BURULI ULCER  (M.ulcerans infection)

Buruli ulcer is an emerging disease in tropical areas. The infection seems
to be spreading widely and rapidly, especially in West Africa and
particularly in Benin. It also has a long history in East Africa. Other cases
have been reported from Malaya, Mexico, New Guinea and Australia and
it would be reasonable to suppose that the condition is widespread in the
tropics.
 It is found mainly among children and young people who live in
river valleys or near swamps or lakes, or whoever spends their time in
and around water.
  The predisposing cause is thought to be environmental. The massive
increase in frequency of Buruli ulcer seems to be associated with the
hydrological changes made for improved irrigation and the production
of hydro-electric power. It is also likely that other conditions
increased by the hydrological changes, such as infestation with the
flatworm Schistosoma, may undermine the immunity of the population
making them more susceptible to Buruli ulcer.
This chronic infection begins with a small painless nodule, usually on the
arms or legs or any part of the body that is normally uncovered. The
early pre-ulcerative lesion is painless, causes no problem and may be
overlooked by the patient. It is only in communities that are aware of
the significance of these early signs that treatment is sought (if available).
This nodule breaks down into an ulcer, which eventually heals, but in
the process leads to scarring and deformity and is a major cause of
crippling in some areas. In many cases among the children of Benin an
osteomyelitis of the long bones develops which can only be treated by
amputation.
At the present time there is no effective treatment except surgery.
A number of antibiotics have been used but with little effect. However,
if caught at an early stage and surgery and skin grafting are available,
there is a good chance of recovery with proper functioning of the limb
involved.  Even if there is effective surgical treatment the necessary skin
grafting may take months to heal, and this can drain family resources
among very poor people. If there is no treatment, scarring and deformity
are the usual result leading to a lifetime of disablement. During the time
that ulcers are healing the mothers of the child patients need to live
somewhere near to their children. They can massively disrupt the
workings of the hospital if a suitable place is not provided.

so Helen’s House has evolved into two wards for the treatment of patients. A small
school has also been added so that the children can continue their education while
in hospital.

To provide somewhere for families
to stay together, CHCT financed a
hostel at this rural clinic. This was
the original Helens House, named
after supporter Helen Trott who
had visited the area on a university
project shortly before her Death.
  At the time, long treatment was
necessary for the healing of the
ulcers up to nine months or a year
so somewhere to live was imperative.
With new techniques, the treatment
of Buruli ulcer has now moved on.
Operating theatre lights, surgical
and skin grafting instruments supplied
by the Charity make possible a much
briefer hospital stay for the children,

Project two: Centre Sanitaire et Nutritional, Zangnanado, Benin.

A set of surgical instruments and operating lights was provided for this
hospital to enable their increasing number of Buruli ulcer patients to

        Theatre lights and staff
Centre de Santitaire Zangnando,Benin

School in the ward at Helens house

Helens House