Coalition commitment saves Afghan boy

  • Published
  • By Army Maj. Andrew Meadows / Army Capt. Dan Coulter
  • Craig Joint Theater Hospital
QALAT, Afghanistan --  American doctors assigned to Task Force Medical's 541st Forward Surgical Team, met 5-year-old Noor Mohammad on a typical hot day in Qalat, Afghanistan. He had huge brown eyes that looked at the doctors with hope and a little fear.

Little Noor -- as many of the staff called him -- had a lump on his arm that had grown back after an incomplete excision at a hospital in Kabul. The Afghan surgeons feared that it might be cancer and in order to save his life, decided his arm should be amputated.

Jordanian doctors assigned to advise the Afghan medical staff at the Zabul Provincial Hospital vetoed the plan to remove the arm and requested a second opinion from Americans deployed in the region.

According to providers assigned to TF Med, the mass was about the size of a tennis ball, but appeared even larger on little Noor's arm.

"Unfortunately, medical resources at our forward operating base are quite limited, so the normal U.S. standard of performing a needle biopsy is not an option. Furthermore, even if a biopsy were taken, there is no pathologist readily available to analyze the sample," said Army Capt. (Dr.) Richard Slusher.

"Even if the mass was cancer, amputation of his arm would not save his life. He would have required chemotherapy, which is not available to him in the area. We do not believe the mass appears malignant," said Army Maj. (Dr.) Rebecca McGuigan.

The opinion by the major was seconded through an electronic consultation from Army Col. (Dr.) Kenneth Azarow, Fort Lewis pediatric surgeon.

With the American and Jordanian surgeons in agreement, the decision was made to remove the mass by performing a second excision, wider and more complete than the procedure Little Noor received a month before in Kabul.

Little Noor's surgical procedure was performed as a combined effort between the Jordanian medical staff and the 541st Forward Surgical Team. Jordanian Capt. (Dr.) Ali, general surgeon, performed the operation with the assistance of Army Capt. (Dr.) Richard Slusher, orthopedic surgeon. The Jordanian anesthesiologist Maj. (Dr.) Bassam and Army Maj. Donald Kimbler, nurse anesthetist, worked together to sedate Little Noor for the procedure.

"The case went smoothly and the mass did not appear to involve the muscle, bone, major nerves or arteries," said Dr. Slusher. It was completely removed with relative ease thanks to the surgical skill of Dr. Ali.

Upon examination after its removal, the mass appeared to be a benign lesion arising from a tendon in the forearm. It was preserved and sent to Germany for analysis by an American pathologist. After the last stitch was placed in the skin, he was carried out of the operating room and placed in the arms of his grateful father.

Little Noor is now using his hand and arm just like any other normal 5-year-old boy and is expected to make a complete recovery.

"The care received by Little Noor represents the commitment of the United States, of the International Security Assistance Force, of International partners such as Jordan and of the Islamic Republic of Afghanistan to the people of Afghanistan. Furthermore, Noor's medical care demonstrates the steadfast resolve of the international community to rebuild war-torn Afghanistan," said Air Force Col. (Dr.) Bart Iddins, TF Med's commanding officer.