October 28, 2010

Surgery helps seal African child’s abdomen, future

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CeCelia Dobor holds her daughter, Darling Grace, whose birth defect was corrected by Vanderbilt surgeons after the family traveled here from Liberia, Africa. (photo by Mary Donaldson)

Surgery helps seal African child’s abdomen, future

The baby girl is a joy for her parents, full of laughter and smiles. But because she comes from a small village in a poor area in the African nation of Liberia, a serious, but correctable birth defect she was born with nearly cost her her life.

Darling Grace Dobor is the sixth child of CeCelia and David Dobor, a traveling minister. Grace, as her parents call her, was born with a severe form of a defect called omphalocele. Her intestines and part of her liver were outside her body at delivery. Abdominal muscles and skin had never fully formed to cover her internal organs.

For five weeks, baby Grace lived with just a cloth protecting her organs. Village officials, feeling superstitious about the defect, advised the parents to let her die, but her parents steadfastly went in search of answers for their daughter.

“I trusted the Lord. I said He would know the future of her life,” said David Dobor.

When Grace was 5 weeks old, they stumbled on a Chinese doctor who had come to Monrovia, the capital of Liberia, to offer volunteer medical care. The doctor agreed to operate and closed the baby's skin over her intestines to prevent infection. But more surgery would be needed to prevent the risk of loops of bowel becoming entangled and cutting off circulation, a potentially fatal side effect.

The initial surgery was a success and baby Grace grew, although she remained petite, and her mother remained fearful of her lying on her large, protruding belly. For months the family searched unsuccessfully to find another surgeon to finish Grace's abdominal repair.

They were preparing to travel across the border into Ghana when CeCelia happened to attend a Christian women's speaking event in Monrovia. That was the turning point.

“We know now Grace is a huge testament to life and love. That testament was through finding Ginger Moore,” David said.

Moore, a Goodletsville, Tenn., resident and member of a Christian women's ministry, traveled to Liberia in June for a speaking engagement.

CeCelia stayed after hearing her speak to tell her about her youngest daughter's plight. Moore was amazed by Grace's story and determined she would find a way to get the baby's surgery donated in the United States.

“I just sent out Facebook messages and blast e-mails. It was friends of friends and contacts that finally hooked me up with charity services,” Moore said.

Wallace “Skip” Neblett, M.D., examines Darling Grace Dobor as her mother, CeCelia, looks on. The child was born with a condition where her intestines and part of her liver were outside of her body. (photo by Mary Donaldson)

Wallace “Skip” Neblett, M.D., examines Darling Grace Dobor as her mother, CeCelia, looks on. The child was born with a condition where her intestines and part of her liver were outside of her body. (photo by Mary Donaldson)

Within a few weeks, the Monroe Carell Jr. Children's Hospital at Vanderbilt had agreed to donate Grace's care, and surgeon Wallace “Skip” Neblett, M.D., agreed to perform the surgery.

From there, things moved quickly. Delta airlines paid to get the family to the United States. When Neblett saw Grace for the first time in early October, he was pleased with what he saw.

“The defect was what we expected, and although she is now almost a year old, the timing really worked out. In these large omphaloceles, the abdominal space is too underdeveloped at the newborn stage to complete the repair. Often it is best to close the skin and wait for the baby to grow to be able to accommodate the organs. She is a good size now,” Neblett said.

Surgery took placed Oct. 21, and was a success. Grace had the right amount of tissue and appropriate abdominal space for Neblett and senior Pediatric Surgery Fellow, Tom Rauth, M.D., to neatly tuck her intestines and liver into her abdominal cavity and close everything up.

“It is so great to have a patient who needs a service that we can give them. We have the mechanism to work this out to offer the care without cost to the family,” Neblett said.

Grace and her family will have to remain close to Vanderbilt until early December for follow up, but the family is now looking forward to a normal life for their youngest daughter.

Moore says Speaking Through Me ministry is currently raising money for the Dobor family. For more information go to www.speakingthrume.com.