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Sunday, January 28, 2007 - Page updated at 12:00 AM

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Complicated surgery nearing for Hamoody

Seattle Times staff reporter

Hamoody's journey


Since Hamoody arrived in May as a frightened, apprehensive 3-year-old, The Seattle Times has followed his acclimation to life in the U.S. as he prepares for the surgery to repair the damage from a bullet wound suffered in his native Iraq. We've watched as he adapted to his foster parents, a new language, strange foods and culture, and a special preschool for the blind. We'll continue to follow his progress.

He played in the pool in the summer, went to school for the first time in the fall, felt snowflakes in December. Through several seasons, Muhammed Hussein, 4, has lived the life of an American boy.

Now, after waiting eight months for the surgery that brought him to Seattle from Iraq last May, he finally has a date -- March 8 -- a new team of doctors and a new hospital.

Muhammed -- known by the nickname "Hamoody" -- faces at least two major surgeries, as well as some follow-up procedures as doctors hope to bring some semblance of normalcy to the little boy who was blinded and disfigured when he was shot by Sunni militants in his native Iraq in May 2005.

Even then, physicians aren't certain how successful they will be.

"It's a complicated surgery," said Dr. Joseph Gruss. "And I really won't know what it will involve until I get in there."

For Randy and Julie Robinett Smith, the Snohomish couple who have been Hamoody's host parents these past nine months, the news brings mixed emotions. They welcome the chance to see the little boy come closer to a normal life. But once his surgeries are complete it also will bring him closer to his return home.

"I don't really care how long it takes before he has surgery," said Julie Robinett Smith, who has become attached to the little boy in the months he has lived in her home.

Hamoody was brought to Seattle by Healing the Children, an international nonprofit that matches hospitals and doctors willing to donate their services with children in need of medical care not available where they live. Doctors at Seattle's Swedish Medical Center agreed to donate their services to help the boy.

Once Hamoody arrived in the U.S., however, doctors realized his condition was far worse than expected. They referred him to Children's Hospital & Regional Medical Center, where pediatric cranio-facial experts examined him, recommended bone grafts and agreed to donate their skills for his care.

"He's a sweet and remarkable boy and seems minimally affected" by his injuries, said Children's Medical Director Richard Molteni. But his wounds are extensive.

When he was shot, the bullet carved a path across the little boy's face and destroyed his sinus cavity, shattered one eye and damaged the other. Though treated in Iraq, there was little doctors there could do for him, and mounds of scar tissue formed, distorting his face.

Initially, doctors in Seattle had hoped to save some of the sight in Hamoody's left eye. But an ultrasound done at Swedish showed the damage to the eye was so extensive, there was little hope.

At Children's, Hamoody will have an electroretinogram prior to his surgeries to be sure that there is no functional vision remaining in the left eye.

Ultimately, he will most likely have two glass eyes. Rebecca Snyders, director of Healing the Children's Oregon and Western Washington chapter, is hoping to find a company willing to donate the prosthetic eyes.

Dr. Gruss will remove the lumps of scar tissue and then bone grafts are planned to form eye sockets so he can wear the prostheses. The bone will most likely come from Hamoody's ribs.

"It's like building a house," Gruss said. "First the structure has to be built." He anticipates two major surgeries with some minor ones for "touch-ups."

Doctors will also move Hamoody's nasal passages higher so he can breathe easier. Hamoody has severe sleep apnea -- meaning he stops breathing during sleep -- because his sinus cavity was damaged.

"The question always comes up: How much should you do for [someone who is blind] to make them look normal when they don't understand they don't look normal?" Gruss said.

"Blind people have a higher perception of things than people who can see. They can feel things; they are aware of things," he said.

They will know if someone is repelled by them. Surgeons try to do what's possible for people like Hamoody to make them look as normal as possible, said Gruss.

Uncle frequently in touch

Hamoody, whose family is Shiite, was riding in a car with his relatives when they were ambushed by Sunni militants on a highway outside Baghdad. One relative was killed, and Hamoody and his mother were seriously wounded.

With Hamoody's mother hospitalized with a head injury for more than a year and his father spending most of the time at her side, Hamoody's uncle Adil Joda took over the boy's care. Through the Internet he found Healing the Children, which agreed to help Hamoody and brought him to the U.S.

