AP: Texas

05/07/2005

By BOBBY ROSS JR.  / Associated Press

The telephone rang in the family room at Covenant Children's Hospital, and suddenly, the stress that Cecil and Diane Fincher had felt for hours turned to despair.

"This may not work," the doctor said. "Just prepare."

The doctors' first attempt to restart 14-month-old Salama Atong Matiop's heart after bypass surgery had failed.

So many people — the Finchers, their church, a medical missionary 9,000 miles away — had prayed for a miracle. But would the miracle become a tragedy instead?

And, if the Sudanese girl with the sweet smile slipped away, how would Cecil and Diane tell her parents?

Michael Matiop, a captain in the Sudan People's Liberation Army, and his wife, Monica, had left Nimule, a war-torn village with mud huts and no paved roads, to seek care for their daughter in Kampala, Uganda.

Unable to obtain wartime travel visas, they kissed their daughter and put her on a plane to the United States, understanding the risks but confident she would return home soon.

"It was not really easy for my wife and I to let Salama go, but deep down in our hearts we knew that as Christians we have a bigger family that would take care of our little sickly daughter," Michael Matiop said.

Cecil and Diane — a West Texas couple raising teenage boys and trying to keep up with church and school responsibilities — had known Salama only a few weeks.

Now they found themselves sobbing in the family room, leaning on their minister for comfort and begging God not to let her go.

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It all started with an electronic cry for help last year.

The subject line on the e-mail said simply: "heart kid."

Dr. Ellen Little, an American pediatrician working as a medical missionary in Kampala, sent the message to all the doctors in her address book about a week before Labor Day.

"Many of you have said to me over the years, 'If there is anything I can do for you, just let me know,'" wrote Little, an Abilene native who operates a small clinic out of a Kampala church. "Well, I'm not sure, but this may be your time."

Little, 34, described how she and other missionaries had traveled to southern Sudan to distribute medicine and teach people about the Bible.

While there, she had met Matiop, a Dinka tribe member and Episcopalian who introduced the missionaries to government officials.

The father of six sons — two deceased — told Little about his only daughter. His wife had taken Salama to another town to seek treatment. Little told Matiop if he ever brought her to Kampala, she'd be happy to examine her.

But getting to Kampala, roughly 200 miles from Nimule, would require finding the money to cross the Nile River in a motorboat, not to mention risking potentially deadly fire from rebel fighters in northern Uganda. Little didn't expect to see Matiop again.

About four months later, Matiop called to say he was on his way with Salama.

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When Little put her hand on the spindly baby's chest, she felt Salama's heart heave underneath.

Salama was panting, evidence of a congenital heart defect that causes blood to pump backward into the lungs.

"It was so clear that she was sick and it was going to take something so major for her to survive," Little said.

But for this little one who'd just celebrated her first birthday, surgery didn't seem like a realistic option. A lack of trained doctors or the proper medical equipment meant Salama couldn't get the lifesaving operation in Sudan or Uganda.

Little felt sure surgeons back home could save the child. But Salama's family couldn't afford the medical expenses or airfare to America. Even if they could, getting wartime travel documents would be next to impossible.

So, Little sent the e-mail.

"I wanted her to get some help," Little said. "But I wouldn't have been surprised if everything had come up dry."

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Something about the e-mail made Cecil Fincher take notice.

Maybe it was his personal connection to Little or his own love of medical missions.

An anesthesiologist, Cecil had studied biology under Little's father, Dr. John Little, at Abilene Christian University. Cecil had mentored Ellen Little when she was a medical student at Texas Tech. The two had traveled together on a mission team that spent a month at a Nigerian Christian Hospital.

Or maybe it was his own son's experience with a heart defect, albeit one less complex than Salama's.

At 3 months old, Benjamin Fincher — now a 5-foot-11 junior high student — had suffered from a cardiovascular abnormality known as a double aortic arch, which required repair of a blood vessel.

For whatever reason, Cecil set out to make the impossible happen.

He met with Covenant Health System CEO Charley Trimble and chief medical officer Dr. Robert J. Salem. His question: Would Covenant consider donating their services?

Yes, they said.

Next, Cecil approached the elders at the Monterey Church of Christ to see if his church would provide airfare and other travel expenses.

Yes, they said.

But not everyone understood Cecil's desire to help.

"'Aren't there a million babies out there like this?'" Cecil said he was asked. "And I said, 'More like 10 million or 100 million. Do we curse the darkness or light a candle?'"

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Lighting the candle proved more difficult, though.

Salama's parents' involvement with the resistance army made it impossible for them to get Sudanese passports. Obtaining paperwork in neighboring Uganda wasn't likely, either, with U.S. officials cautious about granting post-Sept. 11 travel documents.

Eventually, Little secured International Red Cross travel documents for Salama — but not her parents. That meant someone would need to care for Salama in Lubbock.

"We need to do this, Diane," Cecil told his wife.

