122 Where There Is No Dentist 2012
You must start treatment for Noma immediately in order to prevent the hole
from getting bigger. The bigger the hole, the tighter the scar that forms after
you close the hole. A tight scar will prevent the child from opening his mouth
and chewing the food he needs to grow stronger.
1. Give fluids.
The child needs to overcome both
the lack of body water (dehydration)
and his lack of resistance to disease.
Start giving the milk-oil drink
described on p. 111.
If he cannot drink by himself, help
him. Use a spoon or syringe.
Place the fluid on the inside of the
healthy cheek and ask the child to
2. Treat the anemia.
Start giving iron (ferrous sulfate) now. The child should continue taking
the tablets or mixture for 3 months, with food.
over 6 years
under 3 years
Ferrous Sulfate Tablets
200 mg (1 tab) 3 times a day
100 mg (½ tab) 3 times a day
50 mg (¼ tab) 3 times a day
You can also use ferrous fumarate. Advise the mother that the iron
will make the child’s stool black.
Also give food rich in iron: meat, fish, eggs, dark green leafy
vegetables, peas and beans.
Note: A child may have anemia because he has worms. It is a good
idea to do a stool analysis to find out. If he has worms, give him
medicine right away. Mebendazole, albendazole, and thiabendazole
treat many different worm infections. Piperazine treats roundworm and
pinworm infections, and there are other medicines for tapeworm and
blood flukes. Also give folic acid. For doses, see Where There Is No
Doctor, pages 373 to 376, and page 392.