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Neha Was the Smallest Infant to Ever be Treated and Survive in Afghanistan.

An unusual partnership created the French Medical Institute for Children – two private, non-governmental organizations – the Aga Khan Development Network and the France-based humanitarian entity, La Chaine de l’Espoir, and two governments – the Islamic Republic of Afghanistan and France. The result is an institution that has enabled children’s lives to be saved that might have otherwise been lost. Nearly 1,600 children have been treated for congenital and acquired heart diseases, almost half of which had open-heart surgery. Arising during a time of seemingly never-ending war, FMIC is one of Afghanistan’s most remarkable success stories. It has become the enabling catalyst for lives to be changed and dreams to be realized – a place where people have succeeded and survived against overwhelming obstacles and odds. As the U.S. and its allies prepare to shift their missions in Afghanistan from military and combat to aid and development, the general consensus is that nothing done in that war-torn country has been successful. FMIC is one of Afghanistan’s most remarkable reconstruction success stories. It is a model that can be emulated as the U.S. and others strive to complete their development missions there. “FMIC has achieved many successes and achieved excellence in many fields in healthcare in Afghanistan. This Institute is a true example of a successful public-private partnership.” Dr. Suraya Dalil, Afghanistan’s Minister of Public Health, speaking at FMIC’s 2nd International Pediatric Conference, December 2012 “When we have international societies with us and partnerships like FMIC, we can have hope for the future. This hope gives me energy to go ahead.” Dr. Jalil Wardak, Head of Pediatric General Surgery at FMIC

Gul Agha and his wife, Fazila, were desperate to save the lives of their precious new babies. Fazila had given birth to twin daughters only seven months into her pregnancy. Gul Agha got a call at work that Fazila was feeling ill and needed to see a doctor. He rushed her to a public hospital where the doctors decided a C-Section should be performed. One twin weighed 3 pounds 8 ounces at birth and the other just 1 pound 15 ounces. The hospital was unable to provide life-saving care to them. It had no facilities or staff to care for such tiny infants. Gul Agha frantically searched all around Kabul trying to find a hospital that could care for the babies. A doctor at a private hospital told him she wouldn’t admit them because she couldn’t do anything for them. At a public hospital, another doctor refused to admit them because she didn’t want to “damage the hospital’s record at the end of the month,” meaning, Gul Agha said, “they would die and she didn’t want the bad statistic counted against her hospital.” One of Kabul’s largest public mother and child hospitals agreed to put the babies in an incubator for one night, but not for longer than that. It seemed only a miracle could save them. Finally, Gul Agha found his way to the French Medical Institute for Children, known locally as FMIC, and he was told the infants would be admitted and cared for there. At FMIC, the tiny twins were admitted to the intensive care unit. It is the most advanced in Afghanistan and the only one in which the doctors and nurses can provide life-saving care for neonates – premature infants. It is a place of last resort for nearly all of its occupants. No other good choice exists for them. Under any circumstances, hospital intensive care units are places of awe. The most heart-rending ones are those that care for children and tiny infants. In the intensive care unit at FMIC the interplay of human drama and technology is gripping. Tubes, hoses, chords, electrodes, and needles protrude from, attach to, and poke into little bodies that are barely visible amidst all the paraphernalia. Anxious parents hover at their beloved children’s sides, watching every act of nurses and doctors with a mix of desperation and hope. Hushed sounds – muted voices, hissing, clicking, and beeping – create an eerie, mystical aura. The families whose children are in the unit have an almost religious trust that miracles will happen and that their precious young lives will be saved. At admission, the larger of the twins was diagnosed as having respiratory distress syndrome, a condition common in premature infants. She had also developed sepsis, a systemic infection which was life threatening in its own right. After admission, she developed a further complication in which blood clots formed throughout her body’s small blood vessels. These combined conditions resulted in her death within three days. Now Gul Agha and Fazila were even more desperate for the remaining twin, Neha – the tiniest one – to survive. Neha’s weight dropped to 1 pound 12 ounces in her first few days in the hospital. Slowly, she responded to care and began to recover. She remained at FMIC for seventy-one days. She was discharged with the expectation that she would have a normal life. She was the smallest infant to ever be treated and survive in Afghanistan.