MATTAWAN
Isaac Kolleh follows 21-month-old Johnathan Nowell, around the dining room of the Nowells' Mattawan home, piloting a plastic pickup truck. Loud, playful and full of smiles, Isaac looks like an average 2 1/2-year-old.
But Isaac's brief time on earth has been a struggle. He was born in Monrovia, Liberia, with a birth defect called high imperforate anus. Essentially, he did not have an anal opening, and instead, his colon was connected to his urinary tract.
His condition affects about one in 4,000 babies, according to Dr. Marc Downing, director of pediatric surgery at Bronson Methodist Hospital. Monrovia's surgeons, while dedicated, are poorly trained and have limited resources and medical facilities to do the type of surgery that Isaac needed, Downing said. He needed to travel outside of Liberia to get help.
To fund his trip to the United States for corrective surgery, Isaac received help from Children's Circle Mission, a nonprofit Christian organization based in Rockford and started by Lita Kharmai in 2004.
Kharmai came to the United States from, Guyana, in South America, 30 years ago.
Since 2004, Children's Circle Mission has helped with airplane tickets, passports and visas for children from Guyana and Africa to come to the United States for surgery. Host families are not paid, nor are they reimbursed the costs of caring for that child.
Isaac's need first came to James and Sara Nowell's attention in March 2006 through a member of their church, the Third Reformed Church in Kalamazoo. ``I immediately replied and said we would do it, and then asked (my husband),'' she said.
When Isaac arrived in November 2006, he weighed 15 pounds, 2 ounces and was malnourished and dehydrated. An 18-inch segment of his colon protruded from his body. He couldn't stand up or walk on his own. All of his feces were excreted through an opening in his abdomen, called a stoma, which was connected to a colostomy bag.
The Nowells' son Johnathan, at 15 months and 30 pounds, was half of Isaac's age and weighed twice as much. ``I don't think he would have lived much longer,'' Sara Nowell said.
Eating took Isaac about an hour, involving chewing food and spitting it out. He had no interest in playing with Johnathan, his 4-year-old brother, Andrew, or their toys.
Initially, Downing said, he could tell that Sara Nowell felt overwhelmed. ``She was fearful and grossed out and up to her eyeballs in challenge with this, but she has grown a lot through this and done things that she never dreamed she would have needed to do or been able to do,'' he said.
The plan was for a surgeon to reverse the colostomy, create an anal opening and connect the colon to it, a process that should have taken two surgeries. But Isaac was so weak that Downing decided on a revised version of his first surgery. Isaac gained five pounds in five days after his first surgery, James Nowell said.
After that surgery in November, the plan was to allow him six to eight weeks to grow stronger, and then complete the reconstruction in January. Around the holidays, Isaac was noticeably bigger and more outgoing, the Nowells said. ``You noticed his reaction wasn't as lethargic anymore, he swallowed his food better, he was starting to play with the boys' toys,'' James Nowell said.
Complications with Isaac's surgery in January caused Downing to perform two additional surgeries that month, and Isaac was hospitalized 21 days that month.
But he was never alone; the Nowells juggled keeping him company and being at home with their young sons. ``I don't know how we did it,'' Sara Nowell said.
After his fifth and sixth surgeries in March and April, Isaac finally had a functioning anal opening. However, ``Now that he's hooked up medically, they don't know if he'll ever control his bowel movements,'' James Nowell said.
All of Isaac's surgeries were donated by Bronson and by Downing, and he received free well-child visits through Bronson Family Practice. Before Isaac came to the United States, Kharmai had approached Downing and asked him to donate his services.
``It really cost me nothing to take care of Isaac,'' he said. ``It's all Bronson's largesse. She asked me to do it and I was more than happy to do it.''
Bronson tries to perform surgery on two international children a year, according to Bob Doud, vice president for public affairs at Bronson.
Doud estimated the cost of Isaac's surgery at about $40,000, but the additional surgeries increased the cost.
On Saturday, James and Sara Nowell began a 20-hour plane ride to return Isaac to his family, almost 10 weeks later than originally planned. Isaac has 10 siblings and he's returning to a war-torn country with an unemployment level of 85 percent.
Isaac's father had inquired about the Nowells adopting him, but the family says it isn't possible.
``It's going to be hard sending him back to a place that's less fortunate than us, but his place is with his parents,'' Sara Nowell said.
