Firmin Fifonsi, “I told my friends not to go swimming in the river because it is dangerous.”

More than 60 years after Buruli ulcer was first analysed in Australia, doctors have yet to figure out how the flesh-eating infection is transmitted.  The illness strikes primarily in poor, rural communities near water—and mostly in West Africa – but for now medical workers are only able to advise people to seek early treatment at the first symptoms: a painless lump, swelling or a hardened skin patch. Firmin Fifonsi, a 12-year-old student from Bopa, 150km west of the economic capital Cotonou, is hospitalised at one of the country’s five Buruli treatment centres, in Lalo 50km away.

“My foot swelled up and I went to hospital. As [the swelling] did not go away no matter how much medication I took, my teacher suggested that my parents take me to Lalo where [doctors] did a skin graft [to get rid of the infection]. Before, I went swimming a lot in the river. I do not know if that is where I picked up the infection.

“I no longer go to school and my mother takes care of me at hospital. I regret having to be here because I have not been able to continue my studies for awhile now. And I had wanted to do well in my studies to become a high-ranking official in the administration.

“I told my friends not to go swimming in the river because it is dangerous.”

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