She agreed, even if she wondered how they'd fit a baby — a sick baby — into their already busy lives.

Diane, more than Cecil, realized what the commitment would mean — restless nights, no more spur-of-the-moment trips, even something as simple as attending their sons' basketball games would require lining up a baby sitter.

Before leaving for Texas, Salama had never digested anything but breast milk. On the plane with Little, Salama cried for hours and pulled on the missionary's shirt when Little tried to feed her a bottle.

At the Finchers, Salama quickly impressed her new caretakers as likable, intelligent — and demanding.

"As long as someone's holding her or sitting and playing with her, she's happy," Diane said. "But she needs to be where the action is."

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A few days after Salama's arrival, the Finchers got an e-mail from her father. Although he speaks four languages, Matiop doesn't read or write. But a church member in Kampala relayed his thoughts.

"I thank all of you who are extending such gratitude and love towards our daughter, THANK YOU FOR LOVING US," the e-mail said. "My wife, children and myself have been through such terrible times in Southern Sudan. We have witnessed friends and relatives die, we have stayed without food, in it all we have depended on God to help us in such times.

"The opportunity that God has opened for Salama is one of those things that we have seen God answer our prayers."

But doctors soon discovered that Salama's heart problem was worse than first realized.

She had only had one valve in the muscle-pumping chambers of the heart instead of two. Moreover, she had a hole between the two pumping chambers.

"It really did complicate the operation," said Dr. James E. Harrell Jr., who closed the hole and rebuilt the one valve into two during a five-hour operation Nov. 9.

After the initial problem restarting Salama's heart, doctors adjusted her medicines and successfully brought her off bypass. But hurdles remained. The heart block that complicated her first surgery resulted in Harrell inserting a pacemaker, donated by Guidant Corp.

Then, around Thanksgiving, it looked again like Salama might not make it.

A lack of tissue had made repairing Salama's left-sided valve difficult. When that part of the repair came loose, she required additional surgery.

Again, the feisty Salama — who would throw toys into the ICU nurses' station to get their attention — survived and steadily improved.

Cecil and Diane were almost constantly at the hospital, caring for Salama as if she were their own daughter, nurses said.

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After weeks in the hospital, Salama returned home with the Finchers, eating through a feeding tube inserted through her nose.

By mid-January, the girl had become comfortable with Cecil, Diane and their sons, Jonathan, 18, and Benjamin, 14.

"She's really smart," Cecil cooed as Salama played on the living room floor, an alphabet song blaring from a toy as she giggled.

"She's really kind of athletic too," Diane added.

A few days earlier, Salama's father had e-mailed the Finchers with news that the Sudan People's Liberation Army had signed a peace treaty with the government, which he described as "very much remarkable for we as Sudanese" after two decades of civil war.

By this time, the Finchers were making plans to take Salama home and reunite her with her parents.

Diane's voice choked with emotion as she contemplated saying goodbye.

"I've always said that no matter if she lives or dies, God brought her here for a purpose," said Diane, wiping tears. "And whether she goes home and lives until she's 20, or she goes home and doesn't do well, we did what we were asked to do, and I have to feel good about that."

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In mid-February, the Finchers packed up three suitcases for Salama, filling one with clothes, one with medicine and baby formula, and one with some of the many toys and stuffed animals she had accumulated.

Cecil and Diane arranged to pay for a temporary apartment in Kampala for Salama and her family, so Little could check on her until she was ready to return to Sudan.

Matiop, wearing a dress military uniform, struggled for words to thank the Finchers as he welcomed back Salama during a ceremony at a Kampala church. Salama's mother, apparently caring for her other children, did not attend.

"I wish I could do something for you," Salama's father kept saying.

Noticing a flag pin representing the new southern Sudan on Matiop's lapel, Cecil said, "There is one thing: Can I have that little flag?"

Matiop immediately took the flag and pinned it on Cecil's shirt.

Diane cried hard as she left Salama behind.

"Part of it is knowing I'm not going to be in control of what's going on anymore, and hoping that she will grow and thrive and continue to do well," Diane said.

Salama's leaky left valve remains a potential problem, and she'll need a new pacemaker in five years. But doctors say her prognosis is good.

The Finchers saw Salama one more time before returning home. She smiled at them. But she didn't reach for them. Salama was back with her family, and that was fine with her.

The long-term conversion would not be quite so simple. Salama would have trouble adjusting to her baby formula, and would fight a bout with dysentery. She'd lose weight when she needed to gain it.

And the Finchers would worry from afar, frequently offering to send money or even bring Salama back to America if needed.

But because of one little girl from Sudan, the Finchers' world would never be the same.

"It made me realize that babies are babies all over the world. Salama is no different from other children," Diane said. "You don't feel like you're on the other side of the planet when you're there. They're just people, trying to survive and provide for their family."

Or, as Cecil put it, "They're just like us."

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On the Net:

Kampala Ministry: www.kampala.m.inistry.org