October 2, 2012

12-year-old Kenyan girl visits the U.S. to correct spine deformity

Neck, Back and Spine | Patient Stories | Pediatric Orthopedics


Thanks to surgery to correct Salma’s spine deformity and the teams at OrthoIndy, Peyton Manning Children’s Hospital at St. Vincent and NuVasive Spine Foundation, 12-year-old Salma Suleiman has a new chance at life.

Read on to hear Salma’s incredible story and how her life-saving surgery has inspired her to help others in her home country.

Looking for an answer

Being accustomed to the many opportunities available in the United States, we sometimes take the many resources available at our fingertips for granted.

For example, our health care system, 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. Because of this care, doctors may find many conditions or diseases before they become severe or critical.

Salma Suleiman is a 12-year-old girl who 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.

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 Nairobi’s National Spine Injury Hospital.

“I examined her, and—from the start—I could see that her spine deformity was severe,” said Dr. Otieno. “We could not 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 to 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.

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Traveling to the U.S.

“I met 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 to correct Salma’s spine deformity, 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 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 spine 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 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 spine curvature. The severity of her condition caused compression of her lungs and pulmonary hypertension.

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Surgery to correct Salma’s spine deformity

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. “She has gone through quite a lot being a young girl at 12-years-old,” said Dr. Otieno. “A correction of this will 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. On January 4, 2012, Salma was wheeled back to the operating room to fix her spine deformity.

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 deformity, 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 primary concerns of the surgery, other than paralysis, were blood loss and whether or not they would be able to correct her spine deformity. The spinal fusion 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 tiptoe to accommodate her abnormal curvature in the 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 spine deformity surgery

Precious was right. After surgery on Salma’s spine deformity, her curvature went from 170-degrees to 70-degrees, making her ten inches taller. One week after surgery, she was walking the entire 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 not to 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 not to 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 saved her.”

Salma headed to NuVasive’s headquarters, San Diego, where she underwent rehabilitation at the end of January. “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 by training them to take care of themselves.

In June and September, Dr. Schwartz plans to go to Kenya 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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