Saline Atieno developed a harmful and disfiguring bacterial necrosis referred to as Noma as a younger little one in Kenya. Although the illness has a 90 p.c mortality fee, Saline one way or the other survived, solely to face an especially troublesome future in her village on the outskirts of Nairobi. Now, after an enchanting eight-year journey that introduced her to Stony Brook, Saline has not solely survived, however returned residence a reworked 19-year-old lady with a brand new face — and a vibrant new future.
Saline’s story started in 2010 when Leon Klempner, DDS, an orthodontist and Stony Brook Dental Medication affiliate professor, realized of her plight after coming back from an academic mission in Nairobi.
“We introduced a crew from Stony Brook Medication to Gertrude’s Kids’s Hospital in Nairobi the place we spent every week there educating,” stated Klempner, who acquired an e-mail from a doctor affiliated with one of many worldwide cleft charities that included a photograph of Saline. “He advised me that no person in Nairobi was capable of assist her and requested if there was something that I might do.”
Klempner mirrored on the kids that had been turned away in all the years he had spent on missions to creating nations, and was impressed to assist Saline and others in related conditions. In 2011, the non-profit group Smile Rescue Fund for Kids turned a actuality, enabling Saline to come back to the U.S. for assist.
Noma is understood as “the Face of Poverty” as a result of the components related to poverty — persistent malnutrition, poor oral hygiene and sanitation, publicity to viral and bacterial infections — could result in illness development. It had left Saline with a face so severely deformed that even consuming and respiratory have been troublesome.
As soon as she arrived at Stony Brook in 2013, Klempner and Alexander Dagum, MD, chief of Plastic and Reconstructive Surgical procedure, Renaissance College of Medication at Stony Brook College, and their colleagues created a plan to reconstruct her face and mouth to enhance her physiological capabilities and look.
“She was contaminated when she was about 5, and she or he had already been born with a cleft lip and palate,” stated Klempner, including that Saline was homebound, having been ridiculed by different schoolchildren. “We determined that if we might convey her to Stony Brook, she’d be educating case for the residents and on the identical time we might assist her.”
Ten surgical procedures and greater than a 12 months later, Saline’s life had improved significantly, and she or he returned to Kenya in 2014.
“Dr. Dagum did some miraculous work restructuring her face,” stated Klempner, noting that Noma had eaten by means of the pores and skin, muscle and bone in Saline’s face, which left her with a gaping gap that went all the way in which into her nasal cavity. “Because of this, she was susceptible to infections and had problem respiratory, talking and consuming, to not point out the psychosocial points of it. By the point we despatched her again residence, she’d had her face reconstructed and was capable of start talking and consuming usually.”
However Saline’s journey didn’t finish there. As with many plastic surgical procedures, therapeutic time was required.
“You may’t do all the things , notably on a rising little one,” stated Klempner. “It was time to ship her again and reevaluate how and if we’d be capable of deal with her sooner or later.”
Over the subsequent few years, Saline had a collection of recurring infections in her cheek that couldn’t be identified or handled in Nairobi. In 2019, Klempner determined to convey her again to Stony Brook for extra therapy, the place Dagum discovered the supply of the an infection and efficiently handled it. Through the course of this therapy, the COVID disaster hit. Worldwide journey restrictions prevented Saline from returning residence, however Klempner and Dagum discovered a silver lining.
“Since we had her right here, we determined to take the chance to make some further refinements that have been vital,” stated Klempner.
Klempner was capable of coordinate presurgical orthodontic care to allow Dagum to reconstruct her jaw. Stony Brook Dental Medication’s Christine Valestrand, scientific assistant professor within the Department of Prosthodontics and Digital Technology, supplied prosthodontic care and created a maxillary overlay partial denture for Saline to revive aesthetics and performance to her tooth and mouth. Saline will be capable of keep this dental prosthesis in Kenya regardless of the restricted dental care accessible there.
Between February 2019 and late January 2020, Dagum carried out 5 further reconstructive procedures to scale back the danger of future infections and scarring round her lips, face and brow, and eliminated a creating cyst from her cheek.
The prolonged keep reworked Saline’s life in different methods; she improved her English abilities, acquired essential follow-up care and steerage from her Stony Brook scientific care crew, and is now described by her caregivers as a wise and humorous younger lady.
After greater than a 12 months residing with a number household on Lengthy Island, Saline returned to Kenya on Might 2 to a future that features protection of her medical bills in addition to tuition and room and board to a vocational college, all supplied by native donations to the Smile Rescue Fund for Youngsters.
“She needs to be a hairstylist and there’s a one-year program supplied in Nairobi,” stated Klempner. “We really feel we will present her with a vocational talent that may hopefully allow her to be self-sufficient and help herself. Regardless that we’re sending her again, we’re nonetheless right here to help her.”
Since Noma solely survives in pockets of the world which are impoverished, Klempner needed to do one thing to assist her village as effectively.
“We didn’t be ok with sending her proper again to that setting,” he stated.
Through the previous a number of years, Klempner and the Smile Rescue Fund for Youngsters has helped the village buy water tanks to gather rainwater, in addition to photo voltaic lanterns.
“We came upon that the villagers would spend 50 p.c of their meager revenue on kerosene to allow them to supply some gentle for his or her youngsters to do homework after darkish,” he stated. By means of the Smile Rescue Fund, Klempner was capable of present greater than 200 photo voltaic lights for Saline’s village, an funding he stated has helped double the revenue of the village whereas creating safer examine situations for the kids. The group was additionally capable of present personalized wheelchairs for kids that wanted them.
“These easy issues made a life-changing distinction in Saline’s village,” he stated. “We really feel that these kinds of issues are a part of our accountability.”
Dagum echoed that sentiment.
“It’s our job to remodel lives, and it’s an incredible feeling if you assist folks to be themselves and really feel that they will do all the things that anybody else can do,” stated Dagum. “Generally we take issues as a right.”
Dagum admits that it may be onerous emotionally when he treats sufferers — typically prenatally — till they’re of their 20s and even later.
“I’ve gotten to know lots of my sufferers very effectively,” he stated. “Some days I really feel like a father of 1,000 nice youngsters and different days it’s 1,000 youngsters who’re misbehaving. However on the finish of the day they’re my youngsters, and I attempt to handle all of them.”
Although each medical doctors acknowledge the bittersweet nature of their career, in addition they be aware the nice reward that comes with doing such work.
“The additional time that Saline spent within the U.S. through the pandemic gave us a possibility to assist her heal, modify, and see her future,” stated Klempner. “Now it’s time for her to go residence.”
— Robert Emproto