Facing Futures – Healing Abdul

An American bomb took part of this 4-year-old’s jaw in Iraq; specialists at Shands Jacksonville meticulously restored it.

By CHERIE BLACK, The Times-Union
So desperate was Abbas Shenawah to get help for his badly injured son that he offered to hand him over to U.S. soldiers in Iraq because he couldn’t afford to raise him with his disability. He was willing to sacrifice never seeing 4-year-old Abdul again if it meant his shattered jaw could be repaired.
U.S. military air raids had destroyed the Iraqi village where they lived. Abdul was injured during the blasts, and his father begged the soldiers to help right the wrong he felt they had caused in his son’s life. Abdul found help in Jacksonville, with his father by his side. In April, the pair traveled thousands of miles from their native country for Abdul to undergo reconstructive jaw surgery at Shands Jacksonville. The Times-Union followed the steps of Abdul’s arrival, surgery and recovery process for more than two months. It was a healing made possible through his father’s persistence to make his son’s life better. On the morning of Abdul’s surgery, the sun is barely up as he and his father walk hand in hand through pale gray hospital corridors to a large waiting area. Abbas continuously talks to his son during the short walk. Through hushed but reassuring tones in their native Arabic language, he tries to distract the boy as his wide, dark eyes scan his unfamiliar surroundings.
With no translator available, Shands Jacksonville nurses use gestures and smiles to get Abdul to lift his arms so they can change his clothes for surgery. They remove his Felix the Cat jacket, T-shirt, pants and brown Velcro sandals, all donated to him for his trip to the United States.

The procedure
A swarm of surgeons and residents surround the small boy, eager to view his injury. More than 30 percent of his lower jaw is missing, preventing him from eating properly. A person’s jaw is supposed to curve and resemble a “U,” but Abdul’s looks more like a “V” on the X-ray. The back of his mouth is fighting the front for space. When he opens his mouth, the first tooth visible is a rear molar.
Hours later, Abbas sits in the family waiting room while surgeons slice into his son in Operating Room 10. He is alone with no translator and no way of understanding how things are progressing.
Shands’ Facing Futures Foundation paid for the trip to Jacksonville, and the hospital donated the space and doctors’ time, totaling more than $10,000, said Barry Steinberg, a maxillofacial surgeon at Shands. He created the foundation in the mid-1990s to provide surgeries to pediatric patients with facial disorders.
While Abbas waits, Steinberg and his team of surgeons meticulously measure and cut out a piece of bone from Abdul’s leg and sculpt it to fit into his jaw. Three surgeons, plus two nurses and an anesthesiologist hover over the small boy’s head, tilted back to expose the open, injured lower jaw.
This is Abdul’s third surgery, the first two taking place in Iraq soon after his injury three years ago. Those were more for survival than function.
For six hours the surgeons work, finally wiring Abdul’s mouth shut so his wound can heal during the next several weeks. Then anesthesiologists slowly wake him from his deep sleep before leaving the operating room. He thrashes and cries, unable to understand the searing pain and why he can’t open his mouth. They wheel him to the recovery room, and bring Abbas to finally see his son. Abbas looks relieved as he holds him and rocks him back and forth, trying to calm him. This time, the hospital’s maintenance supervisor is there to translate for him as doctors check Abdul’s status.
He says he is grateful. Now recovery can begin.

Part of face blown away
Abbas speaks with grand gestures when he talks about the day Abdul was hurt, and about the years he has spent trying to make him better. Even before a translator relays his sentiments in English, his emotions are clear as his volume rises and falls with each swing of his hand.
He tells how U.S. helicopters bombed parts of his home city of Nasiriyah in southern Iraq one day in May 2003. His brother and two neighbors died that day. Two nieces were injured. Abdul, then 20 months old, had the bottom half of his face shattered during the blasts. Neighbors helped rush him to the hospital where Iraqi doctors simply sewed up his jaw, more concerned with trying to keep the infant alive rather than reconstructing the jaw.
But Abdul could barely open his mouth to eat. Abbas said he and his wife would squeeze juice into Abdul’s mouth for food. Months later, a doctor in Nasiriyah raised money so Abbas could take his son to Baghdad for checkups.
For the next five months, the father rode with Abdul by taxi more than 200 miles to Baghdad every two weeks. He said there were no specialists there, and doctors told him to wait a year before scheduling another surgery. A year later, Abbas had no money to return to Baghdad for the operation.
Desperate, his house destroyed and the car he used for his job as a taxi driver blown to pieces, he asked Italian troops occupying his city to help his son. When they said they couldn’t, he said he turned to the American soldiers also in his city. Through them, a Mayo Clinic Jacksonville nurse found out about Abdul, and she connected him with Facing Futures Foundation. After more than a year of planning, father and son began the long journey overseas to recovery.

‘It’s been heaven over here’
On a sunny day in June, more than six weeks after his surgery, Abdul sits in a red wagon in the courtyard of the Ronald McDonald House. He and Abbas have been living there since the surgery.
He occasionally sneaks out and wants to throw a red ball back and forth near the table where his father sits. But Abbas is afraid he’ll accidentally hit his still-healing jaw, and makes Abdul come back and stay put in the wagon.
Abdul’s mouth is still wired shut, but his cheeks are visibly fuller and his once-fragile frame looks firmer. Doctors say his jaw is healing nicely. Abbas looks healthier, too, courtesy of an unlimited supply of meats and vegetables in the facility’s kitchen.
He has learned a few English words, but still relies on a translator for conversations. Abdul has learned the word “no” and greets people with “hi sweetie,” mimicking the nurses who coo daily over his dark brown eyes and round face.
Abbas, dressed in a white Jacksonville Super Bowl polo shirt, said they are treated like kings by the Ronald McDonald House staff. While here, his son had his face painted for the first time, and he ate his first Sno-Cone.
He and his wife have three other children ages 3 and younger, all left behind to bring Abdul to the United States. They still have no house, he said, and the family lives with neighbors. When he returns to Iraq in a few weeks, he will work odd jobs to help support them.
Abbas said he is thankful to the people who helped give his son a new life. He doesn’t regret the sacrifices he’s made for the past three years to find that help.
“It’s been heaven over here,” he said of his stay in Jacksonville.
He doesn’t view Americans as the enemy, he said. The helicopters flying through Jacksonville skies aren’t like the ones that bombed his city.
And while their future back in Iraq is uncertain, it is a future they will spend together.

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