Panic is rising in Adamawa. Reports say 23 people are already being treated, while 12 have died from a mysterious “flesh-eating” disease. Local health authorities believe the culprit is Buruli ulcer.
This, however, isn’t the first time such a disease has shown up in the region. It is perhaps why health authorities have been able to take control of it relatively quickly, considering how under control everything seems to be. One question keeps popping up though: why do remote regions suffer the worst? Why do Nigerians die from something treatable? Could it simply be down to a weak medical infrastructure?
What Even is Buruli Ulcer?
Buruli ulcer (sometimes called BU) is a neglected tropical disease caused by the bacterium Mycobacterium ulcerans.
It often begins as a painless nodule, lump, or swelling under the skin, usually on the arms or legs. Over days, and sometimes even weeks, that swelling can erode the skin from within, leading to open ulcers with undermined edges (the ulcer might be wider under the surface than it looks).
The bacteria produce a toxin called mycolactone, which kills cells, suppresses immune response locally, and prevents healing. If treatment doesn’t come, or is delayed, the ulcer can penetrate deeper, affecting muscles, tendons, bones (osteomyelitis), and joints. Even after healing, patients can suffer permanent scarring, deformities, amputations, or disability.
So yes, it usually starts small, but can escalate when not treated at all, or on time.
Buruli ulcer is known in over 33 countries globally, especially in tropical and subtropical areas. In Africa, it frequently affects children under 15, but there’s no one who can’t get affected by it. In Nigeria, BU has existed for decades, but awareness is low, and formal surveillance is weak.
A study of 82 Nigerian cases treated in Benin showed that many Nigerians must cross borders for quality care, which is the main issue, as facilities for treatment should be available at home.
Adamawa’s Current Crisis Seems to be Ground Zero
In the recent outbreak, 23 patients, many in critical condition, are receiving treatment. This doesn’t include the 12 that have already died. The deaths are just a painful reminder that delay can be disastrous.
The disease is spreading in rural and remote communities, where health facilities are few and far between. When that happens, minor symptoms are ignored, diagnosis is late, and interventions may come too late.
Earlier reports also recorded 67 cases and 7 deaths in Malabu, Adamawa, suggesting that the outbreak may be larger or underreported. In fact, it’s almost positive evidence that it is.
Why Nigeria, and Especially the North, is Vulnerable
1. Weak Health Infrastructure
Many rural towns in northern Nigeria lack specialized clinics, diagnostic labs, wound-care centers, and surgeons. It’s impossible to treat advanced ulcers in a facility with no equipment.
2. Delayed Diagnosis
Because BU begins as a painless lump, many patients mistake it for an insect bite, snakebite, or ordinary skin infection. Without lab access or clinical suspicion, it goes untreated until it worsens.
3. Cost of Treatment & Accessibility
Treatment often involves several weeks (up to eight) of daily antibiotics (for example rifampicin + clarithromycin) plus rigorous wound care and sometimes surgery. In Nigeria, BU-specific drugs aren’t always available through national programs, forcing reliance on other regimens.
Travel costs, hospital stays, wound dressings, and follow-up all these add up to become quite costly, and many in the North can’t afford them.
4. Neglect & Underreporting
BU is often called a “neglected tropical disease” (NTD), meaning it doesn’t get media, funding, or policy attention. Because cases often happen in remote zones, many are never reported or confirmed. In Nigeria, states including Adamawa, Benue, Cross River, Oyo and others have recorded cases intermittently.
5. Public Awareness is Low
Many people don’t know BU exists. They don’t associate skin ulcers with a serious mycobacterial infection. You’re not likely to be alert to a danger you don’t know exists.
What Must Be Done Now
1. Deploy Diagnostics Everywhere
Every local and state health center needs basic capacity: wound labs, PCR testing (or at least microscopy), and referral linkages. When labs are far away, samples perish during transit or patients never make it.
2. Train Frontline Workers
The Federal Ministry of Health must train community health workers, nurses, and town clinic doctors to recognise early BU signs — painless lumps, swelling, plaques — and refer cases fast. It’s dangerous to wait until ulcers explode.
3. Strengthen Tertiary & Specialized Centers
Wound-care units, reconstructive surgery, and orthopedic teams must exist in regional teaching hospitals in the North (e.g., Maiduguri, Yola, Bauchi). Advanced cases deserve care close to home.
4. Ensure Reliable Supply of Drugs
BU-specific antibiotics (rifampicin, clarithromycin, or alternative regimens) must be stocked and available free or subsidized. Gaps in supply delay treatment and worsen outcomes.
5. Raise Public Awareness & Early Reporting
Through radio, social media, community outreach, teach people that lumps and skin swellings that don’t heal might be more than insect bites. Encourage residents to visit clinics early.
6. Data, Surveillance & Transparency
State governments (especially in the North) must invest in disease surveillance systems. Accurate data helps allocate funding, deploy teams, and manage outbreaks proactively.
How Young Nigerians Can Help
- Spread awareness: Share information, especially in rural or hometown circles.
- Support NGOs & health campaigns: Volunteer, donate, amplify voices.
- Watch your own skin: If you notice a swelling or sore that doesn’t heal, don’t self-treat, instead see a qualified doctor.
- Push for health reform: Demand that your state budgets for better medical infrastructure and neglected disease programs.
Let’s Prioritize Healthcare at all Levels
Adamawa’s current crisis is a tragic reminder that illnesses don’t wait for better days. When infrastructure is weak, disease thrives.
Buruli ulcer is not new or exotic, it’s preventable, treatable, and, with the right steps, containable. But only if Nigeria takes it seriously at every level, from LGA clinics to state hospitals to the national ministry of health, everyone decision-maker must consider this a priority.
If Nigeria fails to act now, we’ll simply let another “neglected disease” claim more victims, especially among the youth, among our future.
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