Joda, a university professor in Iraq, keeps in touch with his nephew, frequently talking with him on the telephone at the Smiths' home.

As the Baghdad-area neighborhood where Hamoody's family lives is still rocked with sectarian violence, Julie Smith knows Hamoody is safe here, where he is growing, learning and doing all the things most kids do despite his lack of vision.

He went trick-or-treating in a lion costume on Halloween -- wearing the mask on the back of his head because he couldn't tell which way it was supposed to go -- and made paper bats at school. He ate turkey on Thanksgiving and learned about pilgrims. Heard all about Santa Claus, Christmas, snow and even tried ice skating. He is learning so fast that "gifted" is a word often used to describe him. Even when it comes to sports he has natural talents, Randy Smith said.

"He's incredibly athletic."

Smith taught Hamoody to toss a football and the little boy easily cocked his arm for a throw -- even though he had never seen anyone do it -- while most 4-year-olds lack the coordination.

When he started attending a developmental preschool for children with disabilities at Central Primary Center in Snohomish, Hamoody was hesitant to go down a slide alone. But at his birthday party not long ago, he joined a mass of other children climbing up and down the ladders and slides at the Snohomish Burger King, where it was impossible to tell he couldn't see until it was time to open presents.

That's when he'd rip open the wrapping and ask in perfect English, "What is it?" again and again as trucks and a tambourine emerged. His new friends, including many older children who look out for Hamoody, would explain what the gift was and how it worked.

He always turned and gave whoever was nearby a kiss and hug as Julie prompted him to say thanks, adding, "Aren't you a lucky boy?"

Over the months he's been in the Northwest, he's bonded with the Smiths and their daughters, Alexa and Erika, and their dogs, Tiffany and Roger. But they talk to him about Iraq and keep his culture and knowledge of his home alive and talk about how he will go back there.

A risky future in Iraq

The surgeries are expected to be completed by this summer and then Hamoody will likely return to the home outside of Baghdad where 17 of his relatives live, including his mother, father, sister and uncle. It's a home where his uncle Joda reads classics of English literature, and children must play indoors or in the courtyard because the neighborhood is dangerous. Even going to school is risky for children, many of whom are kidnapped or killed.

Children who are blind have no future at all, says Joda.

According to the British medical journal The Lancet, 655,000 civilians have been killed since the Allied invasion of Iraq in March 2003 -- 46 percent of those were children. The United Nations reports 34,000 civilians killed in 2006 alone, but both overall numbers are disputed. The Pentagon keeps no statistics on the number of civilians killed.

Because professors are often targeted for execution by militants, Joda is especially at risk in Iraq, and hopes to find asylum in Canada -- easier to obtain than asylum in the U.S. -- and would bring Hamoody to live with him. "My main interest in life is my nephew," Joda said. "Normal people cannot afford living in Iraq, let alone the disabled. I'm trying to do every thing to get my nephew a normal life. ... I trust God will find me a way to help my nephew."

Thus far, there has been no problem renewing Hamoody's visa because of his medical status. When those days are over, Julie and Randy Smith want to make the trip back to Iraq with him. They worry about the difficulty he will have making the transition back home. Until then, every moment with him counts.

As she and Hamoody left an ice-skating rink the other day and got into the car, Smith put on a CD that's become their favorite.

"Get ready! Get ready!" Hamoody shouts excitedly.

As Diana Ross' voice begins, Julie and Hamoody begin to sing their song: "There ain't no mountain high enough/Ain't no valley low enough/Ain't no river wide enough to keep me from getting to you ... ."

Nancy Bartley: 206-464-8522 or nbartley@seattletimes.com

Information in this article, originally published January 28, 2007, was corrected January 29, 2007. A previous version of this story incorrectly indicated that according to the British medical journal The Lancet, 100,000 civilians have been killed in Iraq since the Allied invasion in March 2003. That number was from The Lancet's 2004 study. A study released by The Lancet in October 2006 puts the number of civilian deaths at 655,000. However, the number is disputed. The Pentagon keeps no statistics on the number of civilians killed.

Copyright © The Seattle Times Company

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