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12/20/2002
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People of many faiths join to help Palestinian toddler
By Marty Denzer
Catholic Key Reporter

1220babydoa.jpg
Marty Denzer/Key photo
Ellen Spake and Jane Rues exercise Doa'a's hands during a recent physical therapy session at Rockhurst University. Doa'a's mother, Intisar Al Dalou, holds the toddler.
KANSAS CITY - Doa'a Al Dalou is 15 months old. Even though she observes her surroundings alertly, her big dark eyes hold an echo of fear and pain.

Doa'a, a Palestinian native, was born with severe malnutrition, bilateral club feet and hands, and displaced hip joints. Her shoulder joints were frozen, prohibiting movement. Her parents were desperate to find medical care for her, but little was available in Israel's conflict-torn Gaza Strip.

In April, Elizabeth Alex, news anchor for KSHB-TV 41, visited Kabul, Afghanistan, as part of a medical and fact-finding mission led by Gary Morsch, physician, founder and president of Heart to Heart International (Catholic Key, May 19). As the group was preparing to leave Kabul and return home, Morsch, in response to a request from Kansas Citian Nick Awad, decided to go to Israel to visit a Palestinian clinic in Gaza. Alex and photographer John Batten accompanied Morsch.

At the clinic, Alex met the Al Dalou family. Doa'a, then 9 months old, touched Alex's heart, and she returned to Kansas City determined to help the baby and her family.

She began by profiling Doa'a in a newscast on May 9, but received little response. Then on Sept. 10, Alex, a member of St. Therese Little Flower Parish, contacted Mahnaz Shabbir, vice president of strategic planning and business development at Saint Joseph Health Center. Shabbir, a Muslim, said Alex contacted her about doing an on-air interview on Sept. 11. "The idea hit Elizabeth while we were talking about the interview. I am Muslim, the baby is Muslim, and this is a Catholic hospital. I told her I couldn't promise anything, but I'd see what I could do," she said.

Shabbir first tried other hospitals in the area, but met with negative responses. She then approached the Saint Joseph hospital senior management team to propose offering the medical treatment to Doa'a.

"The cost of such a procedure was never a factor. This hospital has a long history of taking care of people, especially poor people. Our concerns were, do we have the expertise to successfully perform the needed surgery, and the clinical nurses to provide postoperative care? We decided to try," Shabbir said.

It all came together quickly after that.

Anesthesiologist Doug Hagen was asked to join Doa'a's medical team because he had served on medical missions in the Middle East.

Ganesh Gupta, an Indian pediatric orthopedic surgery specialist in private practice agreed to perform the surgery. A Kansas Citian since 1968, he served in the same army reserve unit as Morsch of Heart to Heart. Elizabeth Alex contacted him about Doa'a at Morsch's suggestion, Gupta said.

The hospital had closed its pediatric unit about a year ago, so it applied for a special dispensation from the state of Missouri to allow inpatient use of the short stay unit, a unit normally used for outpatient surgical aftercare of no more than 24 hours. Once the dispensation was approved, a team meeting was held to plan the procedure and the aftercare, as well as therapy. The meeting was attended by the surgery director, pulmonary representative, short stay nurses, the anesthesiologist, the surgeon, Shabbir and Elizabeth Alex.

On Sept. 30, Doa'a, along with her parents, Imad and Intisar, arrived in Kansas City from Cairo, Egypt. The American Embassy in Cairo issued their visas, and their plane tickets were donated by The First Hand Foundation of the Cerner Corporation.

Doa'a's surgery was scheduled for Oct. 29. The preceding three weeks were filled with appointments to the doctor, X-rays, getting settled in at their host family's home, and getting somewhat acclimated to Kansas City and the cold weather. Speaking almost no English, the Al Dalous relied heavily on Nick Awad as an interpreter.

They did take time out to visit the Lake of the Ozarks. In a special news broadcast on Nov. 20, Alex reported that Imad Dalou had "proudly caught a fish," and husband and wife took turns posing with the fishing pole.

Shabbir said Rob Stein of Physicians Reference Laboratory donated all Doa'a's lab work, and Jim Anthony of Carondelet Imaging Alliance donated professional fees for her X-rays.

