22 February 2009


Seventy years ago, when Benin was still Abomey, a Q-tip-shaped parcel of land wedged within French West Africa; when the memory of Portuguese slave ships was fresh and the mention of Dahomey warriors still struck fear; when Mohandas Gandhi was fasting, Adolf Hitler was attacking, Judy Garland was following yellow bricks, and John Steinbeck was writing about angry grapes—seventy years ago, when the world was declaring war on itself for the first time, Gbayi* got sick.

It may have been measles—it often is. The thing is, unlike others who got what he got, he survived, but the victory was unfortunately Pyrrhic: not long after, his lips fell off.

No, seriously. I've written about noma before, but it never ceases to amaze me. See, we all carry around in our mouths somewhere on the order of 800 species of bacteria, but, besides feeding on the detritus you leave behind when you don't brush your teeth (and lining the pockets of Procter & Gamble executives), these bugs do very little of dramatic import.

Except in noma.

In noma, an immune system weakened by a recently-fought-off infection becomes unable to contain the bacteria, and they're left alone, free to devour more than food.

Why they attack some patients and remain docile in others, I don't know. But seventy years ago, when the French were still guillotining people and Clark Gable was going with the wind, they ate Gbayi's upper lip. And part of his nose.

Gbayi is now 77 years old. Age has rendered him unable to walk—he was carried to the stadium on his son's back—and, seven decades later, his hands perpetually hover around his mouth, as if by doing so they can prevent the shame that has shadowed him since Einstein was researching atomic bombs.

And Gbayi was only one of over 2000 stories we saw in two days at the Hall des Arts, Loisir, et Sports this week (loisir, for sure: half the chairs in the stadium were brown—sometimes garish red—leather armchairs, incongruously defying the remaining wood-and-metal seats; they, I assume, are where the important people sit). Over the course of two days, patients who had begun lining up in the middle of the week wended their way through the sports stadium toward the surgical schedulers, who would give them a date for their surgery. Not everyone made it there, but we said yes far more often than we said no.

Massive tumors and goiters the size of watermelons, clubbed feet and contracted arms, burned faces and bowed legs, hernias, hydroceles, and fistulas—each accompanied by a story like Gbayi's.

Physical deformity, a lawyer once wrote, calls forth our charity. The need, as always, is greater than any group of humans can help. But that is perpetually a good reminder.

The first patients arrive on Monday. Pictures will be forthcoming, but, in the meantime, here's a six-minute video from the day (Gbayi shows up near the end):

*Not his real name

1 comment:

Ali said...

Well, if I can't be there, at least you're chronicling it all for me; more than anyone's, your writing sets me smack in the middle of Cotonou. It's going to be a lifeline for me in the next few weeks.