Being accustomed to the many opportunities available in the United States, we sometimes take for granted the many resources that are available at our fingertips. Our health care system for example, while ever-changing and not exactly perfect, is one luxury we might take for granted. In the US, most of our children are given the opportunity for healthcare and because of this care, many conditions or diseases may be found earlier on before it progresses to a serious or critical nature.
Salma Suleiman is a 12-year-old girl whom unfortunately did not have the means to identify her scoliosis before it became too severe, let alone treat it. Because of the severity of her condition, it would have only been a matter of time until her condition claimed her life. Thanks to OrthoIndy, Peyton Manning Children’s Hospital at St.Vincent and NuVasive Spine Foundation, Salma received another chance at life.
Salma lives in Nairobi, Kenya, in Africa’s second largest slum, Kibera. Comprised of about one million people, Kibera’s conditions are extremely poor. Until October 2011, Salma lived with her mother, Zaituni Yusef Suleiman and her 6-year-old and 4-month-old brothers.
Salma’s mother and grandmother brought her to Dr. Soren Otieno, an orthopedic surgeon at the National Spine Injury Hospital in Nairobi.
“I examined her and from the start, I could see that her deformity was really severe,” said Dr. Otieno. “We could not really figure out how she would get help locally because we had never done such a thing in Kenya.”
Luckily the NuVasive Spine Foundation has mission trips to Kenya where they perform spine surgeries and run a clinic for general health care. Salma’s mother heard that the physicians from America were there and she brought Salma to the clinic.
Looking for an answer
“I meet the surgeons from the USA and they told me they could help my daughter,” said Salma’s mother. “Once they sit down with the other surgeons from America they will help her. And she’ll get better.”
The NuVasive Spine Foundation tried finding surgeons and hospitals around the country that would be willing to perform surgery on Salma, with no luck until Dr. David Schwartz, an orthopedic spine surgeon at OrthoIndy was told about Salma.
“The first time I saw pictures of Salma and her condition, I was shocked, horrified and almost couldn’t really figure out how I was going to fix her,” said Dr. Schwartz. “I was also saddened because I saw this cute little girl with this horrible deformity.”
Dr. Schwartz agreed to perform surgery on Salma and approached the Peyton Manning Children’s Hospital at St.Vincent, who graciously agreed to participate. All services were donated free of charge.
Two months before her journey to America, sadly, Salma’s mother died due to complications from childbirth. On December 28, 2011, Salma traveled with Dr. Otieno and his wife and Salma’s guardian, Precious Mbabazi to Indianapolis, Indiana to start treatment.
“On the long trip, Salma was overwhelmed, hopeful and missing her mother and facing much pain,” said Precious.
Upon arriving, Salma went to OrthoIndy Fishers for her first consultation with Dr. Schwartz.
Dr. Schwartz diagnosed Salma with congenital scoliosis with a 170-degree curve of the spine. The severity of her condition caused compression of her lungs and pulmonary hypertension.
After her consultation, Dr. Schwartz sat down with Precious and Salma to explain the surgery and the risks involved. He explained that there was as high as 20 to 30 percent chance of paralysis with a surgery of this magnitude. After hearing this, Salma immediately began to cry.
“Salma didn’t understand that being paralyzed was a possibility,” said Precious.
The family struggle, the recent death of her mother, the long trip and now the surgery risks became a lot for Salma to deal with; expected out of any 12-year-old going through this situation.
“Salma has gone through quite a lot being a young girl at 12-years-old,” said Dr. Otieno. “A correction of this will really improve her self-esteem and bring back the hope that had been diminished in her.”
The week after her arrival, everyone prepared for Salma’s surgery. The morning of January 4, 2012, Salma was wheeled back to the operating room to fix her spinal condition. In surgery, Dr. Joseph Riina, an orthopedic spine surgeon at OrthoIndy at the time, assisted Dr. Schwartz with a posterior spinal fusion with instrumentation.
“Initially we were going to try and do an osteotomy, where we cut through it and remove some bone and then realign the spine,” said Dr. Schwartz. “But once we saw her spine we realized that her spinal cord was in such a bad condition that we were worried during the case that she would become paralyzed if we proceeded with that particular procedure. Her bone was very soft so we got as much correction as we could. We opened her chest wall and lungs and leveled her out so she wouldn’t have heart failure if untreated.”
The major concerns of the surgery, other than paralysis were blood loss and whether or not they would be able to correct her spine. The surgery lasted a total of 12 hours, resulting in 15 levels of spinal fusion.
Before surgery, Salma would become out of breath after walking 12 feet, she couldn’t carry a bag, lift her arms or use her hands. She also had to walk on a tiptoe to accommodate the curvature in her spine. Precious said, “Salma will be taller, she will walk better, her heart and lungs will work better. She just wants to be a normal little girl.”
Life after scoliosis surgery
Precious was right. After surgery, Salma’s curvature went from 170-degrees to 70-degrees, making her ten inches taller. One week after surgery she was walking the full length of the hospital hallways. Three weeks after surgery, she progressed even further.
“I can walk a long distance,” said Salma. “I can rest my hands straight. Before I used to not rest my hands that straight. I used to be bent, but now I’m much straighter than before.”
Salma is very grateful to Dr. Schwartz and the care she received. “I was losing my hope and Dr. Schwartz brought my hope back,” she said. “My hope is I become like other children. It has given me hope, lots of hope. Before I used to not have that hope, but now I have it more than ever.”
Salma isn’t the only one who is grateful. Salma has touched more lives than she will ever know. Everyone who had the privilege of meeting this brave little girl will never forget her. One such individual is Dr. Schwartz.
“I can’t tell you how excited and happy I am for Salma,” said Dr. Schwartz. “She’s touched my life in ways I can’t even tell you. My hope is I can give her a good life in the future. I think we’ve saved her, we’ve really saved her.”
The end of January, Salma headed to NuVasive’s headquarters, San Diego where she underwent rehabilitation. “Now her recovery is really just walking and becoming a kid again,” said Dr. Schwartz.
After rehabilitation, Salma called Dr. Schwartz from the airport on her way home to tell him she was in no pain and she was excited to see her family. She is very optimistic about her future.
“When I grow up I want to be a surgeon who takes kids, helps kids like me, even other kids who are not like me,” said Salma. She also told Dr. Schwartz that she wants people to come to her country and help her people, not just by doing surgery, but training them on how to take care of themselves.
Dr. Schwartz plans to go to Kenya in June and September with the NuVasive Spine Foundation to help other people in need. While there he plans on visiting his patient and friend, Salma.
Precious says it best. “Only God can make perfect bodies. The surgeons that try to fix the imperfect ones are heroes.”
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