and attributed it to witchcraft.
Noma has been described as the “forgotten disease of the poor”and gets it’s name from the Greek word “nemo” meaning “to devour”; and it does just that, it devours the face of its victim. It is a disease that affects those who are already living in extreme poverty. The infection is precipitated by malnutrition, dehydration, unsafe drinking water, and poor hygiene. It is a rapidly spreading gangrenous infection that starts as a small sore and if left untreated, quickly eats away the tissues of the face, leaving a hole. Noma usually affects children ages 1-6 and has a survival rate of only 10%. Those who survive are left disfigured with little hope of ever having their faces restored.
When 30-year-old Fernand tried to keep attackers from stealing his Zebu he lost his nose in a knife attack. (No pre-operative picture was available, but Fernand just had one large hole where his nose should have been)
Mamisy, Hery, and Fernand came to the ship missing the central-most part of their faces: the part that makes them look human.
Mercy Ships sees patients like these in pretty much every country they visit. Whether the nose is missing from noma or from trauma it’s not an easy feat to just “make a new nose.” Thankfully our surgeons have years of experience and have so much to offer these patients. Making a new nose is not a simple procedure and involves multiple surgeries. All three of these men have spent close to 2 months on the ward. The first procedure involves taking part of the patient’s scalp, shaping part of it into a nose, and attaching it to where the nose would be, all the while the scalp remains attached to the head to keep an active blood supply to the new nose. This scalping graft is left in place for 21 days.
Fernand’s scalp flap brought down to create a new nose
Fernand and Hery with their scalp flaps
These three weeks probably feel like ages to these guys. Usually one of their eyes is covered from the scalp graft and they get sterile dressing changes of their open scalp every other day. They see other patients on the ward coming and going, and some days are harder than others. However, this always proves to be such a rewarding time. We get to know these patients and their families, their personalities and their struggles. We walk with them through the tough days when they just want to quit and leave the hospital and we get to play games and laugh at them when they make querky remarks or dance around the ward. We change their bandages and then affix stars to spell their names!
After 21 days, the scalp is cut back from the new nose and returned to the head, leaving the patient with a new nose.
Mamisy shortly after his nose reconstruction
Mamisy spent extra time with us, as he also did not have an upper lip so one had to be made from part of his lower lip. He had a tracheostomy in place for most of his stay.
Now with three new noses, these guys are on their way to recovery.
Mamisy: This boy made us laugh more than most and was the typical 18-year-old mischievous boy. He couldn’t talk for the majority of the time he was on board due to his trach, but made up for it and his personality showed through in playing games, teasing the nurses and dancing around the ward. With the trach removed and his nose in place, here is Mamisy on his last day.
Mamisy
Fernand: He has been discharged from the hospital as well and will return to protecting his zebu with his new nose! This man could never be found without a smile on his face. Him and his wife had the most contagious personalities. They encouraged the other patients on the ward and I will never forget how excited Fernand was for Hery when it was Hery’s turn to get his new nose.
Fernand
Hery: He left the hospital this week to continue his recover at the Hope Center. This boy struggled more than the others with his time at the hospital. For years he had lived under the assumption that he was cursed. Our chaplain team has been amazing in counseling Hery through his bad days and teaching him about the hope of Jesus.
Hery
He also never went to school because of how he looked. Some of the nurses would come in on their days off and teach him to write and do math. It was so fun to see him studying every day on his own and practicing writing letters. I am so proud of this boy!
These three men became fast friends. They bonded over nose-less faces, scalp flaps, and lots of games of Jenga and Dominoes. Meeting each other they realized that they weren’t alone in their sufferings; now they leave, the last one just 2 days ago, with the realization that there is someone even greater who walks with them through suffering. A Father who will never leave them alone. He has healed them physically and I trust that he will continue to heal their hearts.
“He heals the brokenhearted and binds up their wounds. “- Psalm 147:3
All 3 guys at different stages of getting a new nose
Girl. Nurse. Ship. Africa. Dream come true 