Benin: 1998

International staff: 2 National staff: 10 TEAMS TREAT CASES OF BURULI'S ULCER Benin has no national health system. There is a lack of trained staff and modern equipment and preventive medicine is not widely practised. In September 1997, MSF began a project in Benin targeting an infectious disease known as Buruli's ulcer, caused by the development of a bacteria (Mycobacterium ulcerans) in the cutaneous tissues. BU affects a mostly young, rural population and appears to be spreading in West Africa, yet is little known to either medical personnel or the public. No medication seems to be successful and the most effective treatment is surgical removal and skin grafts. In collaboration with the Benin health authorities, MSF is setting up a specialised treatment centre integrated into Lalo health centre in Mono department (pop. 767,854), the region most affected by this disease. A specialised ward will offer hospitalisation for up to six months, although it is hoped that early diagnosis will reduce the time required. Training is given to nursing staff carrying out the very specific treatment required and to community health workers spreading information encouraging sufferers to present for treatment in the very early stages. MSF ensures the availability of the necessary drugs, medical and teaching materials, transport for patients and nursing supervision. The research aspect is conducted in collaboration with Antwerp Tropical Medicine Institute and aims to develop ways to reduce patients' suffering and fight the frequently occuring osteomyelitis for which amputation is the only treatment.