Oct. 29 arrived. Gupta had already removed casts that had been placed on Doa'a's legs by doctors in Egypt. During the surgery, he broke the child's legs at the femur bone. Then, using pins and plates, he positioned her knees to face forward. Additional surgical procedures were performed to reposition her hip joints correctly, and repair tendons in her ankles and feet, wrist and thumbs. Botox was injected into her shoulders to strengthen them and permit movement.

Doa'a's parents were apprehensive as the surgery went on and on. Doa'a had undergone two operations in Egypt and she had had a bad reaction to the anesthesia, swelling up, turning blue and almost dying. Through Awad, Saint Joseph Hospital staff members kept the parents apprized of the progress, trying to reassure them, but until Gupta came in to report that all had gone well, they remained nervous, Alex recalled.

Shabbir said the nurses assigned to the short stay unit filled the room with toys. Noise makers, light-up toys, and stuffed animals found their way into Doa'a's room. Nurse Theresa Taylor's mother sewed Raggedy Ann and Raggedy Andy dolls for the toddler. Nurse Phyllis Tillotson insisted on getting a wagon to pull Doa'a around in since the new casts on her legs made it difficult to put her in a stroller. Charge nurse Janet Miller remembered pulling Doa'a around the short stay unit in the wagon so Intisar could take a shower.

Shabbir said several hospital departments worked behind the scene to make Imad and Intisar and Doa'a comfortable during the hospital stay. The food service department, for example, was careful to follow Muslim dietary laws, such as restrictions on pork, she said.

Shabbir said it took two carts to carry all the toys to the car when Doa'a was discharged a few days later. "It was a positive domino effect. All the pieces were lined up right, and it worked. I remember closing the door of the car after Doa'a and her toys were loaded in and thinking, we did it!"

Three weeks after surgery, Doa'a put her thumb in her mouth for the first time.

She will need a lot of physical and occupational therapy to build up strength and stretch shortened tendons in her elbows, wrists, and ankles. Rockhurst University's physical and occupational therapy departments agreed to work with Doa'a free of charge. The toddler is doing very well, said Ellen Spake, physical therapy departmental chair person at the Jesuit university.

During a recent therapy session, Jane Rues, physical therapy coordinator, measured the movement in Doa'a's wrists, knees and ankles. She recommended the parents encourage the child to hold her bottle or cup to help promote movement in her elbows and thumbs. Doa'a didn't care for the stretching exercises, but her protests only made her parents smile widely.

The physical and occupational therapy will continue as long as is needed to strengthen the toddler's muscles and joints, and improve flexibility. Gupta, the surgeon, wants to inject additional Botox to help loosen the muscles. Braces fitting over the calf and foot to straighten them out have been recommended by the physical therapists. Aquatic therapy has also been prescribed and donated. Gupta said that repetitive movement will help reeducate her muscles to improve motion.

The Al Dalous left three children behind in Gaza, who are cared for by Intisar's mother and brother. Nada'a, 12 years old, and her younger brothers, Shadi, 8, and Mohammed, 4, talk to their parents every ten days. Imad said his children are doing well, but they all miss each other. Phone cards have been collected by TV viewers and given to the Al Dalous so they can call their children, Alex said.

They will remain in Kansas City until Doa'a is released by the doctor and the therapists. It could be another week or a year, depending on her progress. Application has been made to the Immigration and Naturalization Services to extend the family's visas for a year, although Gupta hopes Doa'a will have made enough progress in a few months for them to return to Gaza and their family. They are learning a few English words, and getting used to the winter weather.

Intisar reached into the sleeping baby's stroller and smoothed her hair. "Alhandullallah!" Thank God! Alex said, "The family really has a joyful outlook on life now. That wasn't the case at all when I first met Intisar last April."

Donations accepted for Doa'a's care

In addition to the doctors, Saint Joseph Health Center and Rockhurst University, many individuals and groups have reached out to help Doa'a and her family. They include Heart to Heart International, U.S. Senator Sam Brownback, Congressman Dennis Moore, The Greater Kansas City Islamic Society, Briarwood Elementary School, The Universal Foundation, Rehab Designs of America, Terri Peterson Pool Therapy and Sprint.

A fund has been set up to help with continued therapy and equipment: Baby Doa'a Fund, P.O. Box 289, Smithville, Mo 64089

The family can always use disposable diapers, baby food and international calling cards to help them stay in touch with the children left at home.

END


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