Why are we there?

  • Endemic/epidemic disease

Our work

This is an excerpt from MSF-USA's 2013 Annual Report:

Buruli ulcer is a tropical disease that destroys skin and soft tissue, usually on a person’s arms and legs. This can cause secondary infections, restrict their movement, and cause permanent disability and scarring if left untreated. If the disease is detected early enough, the majority of patients can be cured with antibiotics, although surgery may also be necessary. It is still not known exactly how Buruli ulcer is transmitted. About half of those in Africa suffering from the disease are children.

People with suspected Buruli ulcer in Cameroon are examined and laboratory tests are performed. When positively diagnosed, they receive antibiotics, wound dressing, surgery and physiotherapy at the Buruli ulcer ‘pavilion’ run by MSF in Akonolinga hospital. HIV testing is routinely offered to all patients; 12.5 percent of people entering the program during the year were found to have HIV, nearly triple the estimated population prevalence. Those who test positive receive comprehensive care for both diseases. In total, the team treated 188 people with chronic wounds resulting from Buruli ulcer, applied more than 15,800 surgical dressings, admitted 48 new patients, and carried out 78 surgical procedures.

Since November 2011, research has been underway to facilitate diagnosis of Buruli ulcer in those resource-limited countries where it has a high prevalence. The aim is to provide health professionals with an easy-to-follow diagnostic grid for identifying cases. The first phase of the study was completed this year, and in total 370 patients have been enrolled.

The HIV program in Douala was handed over to the Ministry of Health in April, with tenofovir having been adopted as the first-line treatment.

Wound dressing at MSF’s Buruli centre in Akonolinga.© Marcell Nimfuehr /MSF

At the end of 2013, MSF had 79 staff in Cameroon. MSF has been working in the country since 2000.

Patient story

Natasha, 24 years old, was admitted to the Buruli program in 2007, with an ulcer on her left ankle. Five years later, she talks about her experience.

"In 2000, while I was back home in Akonolinga, I noticed I had a little spot on my left ankle. I ignored it, thinking it was a mosquito bite.

Several days later, a wound formed. My parents put a dressing on it and it healed. At least, I thought so.

But months later the same wound reappeared. We treated it at home again, like the first time, but it didn’t heal. In fact it got bigger, but strangely it didn’t hurt.

We went to the hospital, where a nurse dressed the wound and prescribed antibiotics. After two weeks, a yellow layer formed above the wound. That was when the nurse mentioned ‘Atom’ [the local name for Buruli ulcer]. He told us to go to a traditional healer he knew.

MSF hadn’t arrived yet, and we all strongly believed that Buruli ulcer could not be treated with medicines. For us, it was a mystical disease. My family and I were convinced that people who were jealous of my success in sport had sent me the disease.

So we visited the traditional healer, and I stayed there for four long months. My wound did not heal. I did not know that in the meantime MSF had come to Akonolinga to treat Atom. But one of the Buruli Pavilion nurses, who knew my father, saw that I had the disease and persuaded us to come to the hospital.

When I arrived and saw the other patients, with much larger, much more painful sores than mine, even children with the disease, I thought that maybe I was in with a chance.

It began with dressings and injections. But it quickly became a question of surgery. They were talking about debridement, grafts, and I didn’t understand anything.

The first operation went smoothly, but when I went to have the dressing changed, I nearly fainted. The sore was even bigger. I went into surgery with a small wound, and had come out with a bigger one.

I was certain it wouldn’t heal, and that they would amputate my foot. I was convinced I would never walk again despite everything the nurses said. I didn’t believe them any more.

But hope returned. Yes, some ugly scars were forming, but nothing had been amputated, I could hope to use my foot as before, and my case was not the worst.

I continued my treatment and after a bit more than a year I was discharged. I was cured! We had known it was impossible in the hospital, but it had worked for me.

Sure, I’ve missed several years at school; I think I’ve done one class three or four times! But I have been cured.

Gradually I was able to walk again and one year after leaving hospital I was even able to run. Not as fast as before, admittedly, but I could run, and that was a victory for me.

Today I am preparing for my final exams in communication, and for my wedding!

I don’t go back to Akonolinga as often as I used to, but when I do, I don’t forget to go and say hello to the MSF team."

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