Reversing Part of War’s Damage

Three years after a U.S. airstrike sheared off the front of her nose and killed her mother, Marwa Naim is heading back to Iraq with a new face, thanks to surgeons at UCLA.

Marwa, a 12-year-old Baghdad native, has spent the last four months staying with a succession of Iraqi foster families and undergoing a series of reconstructive surgeries. On Monday, UCLA introduced Marwa to the press, in advance of her being reunited with her family in Iraq.

Shy, giggling and practically hiding behind her translator, Marwa was nonetheless proud and pleased with her new nose.

“I want to thank the doctors,” she said in Arabic. “They made me look much better.”

Marwa is returning to her father and three siblings at the end of the month.

On Monday, she was clearly a little shocked by the roomful of eager journalists and TV lights, seeming to shrink like a turtle into her pale green embroidered top and head scarf.

But offstage, a different side emerged -- playful, talkative. She enjoyed visiting the L.A. Zoo and Sea World. She wants to be a lawyer when she grows up -- but two weeks ago she wanted to be a businesswoman, and before that a dentist.

She clung constantly to Theresa Moussa, a UCLA staffer who has been her translator, companion and surrogate mother. Moussa, the medical center’s international patient coordinator, teased Marwa about the tantrum she threw after waking up from the second of four operations to rebuild her face.

“She started cursing out [the staff]. They had to shut the door on her,” Moussa said.

Marwa feigned innocent shock. “After the first operation, I didn’t do anything!”

And after the second?

“Oh, I really made a scene,” she said with a grin. “That wasn’t my fault. It was the anesthesia.”

Marwa’s journey to Los Angeles was a joint effort between several humanitarian and non-governmental organizations, including the Palestine Children’s Relief Fund, the International Office of Migration, International Relief and Development and the Campaign for Innocent Victims in Conflict, or CIVIC.

“Hers is a sad story, but it’s a story that happens every day in Iraq and Afghanistan and other conflict zones,” said Marla Bertagnolli of CIVIC. “There are tens of thousands of other children and other people who need this kind of help.”

A team headed by Drs. Timothy Miller and George Rudkin of the UCLA Medical Center’s plastic surgery department oversaw four operations on Marwa in just under four months. They rebuilt her nose using cartilage taken from her ear, and folded down a flap of skin from her forehead to form a new covering. The $12,000 cost was absorbed by the university.

Marwa’s face is still slowly recovering from the multiple procedures. It will continue to heal over the next nine months; for now, it is swollen and discolored. Miller, UCLA’s chief of plastic surgery, recalled the condition Marwa was in when she arrived in February: “There was no nasal tip. There was no cartilage whatsoever, and there was a lot of scar tissue.”

While pleased with Marwa’s physical recovery, Miller was particularly enthused about the psychological and emotional improvements he’s seen in her.

“She was being made fun of by the other children in Iraq. It was a very serious matter,” he said. “Now you can see a difference in the way she carries herself.”

Marwa speaks guardedly about the incident that disfigured her and killed her mother. It happened on April 9, 2003, the day Baghdad fell. She was outside her southeast Baghdad home when she saw American helicopters overhead, followed closely by warplanes.

“I ran inside to my mother, and then we felt the attack,” she said.

The blast killed her mother; Marwa was left with a mutilated face and a missing right thumb. Doctors at UCLA briefly considered replacing the thumb with one of her big toes, but decided against it.

The experience left her deeply traumatized, and embittered against the U.S. forces who bombed her home.

“We don’t bring up stories of what happened to her,” said Lilly Karam of Palestine Children’s Relief Fund, which arranged for Marwa’s travel and lodging in L.A.

“We try not to get into some areas that will trigger certain feelings.”

Now the medical staff at UCLA and the dozens of strangers who’ve helped Marwa in the past four months face a different challenge: putting her on a plane and sending her back into the violence and bloodshed of Iraq.

“I have worries like I’d have worries if I had a son or daughter in the military there,” Miller said. “But it is her home, and we all hope the situation will improve.”