Earlier this year, a 6-year-old girl was shot and badly wounded during a firefight between U.S. and Afghan forces and the Taliban. Her father, a Taliban fighter, her mother and some siblings were all killed in the gun battle.
Dr. Chance Henderson, a Texas-born orthopedic surgeon, was there when the girl, whom NPR is calling Ameera, was brought to the hospital at the Bagram Airfield outside Kabul.
"I remember her quite vividly there on that stretcher, and how tiny she looked," he says.
Back in May, NPR reported that it was unclear whether Henderson — who has a daughter close to Ameera's age — and his medical team would be able to save Ameera's severely wounded left leg.
The stakes were high, Henderson explained at the time, because the girl's "outlook on a life as a single amputee that does not have a family is much different than it would be for us in the States. Her future would be grim, and probably her lifespan would be short."
This week, there's good news. Henderson says he succeeded in saving Ameera's leg via a procedure called a cross-leg flap. It involved temporarily attaching her two legs and directing blood flow from the healthy right leg to the left.
"We just take the skin from one leg, the other leg and flap it down kind of all the way to the muscle, and use that muscle and subcutaneous fat to sew to the other leg, to cover that defect, and allow the bone to get her blood supply to it, take away infection and let it heal," Henderson explains. "The nurses were calling it a mermaid flap."
Ameera's legs were stabilized with a bar "so she didn't pull them apart as she was waking up or in normal day-to-day life," Henderson says. "And so she was sewn together, as well as bars and pins holding her legs together."
The flap was divided after four weeks, the operation a success. Since then, the team has worked with Ameera to strengthen her legs, with the help of a custom-made walker.
"She's a little stiff and we have a therapist here that's been working with her to help her walk," Henderson says. "But she's doing quite well."
Ameera is doing so well that she is getting ready to go home soon. It's a bittersweet transition for Henderson and his team.
"She has been here from the first week of this deployment, when we first got here in early April, and so I don't think there's a person at the hospital that hasn't spent hours with her," he says.
Nurses, therapists and physicians have all gotten to know the girl. They've played with her and done what they could to make her feel more comfortable.
"And so she's very near and dear to all of our hearts," says Henderson.
So much so, in fact, that in the beginning, several of them had thought they might adopt her.
"The first night we met her, we all thought, that's it, you know, we've got to save this little girl," Henderson says. "Immediately when we heard that she had lost her family, of course that's what everybody's thinking. We were excited to find she did have other family members, but I think there's a law, a federal law, against military members adopting. And we asked the question and were told no. And I think some of us asked twice and were told no twice, which is a strong no in the military."
Henderson expects Ameera to be discharged "very soon." She'll go into the care of her family, though it's unclear which relatives will look after her. To protect her security, the location where she'll be living isn't being made public. Henderson worries that her time in a U.S. hospital may elicit threats.
The most important thing from Henderson's perspective is for her to lead as normal a life from now on as possible.
"I really want her to be able to run and walk and do all of the normal things that a kid can do almost when she leaves here, just purely because I think follow-up will be difficult, given that she may be far away from here," he says. "I want her to be 100 percent."
When Ameera leaves, he says, "It's going to be a tough day." In the time she has spent at the hospital, she's picked up a little English: "She says 'hi' and 'bye' and 'thank you' — and she's certainly learned how to say 'no' quite clearly," says Henderson.
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