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BALAD, Iraq (March 21, 2008) - A photo of an adorable little boy
with a bowl haircut and big, brown eyes was posted alongside a sign
that read, "I may be little, but I am strong." But the scarred
child within the hospital isolation room didn't look like the boy
in the photo; only the lively eyes were the same.
The 3-year-old boy was the victim of a stove fire that left him
with second- and third-degree burns covering 45 percent of his
body, along with inhalation burns to his lungs. Under the best
health care conditions, the mortality rate for such severe injuries
is 70 to 80 percent. In Iraq, it's a death sentence.
He's little, but he's strong. Al Amreeki survived.
The credit for saving Al Amreeki's life belongs to the medical
staff working at the Air Force Theater Hospital here, where the boy
has been under constant medical care since Jan. 25.
Now Al Amreeki will begin a new chapter in his recovery -- in
America. Again, he has beaten the odds.
The boy and his mother have left Balad and soon will board an
Air Force C-17 Globemaster III. The pair will travel first to
Landstuhl Regional Medical Center, Germany, and then on to the
United States.
Getting the boy permission to leave Iraq on a medical airlift
mission required OKs at multiple levels by civilian and military
leadership in Iraq and the United States, including from the office
of the secretary of defense. The Shriners Hospitals for Children in
Cincinnati will provide his ongoing treatment. Children Without
Borders, a nonprofit organization, will serve as the host agency
for Al Amreeki and his mother.
"I don't know how to thank the American people. They are a great
and kind people, because they saved my son's life," said Al
Amreeki's mother, Amil, through an interpreter. "I pray to God to
not let the efforts of these people be wasted. I want him to be as
healthy, and beautiful and cute as he was before."
Yet, Al Amreeki's medical outcome is still unknown.
"He's at Mile 2 of what I would characterize as a marathon of
treatment; the first two miles were marked by a very steep hill,"
said Air Force Maj. (Dr.) David Norton, 332nd Expeditionary Medical
Group intensive care unit director at the Air Force Theater
Hospital, who is deployed from Keesler Medical Center at Keesler
Air Force Base, Miss.
Upon the boy's arrival at the Balad hospital, Al Amreeki's
injuries were so bad that he was considered "expectant" by hospital
protocols, which means a patient's injuries are too severe to treat
beyond administering pain medication and that death is expected.
Despite Al Amreeki's devastating diagnosis, the hospital staff
decided to try to treat the toddler anyway, Norton said.
"We decided to give him a chance, and he has done very well,"
the doctor said. "For whatever reason, this is a little man who
wants to live; he's a fighter."
Over the past weeks at the Air Force Theater Hospital, Al
Amreeki has undergone multiple skin grafts to his face, neck, chest
and arms. The hospital technicians have been diligent in sloughing
off the dead tissue that was burned in the fire when his nylon
clothes melted onto his skin, and they have aggressively treated
his four bouts of sepsis, which caused the boy to run 107-degree
fevers, with antibiotics.
"He's kind of our miracle child," said Air Force Capt. Michael
Riegler, 332nd Expeditionary Medical Operations Squadron nurse, who
is deployed from Wilford Hall Medical Center at Lackland Air Force
Base, Texas. "For as much as he fought, I felt we could try to
fight for him."
For the hospital staff, fighting for the child included tracking
down his family members.
On the day Al Amreeki was burned, his mother, Amil, was outside
their home speaking with her mother-in-law.
"Suddenly we heard him screaming. We ran inside and saw this big
fire, and he was in the middle of the fire. His clothes were
sticking to his body," she said.
The boy was first taken to the local Iraqi hospital, but the
doctors there said they could do nothing for him, his mother said.
They told her and the boy's uncle, who accompanied her, to take Al
Amreeki to the "American hospital."
To get there, the family would need to go to an Iraqi
checkpoint. Travel in the region is dangerous because improvised
explosive devices are emplaced along certain roadways, so the boy's
uncle took him to the checkpoint without Amil.
At the checkpoint, American soldiers saw the critically injured
boy and transported him and his uncle by helicopter to the hospital
here, where doctors treat battlefield injuries and illnesses of
servicemembers and Iraqis alike on a daily basis.
Wounded Americans who arrive at the hospital usually are sent to
Landstuhl for follow-on care, while Iraqis who are too sick or
injured to survive in an Iraqi hospital are treated at the Air
Force Theater Hospital until they are well enough to be returned to
the Iraqi medical system.
Riegler said the uncle visited the boy the first couple of days
after he was admitted to the hospital, but was told the boy likely
would die. Then the hospital staff no longer saw him; he had
returned to his village without leaving his name or contact
information.
Two weeks passed and little, but tough, Al Amreeki did not
die.
Firmly believing that a parent's presence would help the boy
recover, Riegler and an Iraqi interpreter working at the hospital
began trying to track down Al Amreeki's family.
Born in Baghdad and now a resident of San Diego, Basem Hadi, an
interpreter at the hospital, had experience tracking people down in
the past, having spent the previous three years as a U.S.
government contractor serving with Army Special Forces soldiers in
Iraq.
