News

<STRONG><BIG>10 SURGERIES RESULT IN NEW FACE AND SMILE FOR GIRL FROM KENYA — ALL THROUGH AN EXTRAORDINARY ACT OF GIVING
</BIG></STRONG>

<p><div class="photobox2">
<img src="/sdmpubfiles/cckimages/page/Drs_Dagum_and_Klempner_with_Saline.jpg" width="279" height="216" alt="" /><div class="caption">Saline Atieno post-op with Dr. Leon S. Klempner (left)<BR> and Dr. Alexander B. Dagum.
</div>
</div>

<P>STONY BROOK, NY, June 2, 2014 — After one year in the United States and ten reconstructive surgeries at <a href="http://www.stonybrookchildrens.org/&quot; target="_blank">Stony Brook Children's Hospital</a>, Saline Atieno, a 12-year-old Kenyan girl, will soon be going home with a transformed face, a new ability to smile, and a future with promise.</P>

<P>At age 3, Saline was diagnosed with <a href="http://www.nlm.nih.gov/medlineplus/ency/article/001342.htm&quot; target="_blank">noma</a>, a devastating bacterial necrosis that develops in the mouth and ravages the faces of victims. According to the World Health Organization, some 140,000 new cases of noma are diagnosed annually in developing countries.</P>

<P>Noma affects primarily young children. The disease is called the "face of poverty" because it results from poor water sources, hygiene, and/or malnutrition. Ninety percent of the children who contract noma die from it. Somehow Saline managed to survive but was left with a severely deformed face. So disfigured, Saline found eating food became more difficult, and the ability to smile impossible.</P>

<P><a href="/surgery/people/faculty/dr-alexander-b-dagum">Alexander B. Dagum, MD</a>, professor of surgery and chief of our <a href="/surgery/divisions/plastic-reconstructive-surgery">Plastic and Reconstructive Surgery Division</a>, led the team in the ten surgeries at Stony Brook Children's. The series of surgeries involved major reconstructions of Saline's lips, mouth and nose. A hole in her face was sealed, and Dr. Dagum created a palate that separated her oral and nasal cavities so Saline could eat and speak normally again. With grafts from Saline's ribs, Dr. Dagum recreated her missing nose. He used tissue from her lower lip to help create a new upper lip.</P>

<div class="callout"><p><b><I>It was not possible to successfully treat Saline in Kenya, and thankfully<BR>
she was able to come to the United States and to Stony Brook.</I></B></P></div>

<P>"All severe facial deformities are difficult to treat and are devastating to the children affected and their families," says Dr. Dagum, who has traveled worldwide on many medical missions to treat children affected by noma and other facial deformities. "It was not possible to successfully treat Saline in Kenya, and thankfully she was able to come to the United States and to Stony Brook. Here we saw her transform not only physically, but emotionally and socially, from a shy girl who'd cover her face to a girl who plays and enjoys life."</P>

<P>In June 2013, <a href="http://coolsmiles.com/our-team/dr-leon-klempner/&quot; target="_blank">Leon S. Klempner, DDS</a>, assistant clinical professor of dentistry, who assisted Dr. Dagum during all of the surgeries, led the process to bringing Saline to Stony Brook.</P>

<P>When Dr. Klempner visited Nairobi, Kenya, in 2010, it became a tipping point in his efforts to help children with cleft palates and other dental deformities. Upon learning about a young girl named Saline who suffered from the effects of noma, he decided to start his own non-profit organization to help kids like her. The following year, the <a href="http://smilerescuefund.org/&quot; target="_blank">Smile Rescue Fund for Kids</a> became a reality. The fund enabled Saline to come to the U.S and Stony Brook.</P>

<P>On his fateful 2010 trip to Kenya, Dr. Klempner was accompanied by his wife, Laurie Klempner, RN, who works in the antepartum unit at Stony Brook University Hospital, and Dr. Dagum. Now Dr. Dagum serves on the board of directors of the Smile Rescue Fund for Kids.</P>

<P>According to Dr. Klempner, in Saline's case, the progression of the bacteria was "somehow self-limiting" but the bacteria left scar tissue. Kenyan surgeons performed a microvascular free-flap reconstruction, but it failed. Her condition was too severe to be assisted by any of the world's known charities, including the Smile Train organization, which referred her to Dr. Klempner. So he decided to start his own non-profit organization with the mission to "help one kid at a time."</P>

<div class="callout"><p><b><I>Here we saw her transform not only physically, but emotionally and socially,<BR> from a shy girl who'd cover her face to a girl who plays and enjoys life.</I></B></P></div>

<P>From June 2013 to June 2014, Saline's life would dramatically change. Under the direction of Dr. Dagum, the Departments of Surgery, Anesthesia and Pediatrics performed the work free of charge as a designated School of Medicine teaching case. Three local families stepped forward to house Saline, including of Douglas Muller, PA, of Dr. Dagum's division. Saline's mother remained in Kenya with her older sister; two other siblings and her father are deceased.</P>

<P>The complicated procedures, and time needed for healing in between each reconstructive surgery, extended the need for Saline to remain in the United States. What was projected to take several or perhaps six months took one year.</P>

<P>Saline had no problem with being on Long Island for one year, as she looked beyond the toil of enduring all those procedures and embraced her host families. Not knowing a word of English when she came, Saline now understands English quite a bit and speaks some too. While living the past few months with Jennifer Crean's family in Hauppauge, NY, she went skiing, ice skating, and fishing. Just before leaving for Kenya, Saline went on a roller coaster for the first time.</P>

<P>Ms. Crean said Saline is like any pre-teen who loves to do things, has a lot of energy, and plays video games too. Proud of her face, Saline is now enjoying smiling and looking forward to a new adventure in Kenya — attending a boarding school arranged by donors and volunteers via the Smile Rescue Fund for Kids.</P>

<P><TABLE border=1 borderColor=#990000 cellPadding=7 width="100%"><TBODY><TR><TD>
<font color="990000">Noma (from Greek <I>nomē</I> meaning to eat up)</font> is a disease of extreme poverty and malnourishment, reported throughout history in Asia, Europe, South America, and Africa. It was found in German and Japanese concentration camps during World War II. <BR><BR>

Infection occurs mostly in children, though it has been described in neonates, adults, and the chronically ill. The true prevalence and incidence of noma are not fully known, as it is believed only 15% of patients with acute cases of the disease get medical care.<BR><BR>

Noma is a disease of shame, and the condition often results in forced isolation from the community and family; many children are sent to live in isolation rather than being taken to medical care. (See <a href="http://www.facingafrica.org/&quot; target="_blank">African patients with noma</a> — <font color="#990000">warning:</font> graphic images.)<BR><BR>

Untreated, acute noma in children is usually lethal. Antibiotic treatment and nutritional support decreases mortality to less than 10%. Nevertheless, plastic orofacial reconstruction is often necessary for both functionality and cosmesis.<BR><BR>
</TD></TR></TBODY></TABLE></p>