Reconstruction is usually very challenging and should be delayed until full recovery (usually about one year following initial intervention). Prognosis
Noma is associated with a very high morbidity, and a mortality rate of approximately 90 percent. Epidemiology
The disease affects mainly children in the poorest countries of Africa, Asia and South America. Most people who acquire this disease are between the ages of two and six years old. The World Health Organization estimates that 500,000 people are affected, and that 140,000 new cases are reported each year. History
Known in antiquity to such physicians as Hippocrates and Galen, noma was once reported around the world, including Europe and the United States. With improvements in hygiene and nutrition, noma has disappeared from industrialized countries since the 20th century, except during World War II when it was endemic to Auschwitz and Belsen concentration camps. The disease and treatments were studied by Berthold Epstein, a Czech physician and forced-labor prisoner who had recommended the study under Josef Mengeles direction. Society and culture
Children and other noma survivors in Africa are helped by a few international charitable organizations, such as Facing Africa, a UK registered charity that helps affected Ethiopian, and Swiss charity Winds of Hope. There is one dedicated noma hospital in Nigeria, the Noma Children Hospital Sokoto, staffed by resident and visiting medical teams supported by Médecins Sans Frontières.
Attempts to understand and manage the mechanisms at work in floodplains have been made for at least six millennia.In the United States, the Association of State Floodplain Managers works to promote education, policies, and activities that mitigate current and future losses, costs, and human suffering caused by flooding and to protect the natural and beneficial functions of floodplains – all without causing adverse impacts. A portfolio of best practice examples for disaster mitigation in the United States is available from the Federal Emergency Management Agency. Control
In many countries around the world, waterways prone to floods are often carefully managed. Defenses such as detention basins, levees, bunds, reservoirs, and weirs are used to prevent waterways from overflowing their banks. When these defenses fail, emergency measures such as sandbags or portable inflatable tubes are often used to try to stem flooding. Coastal flooding has been addressed in portions of Europe and the Americas with coastal defenses, such as sea walls, beach nourishment, and barrier islands. In the riparian zone near rivers and streams, erosion control measures can be taken to try to slow down or reverse the natural forces that cause many waterways to meander over long periods of time. Flood controls, such as dams, can be built and maintained over time to try to reduce the occurrence and severity of floods as well. In the United States, the U.S. Army Corps of Engineers maintains a network of such flood control dams.