Adversity often leads to prosperity ileal conduit urinary diversion another first time surgery in Afghanistan
Abubakr (3) lives in Kapisa, a province in the centre of Afghanistan. 
When Abubakr was a one-month-old baby, doctors observed a rare disease of Bladder exstrophy. In this disease, the bladder is open and exposed on the outside of the abdomen. This disease was anguish for the whole family since many of the doctors advised him to go abroad to seek treatment. Meanwhile, the family of Abubakr faced a dilemma whether to go abroad or search for a trustable hospital in their hometown. On the other hand, the pandemic of COVID-19 worsened the situation. Most of the hospitals were closing their services due to COVID-19.
In this tough situation, there was hope for this little kid. The provincial hospital of Kapisa referred Abubakr to la Chaine de l’Espoir located in Kabul through which Abubakr’s family visited Dr Homayoon Ghairatmal, the paediatric surgeon at FMIC.
Thankfully, FMIC was a safe haven for patients across Afghanistan. The protective measures were applied accurately and the infection control team was trying their best to save the patients and healthcare staff. When little Abubakr visited FMIC paediatric surgeons, he was in a critical condition and his father was losing his hope, but Dr Homayoon Ghairatmal insured him that “adversity often leads to prosperity”.
After a complete checkup, it was observed that little Abubakr is suffering from a rare disease called “Bladder Extropy” in which the lower part of the abdomen wall is not formed as a result, the urinary bladder is out of the abdomen and it’s not formed normally and if the patient is not treated, the prognosis will be kidney failure or cancer.
The surgery team made their final decision to conduct a surgery for the first time in paediatric surgery of Afghanistan, an “ileal conduit urinary diversion”. Of course, a multi-disciplinary team including nurses, anaesthetists and surgeons was formed to avoid errors. In this surgery, the ureters (the tubes that carry urine from the kidneys to the bladder) drain freely into part of the ileum (the last segment of the small intestine). The end of the ileum into which the ureters drain was then brought out through an opening in the abdominal wall. Within few days, Abubakr was getting recovery fast and convincing.
In the follow-up visits, in early 2021, Abubakr was a normal kid playing with his parents without any suffering. According to Abubakr’s father, “it was impossible for me to travel abroad and there wasn’t any chance of healing to my son, but FMIC was here to help me”.
