The threat from „Buruli ulcer“ is not the absolute number of afflictions. Annually, less than 20'000 persons are afflicted by it worldwide. However the consequences for the afflicted are terrible: By the time the disease is detected by the doctors, over half of the patients are already crippled. What makes the disease particularly tricky: it attacks primarily children – about 70% of the afflicted are younger than 15 years. Buruli ulcer cripples, and it cripples above all children.
Buruli ulcer (UB), also called "Buruli", is caused by the mycobacterium ulcerans, a relative of the leprosy and tuberculosis bacterium. Buruli ulcer is another mycobacteria disease, which afflicts people. Like leprosy, it does not kill, but cripples. And like leprosy, it is an insidious danger: By the time the disease is finally recognised, it has mostly already caused grave damages.
Buruli ulcer was described in Uganda as endemic disease as early as the end of the 19th Century. These observations, however, did not attract any further attention. In 1948, the disease was defined precisely for the first time in Australia, the virus was called mycobacterium ulcerans (ulcering = destruction).
The "Buruli" region in Uganda, where the disease occurred frequently in the 1960s, has given the disease its current name.
Perhaps, Buruli ulcer has always existed, yet no one really took note of it and, thus, the suffering of the affected people took place in secrecy. The fact is that Buruli ulcer is advancing today, the number of affected people is increasing worldwide and the World Health Assembly declared the disease as a threat to world health and an impediment in the achievement of UN Millennium Development Goals in the year 2004.
The path of infection is unknown even today. Buruli ulcer is probably not transmitted from person to person. It is not yet known precisely what role certain water-insects, flies and mosquitoes play.
In a particular way, the bacterium arrives below the skin surface, preferentially at the legs. There, the bacteria multiply and eat away at the sub-skin tissue for weeks and months insidiously, without the affected person feeling any particular pain or developing a fever. Often, only a small „pimple“ or a general swelling is externally visible.
Finally, the skin over the inflamed areas dies off and a frightful ulcer is visible. This can spread further, if left unattended. If the destruction develops over one leg or one arm, scarred adhesions develop, which impair the movement of the extremities. Without treatment, the disease eventually burns out, the afflicted are severely crippled, they can no longer walk or use their hands or feet.
If Buruli ulcer is recognised too late, the only option is extensive surgical treatment with skin transplantations and protracted physiotherapy. Early forms respond moderately to antibiotics and are removed relatively simply through a small operation. If the bone has been attacked as well, amputation is often the only option left to save the life of the patient.
Further information on our local Buruli work can be found here:
In the year 2004, the 57th World Health Assembly – WHA had given the call for campaign against Buruli ulcer.
The increase in the number of afflicted people and the special susceptibility of children is described as a threat to world health.
Besides the suffering of the patients, the WHA sees further dangers from Buruli ulcer: The creation of poverty and the destruction of the education opportunities of the concerned children.
In the Declaration of Cotonou (Benin), 2009, the WHO calls once more for an increased fight against this spreading disease. In particular a comprehensive use of antibiotics, access to decent treatments and intensified efforts in preventing and healing Buruli related disabilities are pointed out.
We have taken up the fight against Buruli ulcer in Cameroon in 2002.
We enable the free-of-charge treatment of the patients countrywide. This often requires expensive operations with extensive physiotherapy and long stays in hospital.
We have constructed a school within the hospital premises of Ayos, so that the treated children continue to go to school and learn.
Since 2005, we have extended our work to further provinces that are heavily afflicted. We have contributed to the establishment of four more treatment centres in Atok, Mbalmayo, Bankim and Mbongwe and in informing the population about the disease.
We are committed to the detection and treatment of Buruli ulcer at an early stage. For this purpose, we support awareness campaigns and the training of doctors and lay-help.
We are fighting for the elimination of the threat of the disease.Therefore, we encourage research, in order to recognise the path of transmission. This is the reason why we are involved in the planned development of the Buruli National Programme in Cameroon.
Since December 2005, we are represented in the Technical Advisory Group – TAG-BU of WHO for Buruli ulcer through the expert Dr. Alphonse Um Boock. Our expert for rehabilitation, Valérie Simonet, is a member of the WHO Advisory Group for the prevention and treatment of disabilities caused by Buruli Ulcer. She has developed the «Field Guide» for the prevention of disabilities, that is published by WHO.