An Unusual Friendship

When Ismalia first arrived on board the Mercy Ship he had a hole in the middle of his face. At the age of twelve, a bacteria called Noma had eaten away Ismalia’s nose. “I used to never go out because everyone, including my friends would laugh at me,” Ismalia says, recalling the ridicule he’s endured over the past seven years. “No one stood up for me. I stopped going to school when it started."

Precipitated by malnutrition and a weak immune system, Noma is a gangrenous disease that usually attacks the face, especially the mouth and cheek. Most commonly, an ulcer develops in the lining of the mouth leading to massive tissue loss within weeks or even days. Plastic surgery is the only option, but can rarely be afforded by the overwhelmingly poor victims of the condition. Now a young man of 19, Ismalia has been beaten down by the social isolation he’s endured. He came onboard frightened and withdrawn. But in just five short weeks, both his face and his personality have undergone a remarkable transformation.



A huge grin lights up Ismalia’s face as he shakes hands with the nurses and crew of Mercy Ships who have come to bid him farewell. Confident and smiling, Ismalia says he’s excited to be going home. He can’t wait for people to see his new face.

Crewmember Johan Pieter Johannesen, from the Faroe Islands, is especially sad to see Ismalia go. Johan has spent countless hours on the ward with the young man. Through the ship’s Adopt-a-Patient program, Ismalia and Johan have become fast friends. The Adopt-a-Patient program pairs volunteer crew members with surgery patients on board. Crew are encouraged to build relationships with the patients by welcoming them onboard, helping them settle in, playing and praying with them, and working alongside the ward counsellors to help meet the patient’s spiritual needs. A very successful initiative, the program helps patients feel welcome on the ward, while giving crewmembers from non-medical departments a chance to participate in patient care.

“The evening Ismalia arrived, I went down to visit him,” Johan says. “He seemed to be terrified and ashamed and just hid under the blanket. He wouldn’t look up at all.” Now as they say goodbye to each other, Ismalia radiates confidence. After seven years of believing he should be ashamed of the way he looks, Ismalia holds his head high. No longer a shy boy, Ismalia laughs easily. He jokes about his new nose, arguing with Johan over whether African or Caucasian noses are the easiest to rebuild. “African noses are easier to mould because they’re flatter,” Ismalia contends, “Whereas European ones are longer and sharper.”

It’s hard to imagine a stranger conversation, but it’s easy to see why the topic so fascinates Ismalia. Over just a few short weeks Mercy Ships surgeons have fashioned him a new nose using a flap of skin taken from his scalp. Now, apart from the line of stitches and a slight colour difference, the new nose fits perfectly. Ismalia’s smile suggests he’s more than happy with the results. “I was so excited when I saw my new nose,” he says. “I am so proud of it.” The pain of being ridiculed by peers for so many years took its toll on Ismalia. But after more than a month of loving attention from Johan and the medical staff, Ismalia is clearly coming out of his shell. In addition to Johan, he’s also gotten close to a fellow patient named Samuel. Samuel is also recovering from surgery on his face, so the two had much in common.



Perhaps the most compelling sign of Ismalia’s transformation is his renewed interest in the future. Before the surgery, a career was out of the question. Inspired by Johan, a teacher by profession who serves in the onboard Academy, Ismalia is now talking about going back to school and perhaps becoming a teacher himself some day.

With a farewell to Johan, the two friends part company. An unusual and brief friendship maybe, but one that will be remembered for a lifetime. For the first time in years Ismalia has received unconditional friendship and acceptance. With his new face and restored self-confidence, Ismalia heads for home.

© 2007 Mercy Ships International www.mercyships.org