Surgery gives a young man hope

A West Bank grenade disfigured Baha Salim, and despite many failed surgeries, the young man remains determined to resume a normal life. At an Abu Dhabi hospital, Baha has found healthcare professionals with the inspiration and expertise to help him win his fight.

Baha Salim underwent reconstructive eye surgery at Mafraq Hospital in Abu Dhabi five years and seven months after a grenade attack in Palestine left him scarred.

Baha Salim lost more than his younger brother and his eye when a grenade tore through his family home in Nablus, Palestine.

The attack in the West Bank city almost six years ago was so disfiguring, the place where he lives so lacking in basic healthcare and the numerous attempts to repair his face so inadequate that he has been housebound ever since, unable to go out in public, let alone get a job. On Tuesday, however, Baha, 21, was given his best chance yet to have the life he longs for when he underwent six hours of intricate surgery at a hospital in Abu Dhabi to reconstruct his eye socket.

"I just want to work," he says. "I don't care where but as soon as I am better, I will start looking for a job." He was 16 when an Israeli offensive was launched in June 2004. It was after midnight when he, his father and brother went to their balcony to investigate the sound of gunfire and rocket launchers. Bullets rained down on them, and then a grenade tore through the home. According to the Palestinian Human Rights Monitor, at least six other civilians died that night.

The Palestinian Centre For Human Rights (PCHF) says that between June 24 and 27, 2004, nine people died and 20 were injured in Nablus. Although he talks about the attack as if it were yesterday, Baha has little recollection of what happened over the next three weeks, which he spent sedated under heavy pain relief in a hospital. He woke to the news that his father had also sustained head injuries in the blast and his 18-year-old brother was dead.

"It was the hardest part of all of this," he said. In a country that offers its 600,000 children little or no access to healthcare, he became resigned to his injuries. Yet he still held out hope for a normal future, that one day he might not be ashamed to leave his house, would not face the ridicule of his peers for a wound he termed "hideous", even after undergoing 11 surgeries in Jordan and the US that failed to repair the damage.

Baha is one of several youths who have been given medical treatment in Abu Dhabi with the help of the Palestine Children's Relief Fund (PCRF) and the Sheikh Mohammed bin Rashid Al Maktoum Charity Establishment. More than 75 per cent of the population in the Palestinian Territories lives below the poverty line, on around US$2 a day. Most live in areas that are too remote to reach the few hospitals that exist. There are just 1.6 doctors per 1,000 people, and just 78 hospitals for the entire Palestinian population, which the UN estimates to be nearly four million people.

Dr Christoph Reuter, the reconstructive surgeon who carried out the procedure at Mafraq Hospital, hoped it would be life-changing for the young man. "Baha walks around with half his face in bandages," he said. "If not, people would be screaming and people would be scared. He has a hole instead of an eye. It's horrific for him and anyone else to see." Dr Reuter used bone from Baha's skull to reconstruct the eye socket, painstakingly connecting blood vessels to those in his face.

He took skin from inside Baha's mouth to repair soft tissue around the eye and create an eyelid, preparing the socket to hold a false eye that will be supplied by Moorfields Eye Hospital in Dubai. Before then, Baha will undergo one or two minor surgeries, focusing on the muscles and the eye. "We deal with a lot of procedures here for damage to the face from things such as sports injuries or car crashes, but not to anything like this extent," Dr Reuter said. "Fortunately, they are not that common."

Injuries sustained in Second World War and the Vietnam War led to major advances in facial reconstruction, he said. With developments in medicine in recent decades, people are surviving injuries that would previously have killed them. Dr Andrea Chichio, from Moorfields Eye Hospital, was present during the surgery, charged with fitting the first stages of the artificial eye. An acrylic ball implant was placed deep inside the eye's socket to replace volume lost in the blast. Tissue from inside Baha's mouth was used to cover the ball.

The artificial eye, handcrafted to match his healthy one, will be fitted in two months, after the eye has healed. An ocularist will travel from Australia to Dubai to work for one week on Baha when he is ready. Baha now has a clear shell in his eye while the healing takes place. After the operation, he was still in a great deal of pain. He was fed, bathed and cared for by Salwa Qadaimi Dajani, who has taken on the role of his "Dubai mother".

Mrs Dajani, herself from Ramallah, in Palestine, says that having sons aged 13, 17 and 18 brings her closer to Baha. "He is just like a son," she says. "Leaving his family behind is very tough for him and I want him to have support." She moved to Dubai 18 years ago, and remains well aware of the hardships faced by others left behind. "I want him to feel someone is with him here," she added. Baha's wound is wrapped in bandages. His healthy left eye is dark brown and rimmed with thick lashes.

He longs for the next weeks to pass, so that a long chapter of pain, hospital visits and operations will be behind him. With everything he has been through, he is undaunted by his ultimate return to life in the occupied territories, with its road closures, power cuts, security controls and threat of attack. "I'm not afraid," he says. "I'm not scared of anything." [e-mail]

In an article headlined "Surgery gives a young man hope" (page a3, on January 17) we incorrectly stated, due to an editing error, that Abu Dhabi's Al Mafraq Hospital, which conducted a facial reconstruction on Baha Salim, is located in Dubai. We also neglected to mention that the operation was facilitated by the Palestine Children's Relief Fund. The National regrets the error.