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Saturday, May 7, 2011

Complex bladder surgery for 6-year-old Boy

Complex bladder surgery at N.J. hospital gives 6-year-old Afghan boy chance for a better life



U.S. Army Major Glenn Battschinger was leaving a meeting in eastern Afghanistan last April when something caught his eye.
A woman wearing a blue burqa was walking toward him, gesturing frantically. There was desperation on her face and in her voice.
"We didn’t speak the same language, but I understood just from looking into her eyes that she was asking for help," Battschinger said.
A small, frail boy, obviously the woman’s son, stepped out from behind her. Hunched over and bowlegged, he was naked from the waist down, his hand covering his groin.
When the woman pulled the child’s shirt up, Battschinger couldn’t believe what he saw: The boy’s bladder was outside his body, protruding from his stomach, and he had no genitals.
"I thought, ‘Holy smokes, I can’t walk away from this one,’" Battschinger, 49, of Mays Landing, recalled yesterday.
That chance meeting more than a year ago began a process that brought 6-year-old Muslam Hagigshah to New Jersey for life-changing surgery at St. Barnabas Medical Center in Livingston.
Yesterday, the Afghan boy and the American soldier were reunited during a press conference at the hospital.
Muslam was diagnosed with bladder exstrophy, a rare condition that affects roughly one in 50,000 births, said Moneer Hanna, a pediatric urologist at St. Barnabas who operated on the boy. Battschinger and others tried to get help for Muslam. But doctors in Afghanistan had given up on treating the boy and U.S. Army doctors there were not equipped to perform the surgery to correct the defect Muslam had since birth.
Battschinger, a member the Army’s 404th Civil Affairs Battalion which works to improve the lives of Afghani citizens, was running out of options. So he and family members in New Jersey scour the Internet for places that might be able to help the boy the medical attention he needed.
They located an organization called Healing the Children, a non-profit that links medically needy children with worldwide care. The group — which since 1979 has organized medical pilgrimages to the U.S. for over 7,000 children from 105 countries — then contacted Hanna, who has previously worked with Healing the Children. 
Hanna and St. Barnabas agreed to treat Muslam free of charge.
With the approval of Muslam’s family, Airline Ambassadors, another non-profit, arranged to have the boy flown to the United States, where he went to live with the Oplinger family of Summit, who have hosted other children in the past.
Muslam underwent his first surgery in October to put his bladder back inside his body. A second surgery, to reconstruct his genitals and other parts of his body, was performed April 29.
Hanna, who has performed 155 such procedures, which he calls the "ultimate challenge" in pediatric urology, said there’s an 85 percent chance Muslam will recover and function normally. Without the surgeries, he said, the boy could have developed various infections and had a shortened life span.
At Saint Barnabas yesterday, Muslam greeted a host of visitors with a shy but impish grin. Battschinger, a father of two, greeted the boy with a kiss on his head, and questions about how he was feeling and how his American life was going.
Missy Oplinger, Muslam’s host mother, said the boy has clearly adjusted to life in America.
He’s fluent in English, attends kindergarten classes in Summit and loves sports, especially lacrosse. He’s become an avid fan of host brother Matthew’s Delbarton School freshman lacrosse team and knows every player’s number.
But there are still some cultural differences, Oplinger said.
One day, when she was driving Muslam to school, he told her she shouldn’t drive. When she asked him why not, he said, simply, "because you’re a girl."
Oplinger also recalled a particularly moving moment after Muslam’s first surgery, when he tried to put on pants for the first time. The boy was clearly afraid, recalling the pain he’d experienced when he tried to wear pants over his exposed bladder.
But with some motherly encouragement from Oplinger, Muslam succeded.
"To see him put on pants for the first time, and walk around like anybody else — that brought tears to my eyes," she said.
The next step in Muslam’s journey will be with Battschinger. The two will return to Jalalabad, Muslam’s home in Afghanistan, where he’ll be reunited with his mother and the rest of his family. Battschinger will make the trip as a civilian and help drill two water wells — one at the family’s home and another to serve the rest of the village.
The return may be as bittersweet as the originally departure for Muslam and his family. The boy’s mother — whose name Battschinger still does not know — had faith her son would come out okay in the end.
Battschinger recalled the day Muslam’s mother had to sign the waiver that would allow her son to come to the United States. After an interpreter explained the consent form to the woman, she spoke just one word, common in the Muslim world, as she affixed her thumbprint signature to the paper.
"Inshallah," the mother said.
In English: "It is God’s will."

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