Under the bright lights of a hospital room, the sisters sat next to a frightened little girl who barely acknowledged them. She kept her head down, eyes fixed to the floor.
Arefa was 6. Much of her face and hands had been singed, and a cloth hid a head wound that had not healed since a fire raged through her family's tent. She'd flown in the day before from Kabul without her parents.
Jami Valentine and Staci Freeman watched as the doctor pulled back the sticky cloth. The stench intensified; the wound was severely infected. The surgery Arefa came for would have to wait. The infection made it too risky.
John Lorant, a plastic surgeon at Shriners Hospitals for Children in L.A., gave instructions and the sisters did as told. Staci held Arefa's hand. Jami put on gloves and then gently washed the wound that extended across the crown of the girl's head. Arefa cried and moaned.
"I need you to do this every night," Lorant said.
Jami and Staci were stunned to hear those words, they recalled.
"If you aren't able to do it, we're going to have to find someone who can," Lorant said.
Caring for Arefa had been Jami's idea. She paused, gathering her thoughts.
"We can do it," she said.
But deep down she questioned whether they really could.
::
The sisters saw Arefa for the first time as she came down an escalator at Los Angeles International Airport. Tears streaked her pale face.
She looks so compact and fragile, thought Staci.
So afraid, thought Jami. So very afraid.
Arefa was one of several Afghan children brought to the United States by the humanitarian group Solace for the Children for medical treatment. The other children fanned across the terminal that June day to meet the families that would take them in. Not Arefa. She stood apart from the sisters, refusing to hold their hands.
She threw up in the car; when she got to the sisters' apartment in El Segundo, she collapsed on the floor, clawing at the carpet, sobbing.
At the hospital the next day, the sisters would learn that Arefa was malnourished. Even if there hadn't been an infection, the doctor said, she was too weak for surgery. The sisters needed to help her get her strength back.
They stuffed their refrigerator with the foods she liked: chicken, grapes, apples, peaches and strawberries. Arefa hated the taste of the protein shakes that supplemented her diet, so the sisters used a syringe to force the liquid down her throat.
Three years ago, the sisters had cared for an Afghan girl who needed an operation on her mouth, and their toughest task was making sure that after surgery she ate only soft food. Arefa was going to be more complicated.
They found communicating with her difficult because of the language barrier. Homemade flashcards helped — photos of a doctor or a little girl brushing her teeth, for instance.
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