Twice a year, an international team goes to the impoverished African nation to perform transformative facial surgery on social outcasts, says Tony McNamara
TOMBUKI is a 35-year-old Ethiopia man who suffers from a devastating condition called noma — it results from an untreated oral infection and causes horrific facial deformity.
Such is the shocking appearance of the condition that, frequently, other members of the village community
banish the unfortunate sufferer. That can have calamitous consequences for him or her.
The Ethiopian health system is underdeveloped, so there is no service for people such as Tombuki.
People like him are isolated in a country that is almost biblical in its lack of development. Families in rural areas live in mud huts with their animals.
In rural Ethiopia, people practise witchcraft, unaware of modern medicine for cures, let alone having access to the healthcare we take for granted in this part of the world.
In addition, there is widespread illiteracy and patients often do not know their age — in planning surgical operations, it is essential to take account of age and previous medical history.
The people of Ethiopia were, tragically, brutalised for decades under the leadership of Emperor Haile Selassie, who was ousted in 1975, only to be replaced by a brutal military leadership (the Derg).
According to Amnesty International, they killed at least 500,000 Ethiopians, before they were replaced by representatives of the largest of the nine Tribes in the country.
As a result of these political crises, which lasted 60 years, public services and administration have stagnated and the health service is many decades behind what might be considered a basic provision.
The recent election of a new prime minister, Abiy Ahmed, is being seen as an opportunity for change. Time will tell.
In the past few weeks, seven doctors and nurses from Cork University Hospital have been part of a team of 20 international personnel operating on 30 patients such as Tombuki, under the umbrella of a British charity, called Facing Africa.
These patients are being given hope and the expectation of inclusion in their society again.
The charity, led by retired entrepreneur Chris Lawrence and his wife, Terry, has successfully completed 10 such missions and has treated 500 patients who suffer from noma.
The charity employs two staff, one of whom spent eight weeks in Cork University Hospital earlier this year, being upskilled.
Their primary focus is to seek out people in rural Ethiopia who have noma and to tell them that there may be a cure for their condition.
This is a particular challenge, considering that such people are illiterate and depend largely on witchcraft for their healthcare.
Clearly, there are ethical questions for the charity in deciding, with clinical advice, which patients should be offered the opportunity for treatment and which should not.
Twice a year, an international team is assembled, consisting of plastic surgeons, anaesthetists, and nurses, who volunteer.
I have just witnessed their incredible skill and capacity to function as a first-class team, providing excellent care to these unfortunate patients.
In preparation for each of the two missions per year, the charity contracts for the use of operating theatres, beds, and other essential resources.
One can only be impressed by the incredible compassion and professionalism of the work of the charity.
It is no small task to organise the assessment of patients for surgery in the weeks prior to the team arriving in Addis Ababa, to provide the surgery and immediate post-operative care, and then to provide care for the weeks prior to the patient being discharged back to their village community.
The charity purchases accommodation in a centre run by the Cheshire Foundation, where patients are prepared for surgery and cared for thereafter. I visited the facility, where one of the nursing team from Cork University Hospital has been working as part of this mission and witnessed the professionalism, empathy, and care shown by the entire team, led by the staff from CUH.
Indeed, it was heartening to see the patients making a full recovery and to be able to witness the gratitude that those patients have for the opportunity of a new life, following facial reconstruction.
In the western world,we live in a society that is increasingly characterised by a ‘me only’ attitude. There is an increasing sense of entitlement, without a commensurate commitment to giving of one’s time to help those less fortunate.
The vast majority of the 102m people of Ethiopia will never experience a life that is more than day-to-day survival in the most awful circumstances. We should be exceptionally proud that the team from Cork University Hospital and Facing Africa are leading a specialist service for Noma patients and, in the process, are exemplifying the very best of our outstanding healthcare professionals.
Tombuki is a very fortunate man, having made the journey from the affliction of Noma to being ‘found’ in a
remote area of northern Ethiopia and then being offered the opportunity to have a life-changing operation.
We should be very proud of the part played by our colleagues in changing his life and the lives of many others.
Facing Africa facingafrica.org
Tony McNamara is the chief executive of Cork University Hospital