I have never been to Africa. I have vague pictures in my mind of green forests covered in flowers, shaded by giant trees, and shrouded in mystery. Words and images from books, stories, and the ever-present world of movies and television have given me a vision of a place of beauty and excitement, tragedy and pain. Yet I have never known the reality of this continent, so far away and yet which would become in many ways so close. Watching the miracle of Martha has opened my eyes, my heart, and my soul to this world in ways that have changed me and those around me forever. For miracles do occur. Sometimes they are so loud they shout their existence, taking us by surprise and overwhelming our senses. But sometimes, somehow, they occur so quietly, so unexpectedly, that we stand back outside them and wonder with quiet awe at what has occurred. And so is the story of Martha Kawala. Her courage, her strength, and her faith brought her from a world across the sea to my home and my heart for all time.
Author got mail
It was the last day of the first year of the new millennium—a beautiful, warm Tampa day filled with quiet peace after the holidays. I opened my laptop to check my e-mail, expecting messages from friends and family scattered around the country. My 15-year-old daughter sat reading at my feet, and the afternoon sun touched her face. With the onslaught of viruses found in e-mails, I was reluctant to open messages from unknown senders, afraid of somehow becoming infected. Contained in the middle of many messages was one, and the subject line: Appeal for sponsorship in heart surgery. I almost didn’t open the message; I almost hit the delete key. Something, however, prodded me to look inside. And there was the message:
I am a 15-year-old girl in Uganda…Three years ago doctors identified that I have a hole in my heart…I feel pain and fatigue whenever I carry out any tedious activity…I am a total orphan, my father died five years ago and my mother three years ago…I have grown very thin for my age…I find it difficult to walk long distances…There is no facility for heart operation in Uganda…I am, therefore, kindly appealing for your kind consideration to sponsor me in any way possible…God bless you in your efforts to save the needy.
She had gotten my e-mail address from a doctor in her village who had read an article I had written about Haiti (Bulletin, October 1999), and with the hope and faith of a child, she had written to me. How can one offer help to an orphan in Uganda? How can one person do anything to help someone known only through the world of cyberspace? How can all of the pieces come together to make open-heart surgery happen for a child on a continent so far away? How can one turn one’s back to a child so in need, so in pain, knowing that without an operation done so commonly in this country, she would die? I knew in my heart that it would be possible to arrange for the procedure to be done, somehow, and I knew I would do all that I could to help this child.
Making the miraculous possible
Martha’s problem was an atrial septal defect, and she had no signs of pulmonary hypertension. So, the problem seemed to be surgically correctable. I began asking questions about how it would get done. I spoke with my pastor, Dr. John DeBevoise, of Palma Ceia Presbyterian Church, and he agreed we should not give up and encouraged me to try. I also spoke with Sister Pat Shirley at St. Joseph’s Hospital, a Catholic institution where I work, and she told me of a program that Rotary International has known as “Gift of Life.” Through this program, children from other countries, primarily in the Caribbean, have been sponsored to come to Tampa for life-saving surgery. No one had ever come from another continent, but it was worth a try. I spoke with the hospital administration, which agreed that if the program would sponsor the child, she could come to our facility. I spoke with the cardiac surgeons, and Victor Morell, MD, agreed to operate if all the conditions were favorable. I then remembered a discussion with Mr. Dennis Viera, of Rotary International, who had talked to me about digging wells in other countries, and I contacted him for help with the Gift of Life Program. He contacted the Uganda Rotary, who agreed to help. The Uganda Rotary was unable to afford the tickets for Martha and her uncle, Emmanuel Ofumbi, to come to this country, so I again began asking for help. Pastor DeBevoise, whose congregation took Martha and her uncle in as their own, agreed to cover the cost of what we could not raise. Nurses, doctors, anesthesia personnel, and church members donated the $3,500 necessary for the trip. Martha and her uncle were to stay with me and become part of my family for the month that they would be here. My husband, Bob, and my three children eagerly anticipated this new addition to our family.
Martha’s arrival
We stood at the airport—Dr. DeBevoise, Mr. Viera, and I—awaiting the arrival of Martha and Emmanuel. I wondered what Martha and her uncle must be thinking as they entered such an unknown world, what fear they must be feeling. I thought about a 15-year-old facing such unimaginable surgery, of her wondering, perhaps, if she would ever see her home again. We had only communicated by the Internet, and I had no idea who would emerge from the plane, just as they had no idea who would greet them. We waited and I was filled with hope and fear as I thought about what could happen. Martha and Emmanuel were the last to deplane, and we had begun to worry that they would not arrive. But as they came up the escalator and entered our world, I could not help but reflect in amazement at the events that had occurred. It was as though it was all meant to be, and I knew in my heart all would be well.
The life-saving procedure
Following a repeat echocardiogram in Tampa, Martha had her operation at St. Joseph’s Hospital. I stood with her as she was brought into the operating room and was anesthetized and while all of the preparations were made for her openheart surgery. At the time her heart was exposed, her right atrium was markedly enlarged, and she was found to have a sinus venous atrial septal defect. Using an autologous pericardial patch, Dr. Morell was able to funnel the flow of the right-sided pulmonary veins through the atrial septal defect into the left atrium, and restore her to what would be a normal life. Standing scrubbed in on the case, I watched the beauty of the dance of the cardiac surgery team, each member an integral part of a ballet that took place with form and grace. In the pediatric cardiac surgery unit that night, Martha smiled weakly at me as I assured her that she would be fine. Her postoperative course was relatively stable, though complicated by the development of a pericardial effusion that responded to placement of a temporary catheter, which was removed when the problem had been resolved. The excellent care of the nurses and physicians resulted in a quick recovery, and she began to laugh and smile, eat some of our foods, and venture into the world of Florida that surrounded her.
A community bands together
The local Rotary Club kept her active, and she was able to spend a day with Mickey Mouse at Disney World. She attended Plant High School with my daughter Chelsey. The entire community became involved in her story, and reached out to help her in any way possible—visiting her, bringing her gifts and cards, and sharing their love. As she stood next to the pastor in church on Palm Sunday, reading the text with self-assurance and poise, I was amazed at the journey this child had traveled and all that it had meant to so many whom she had touched. It had been such a short time from New Year’s to Easter, yet, in this time, so much had unfolded. Martha had become part of my family, as had her Uncle Emma, and my children shall always remember this time and what it meant to us all, for this was the year that Martha came from Africa to be with us. Africa, once an unknown continent, is now made personal by the wonder and beauty of these people who had entered our lives.
Our Gift
Martha has a new life now, with her heart fixed. But we are the ones who have been given the true gift, for we have been able to witness the unfolding of a miracle, and to experience the change in those around us who truly care enough to reach out a hand to an unknown orphan across the sea and be forever blessed by her beauty, her grace, and her love. Miracles do occur each day. We are always given the opportunity to experience them, but it is up us to see them and, in this realization, have a world opened to us that we otherwise would miss. It is funny how this world, which seems so very large, is in reality so small. It is funny how so many of our actions continue on, even when we have left them, to touch us again and again as we travel in this journey of life. It is up to us to recognize and remember them, for we are all interconnected on this our earth. Martha is one child in a world of so many in need. But one child is the world to those around her. For this child, and this miracle, I will be forever grateful. I have learned that impossible things do happen, if given the chance. And I will never again be afraid to try. None of us should be afraid to try.
— Sylvia D. Campbell, MD
Reprinted from VOLUME 86, NUMBER 7, BULLETIN OF THE AMERICAN COLLEGE OF SURGEONS
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