Cecilia's story

Wow, what an amazing morning. I took Cecilia, the refugee from Sudan who has the skin graft problem, to the plastic surgeon.

First trying to meet her at the central bus station was a bit of an ordeal; I didn't have the translator with me yet, and I couldn't find Cecilia. I called her cell phone (the Sudanese community has a few that they give out when someone has to travel), and we couldn't communicate enough to find each other. So, I looked around the bus station for a Beduin (I preferred a woman Beduin) to give my phone to and help me find Cecilia. Then I was worried that the person may take advantage of me and take my cell phone. I found a Beduin man with very kind eyes before I saw a suitable woman candidate. I took my chances and asked him (in Hebrew) for some help. I gave him my phone so he he could talk to her in Arabic and help us find each other. I said a little tiny prayer, also. He started talking to her, and walking away. I got a bit nervous, but I kept my cool and followed him. He eventually brought me to Cecilia, and quite self-satisfied, with a nice smile, he handed me back my phone. I thanked him graciously and greeted Cecilia. We then picked up Maya, the interpreter, and went on to Soroka.

Our appointment was with Prof. Lior Rosenberg, the head of plastic surgery at Soroka. He was right there in his office, ready to receive us. All the nurses in the plastics unit recognized me and greeted me with smiles and hellos.

I made the introductions, and Cecilia began by silently passing Prof. Rosenberg her medical history paperwork from her pancrititis trauma. He read it over, took his time, then spoke with her through Maya (translator). He did an examination of her belly, then gave his recommendations. Remember that Cecilia has no medical insurance, and no citizenship status, so any treatment would have to be pro-bono.

She has a very complicated problem. Her stomach fascia and muscles are split in half, and separated wide apart with a thin skin graft in the center holding her bulging intestines, all of which are hanging out in this surgically created hernia. She was sent home that way after the hospital (Ichilov) saved her life, but couldn't close the stomach properly because of inflammation and draining. Since she is a refugee, and has no insurance, they saved her life, had her in a coma for 6 weeks, then sent her "home" (there was no home at the time) without any follow-up. It's all they could do for her. Cecilia has three young children, one is severely handicapped, so she had to just go on as well as possible. But she cannot work with her condition, and she needs to work, in order to get health insurance for herself and her children.

So, Prof. Rosenberg first suggested that she needs an elastic hernia belt to keep her innards inside her. Then, after she gets used to that, she may be able to work.

[All the Sudanese refugees in Arad work in the hotels at the Dead Sea nearby. The hotels are the only employment opportunity for these refugees. They work as house cleaners, and in exchange for their hard work, they get a very minimal salary, an apartment provided for them & their family, and health insurance]

After she can work for 6 months or so, she'll have insurance, and she can come back to discuss options with Prof. Rosenberg. He said very seriously and clearly that he would not be able to operate on her for free. He does a lot of pro-bono surgeries, but low risk ones. He fixes cleft palates, fixes skin abnormalities, does simple bone reconstruction, but they are not what he considers high risk. The surgery that Cecilia would need is very risky. He said even in a case with ideal conditions (like national insurance as well as private insurance, independently wealthy, no small children, etc) he'd have the candidate consider this surgery 10 times before deciding. The graft presently is stuck to the intestine with adhesions and scar tissue. Removing the graft brings the risk of perforation of the intestine. Then, he said, she would be in grave danger because of possible sepsis. She'd be back in a coma, and either die, or never walk again. Even with a successful surgery, she'd be in hospital for at least a month, and what about her kids? So, he made it clear that if she manages well with the hernia belt, she should maybe just leave "well enough alone".

He also strongly recommended to do a tubal ligation so she cannot get pregnant. He said a pregnancy would kill her. That surgery would not upset the larger problem at all, and can be done laproscopiclly quite simply.

So, first the hernia belt, then get work and insurance, then tubal ligation, and only after her children are a bit older, she can start to consider fixing her belly, but the doctor was doubtful if it's actually a plausible option.

OK, so then the three of us (Maya- translator, Cecilia & I) went to another place in the hospital to talk. Maya finagled a hospital meal for Cecilia, and made us all tea. We wanted to make sure Cecilia understood every aspect of the meeting (Rivka, sound familiar?). I then called the coordinator of COHI (www.cohintl.org) to see what can be done for funding for the hernia belt (around 300 shekels, or ~$80 US). I was told that there is money for it and got the OK to go get it with Cecilia. So, off we went, the three of us, to the medical supplies store downtown. I knew exactly where it is, and even where to park, because of all the times I have been there to get my assorted paraphernalia for my graft.

I explained to the health professional in the store about what we are looking for, and she took out a few models for Cecilia to try. All of this was with Maya doing simultaneous translation in Arabic for Cecilia. We were shown three different models that could help. All of them were tried on Cecilia, and she liked one specifically for it's comfort. It was perfect for her, and held in her intestines, held her together, perfectly. She put her clothing over it, and looked at herself in the mirror. She turned sideways. (remember, this is the woman who looks 6 months pregnant, and we thought she was pregnant when she first approached us for help). She smiled for the first time I had ever seen. She straightened her body, lifted her head, and fixed her head scarf. She said she feels new, and pretty. I was close to tears, and so was Maya. Cecilia was always with her head low, and her hand holding her guts so they won't sway back & forth with her movements. All-of-a-sudden, here is a woman transformed to tall and proud. Amazing. When we walked out of the shop, she said her feet feel lighter, and her back feels lighter. Her head was looking straight ahead.

I was reminded about my own first visit with Prof. Rosenberg. My donor leg was hurting me like crazy all the time. I couldn't stand on it for more than a few minutes at a time without tons of pain. Prof. Rosenberg suggested that the first thing I need is silicone sheathes and pressure on it, and it'll get better that way. It was a while before I got the right things, but just wrapping the ace bandage on it, with silicone that I got at the [same] medical supply store gave me tremendous relief. It was a miracle, as far as I was concerned. So much pain and suffering, and his suggestion started my life changing for the better, finally. From that point on, I got into the scar management clinic in Soroka, and got the proper pressure bandage and silicone, and started to heal better. It was after my appointment with Prof. Rosenberg that I started to feel hope.

I am quite sure Cecilia feels that way right now as I am writing this.

Thank you, Master of the Universe, for helping me to help Cecilia from my own painful experiences. That is tikkun olam, isn't it.