Very little is known about the Buruli's ulcer. It is found near stagnant water but how it is transmitted to the human body or why the immune system cannot fight it is still unknown. It often develops without a person knowing - or realising the seriousness of the condition. The arms and legs are often where the Buruli ulcer manifests. Early stages can be a sense of swelling under the flesh. But as there is often no fever, pain or other indicators of trouble, many people do not seek help, thinking the problem shall pass. Left without medical care, the lesions can develop into enormous swelling and skin lesions where surgery - often drastic - is the only possible action. In the worst cases, most of the skin, the subjacent fabrics and even of the bones can be completely destroyed.
There is no effective treatment. The only solution at the present time is to cut away the infected parts. If caught early enough, this can be little more than minor surgery. However at an advanced stage, skin grafts, similar to what is done for serious burns, can be necessary. At times, if the condition has developed with no treatment, amputation maybe necessary.
Severe surgery, and obviously amputation, can leave a person handicapped. It is not always successful. In up to 30% of the cases, the Buruli ulcer reappears after surgery. In addition, major surgery is very expensive and can represent a major financial burden on the national health systems.
Research to assess the effectiveness of antibiotic treatment is urgently needed. If successful, this may drastically reduce the cost of treatment that currently, is limited to surgical procedures. WHO has therefore developed in 1998 the UN Buruli Ulcer Initiative in order to set the disease as one of the priorities.
In the first stage, the hospital of Akonolinga will be equipped with the necessary surgical instruments. An MSF logistician will organize the basic restorations required to bring the facilities to the required level - including a permanent supply of running water in the operating room.
An MSF nurse will train the hospital personnel regarding hygiene, cleaning of the wounds, choice of therapy, and other techniques. An expat surgeon will coordinate the surgical operations and train the hospital doctor incrementally so the hospital staff can eventually take on the responsibility for the surgery.
In a country where the medical care if usually a fee-based service, this treatment, including the hospitalisation, will be free, thanks to an agreement MSF has negotiated with the Cameroon government.
ALES will run the information component of the project in order to sensitize the population and health officers in order to detect cases in an earlier way.
ITS (Basle Tropical Institute) showed an interest in the research part of the project, concerning confirmation and treatment follow up.
© Isabelle Andrieux-Meyer/MSF - 2001
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There is no effective treatment. The only solution at the present time is to cut away the infected parts. If caught early enough, this can be little more than minor surgery. However at an advanced stage, skin grafts, similar to what is done for serious burns, can be necessary.