"Do you know anything about this baby?" Basem said he would ask
every Iraqi person he encountered at the hospital and on the base,
since 90 to 95 percent of the Iraqis that come through the hospital
are from Salahuddin province.
"The Iraqi family is very extended," he said. "If the father
doesn't come, then the mother; if the not the mother, then the
uncle -- somebody."
Eventually, his queries led him to an Iraqi army member in a
nearby city who said he knew of a family that had a burned child,
but little was known about the family except that the father had
been killed about a year ago by insurgents and it was rumored that
the mother had remarried.
An appointment was set up by the Iraqi army for the uncle to
meet Basem and Riegler at the gate leading to Balad Air Base.
"I grabbed Mike; I told him, 'We got it!'" Basem said of finding
little Al Amreeki's family. "Now I started to see hope."
When the uncle arrived at the gate, he told Basem and Riegler
that it was true Al Amreeki's father had been killed by insurgents,
but that Amil was unmarried and Al Amreeki was her only child.
Shortly thereafter, Amil accompanied him to the gate to meet again
with the pair from the hospital.
"She asked me, 'How is my baby?" Basem said. "I gave her hope.
At the time his face was so swollen, I teared up, but she knew who
he was."
Reuniting the family was only the beginning of the hurdles
Riegler and Basem would overcome in trying to help Al Amreeki,
whose medical condition was, and still is, precarious.
The pair knew that even if Al Amreeki lived, his scarred face
and body would make his survival in a culture critical of
deformities difficult, to say the least. Additionally, once the
child returned to the Iraqi health care system, he would not
receive the intense physical therapy and occupational therapy he
would require for years to come. This made the pair seek out
additional help from nonprofit organizations in the United
States.
"It was almost impossible, but not quite," Riegler said of
finding Marjorie Westerkamp, the transportation coordinator for the
Shiners Hospitals for Children in Cincinnati. "There were huge
bumps in the road."
Those "bumps" included getting permission from the Iraqi
government and Ministry of Health to allow Al Amreeki and Amil to
leave Iraq under a humanitarian parole visa as well as coordinating
to get them flown from the country on an Air Force medical
evacuation mission, during which the aircraft serves as a flying
hospital. Since air travel can bring on additional medical
challenges for patients, during medical evacuation flights patients
receive even more care in the air than on the ground.
"It's fine if we get tired," Basem said of their constant work
toward getting the child moved. "I felt we had to help this human
being. I feel like it's my baby."
Al Amreeki is the fourth Iraqi patient brought to the Cincinnati
hospital for burn treatment. There is no charge for any care or
services provided within Shriners Hospitals for Children
facilities.
"We've been working for weeks to get Al Amreeki here," said
Marjorie Westerkamp, a registered nurse and transport team
coordinator at the Cincinnati hospital. "It's only with a lot of
effort and collaboration can you get a boy from the other side of
the world and a war zone to Cincinnati for burn treatment. Shriners
Hospital is so happy to be able to provide burn care to children in
need -- it is what we do every day."
The entire process took more than six weeks to coordinate and
included a required trip to Baghdad to complete paperwork for Amil
- a city larger than any she had been to before.
Now Amil and Al Amreeki will travel to Cincinnati, but Amil said
that the next part of their journey to recovery would not have been
possible without the work of the medical personnel at the Air Force
Theater Hospital at Balad.
"I'm his mom, but the nurses, male and female here, they are
more than mom or dad to him. They love him and take good care of
him. They check his IV and stop by to visit. The words 'thank you'
are not enough," she said.
As the boy grows, his lungs will return to "close to normal"
status, Norton said, but his growth will also cause his scars to
pucker and his skin to grow tighter. Over the years, Al Amreeki's
scars will need to be opened periodically so the boy will able to
grow at a standard rate.
For now, Al Amreeki will receive treatment in the United States
for a year; after that time, his situation will be
re-evaluated.
For the two men who heavily invested themselves in getting Al
Amreeki to the United States, his story has become one of hope for
a people and a nation striving to unite and succeed.
"You're American; I'm Iraqi, and the two of us got this done,"
Basem told Riegler.
For the captain, a father of a 5-month-old girl and a 3-year-old
boy, Al Amreeki's story is a huge success. His current deployment
is his first after becoming a father.
Having served just over a year in the Air Force following an
interservice transfer from the U.S. Navy, where he served 19 years,
the captain has spent little time treating children, until now. In
his position at Wilford Hall Medical Center, he works in the adult
intensive care unit and as a critical care air transportation
nurse.
"It's almost like winning the lottery. This child is one of the
few who will have a chance," Riegler said. "I'm hoping he's
something special - a symbol for this country. We've given the
family this hope. I'm beyond happy for them."
Basem also said young Al Amreeki's story is special.
"I feel that (Al Amreeki) is the Iraq situation, and I need him
to survive as much as Iraq. A lot of people I see don't have hope
in the Iraqi future, but I have hope. I see (Al Amreeki) as the
Iraqi people - one people, one country," he said. "Everybody said
(Al Amreeki) would die. Now everybody knows him and everybody loves
him."
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