Buruli – the little sister of leprosy Buruli ulcer is a gruesome disease, which is often referred to as “the little sister of leprosy”, as it too can cause disfiguration. Buruli most frequently affects residents of remote villages, particularly in West Africa. People there are forced to use stagnant water for personal hygiene and laundry and children usually play in the ponds. The disease is triggered by a mycobacteria ulcerans infection, which is carried by water insects indigenous to rural areas. Like leprosy patients, Buruli sufferers are often ostracized. Approximately half of those affected by Buruli ulcer are children below the age of 15 years.