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Tuesday, January 17, 2006

The Atlanta Journal and Constitution


New face, new future Ga. surgeons offer hope to Zambian girl


Edition: Home

Section: Atlanta & The World

Beatrice hid her face behind her fingers. The slight child slowly peeled back her fingers, revealing her eyes, mouth and nose. Her doctors smiled at the startling transformation.

The 8-year-old orphan from Zambia wasn't so sure. She had dreamed about having a nose, like other children, since she came to Atlanta for reconstructive surgery. As her team of doctors surrounded her for a final consultation Aug. 17, she wasn't comfortable with the new look.

She had lived without a nose since surgery for a tumor on her face as an infant left her with a hole where her nose and upper lip had been. Her appearance has always been more startling to others than the little girl with the upbeat personality.

Beatrice looked around the room at speech pathologist Kara Kenkle and Doctors Jack Thomas and Joseph Williams. She had known Williams the longest and gave him an approving glance and hug.

Williams, a pediatric craniofacial surgeon, praised the group responsible for the child's new face. The 9-member team, at Children's Healthcare of Atlanta at Scottish Rite, included two pediatric plastic surgeons and speech pathologists, a pediatrician, dentist, orthodontist, prosthodontist and audiologist. All donated their time.

"Our goal has always been to get Beatrice to a point where she is comfortable enough to enjoy being a child," said Williams.

Childspring International, an Atlanta-based organization that finds medical treatment for children, mostly from Third World countries, brought Beatrice to Atlanta 15 months ago. Helen Shepard, Childspring development director, said that in a few months, Beatrice will return to live at Emma's Kids, a Church of God ministry and school that helps street children in Zambia.

Her doctors say Beatrice will come back to Atlanta for future surgeries. Williams is happy with changes in his young patient but won't be totally satisfied until he can do another operation in about a year to bring her jaw forward. That will increase space in her head, improving her speech and appearance. When she is a teenager, she will have more work to build an upper lip and a permanent nose.

During the first procedure a year ago, Williams and Dr. Mark Deutsch took a flap of skin and vein from the child's right forearm and created a palate and platform for an upper lip by pulling the skin around a titanium plate.

In January, Williams took bone from her hip and transplanted it into her jaw. He also worked on bringing in the corners of her mouth.

In early August, Beatrice received a prosthetic nose, an acrylic appliance to cover the roof of her mouth, and a partial denture attaching new teeth to existing teeth in the back of her mouth.

Thomas, a pediatric dentist, said the piece allows Beatrice to speak easier and normalizes the mouth and nose by separating them.

"She has a normal-looking smile now. She looks tremendous," he said. "This has made her more social and confident."

After her second surgery, Beatrice moved from a home in Smyrna to live with a family in Alpharetta. Her temporary guardian, who doesn't want to be named, said the little girl has adapted well to her two children, a houseful of animals and a busy life in suburban Atlanta.

When Beatrice started kindergarten a few weeks ago, she decided to leave her new nose at home. Her caregivers think having a nose was a more dramatic change than the little girl anticipated, and it will take awhile for her to adjust.

"We aren't through yet, but we are close," said Williams. "What we wanted was to give her a chance for a normal life. In a lot of ways, we've done just that."

CAPTION: ANDY SHARP / Staff 8-year-old Zambian orphan Beatrice shyly covers her face with both her hands.

CAPTION: ANDY SHARP / Staff 8-year-old Zambian orphan Beatrice covers half her reconstructed face with one hand.

CAPTION: ANDY SHARP / Staff 8-year-old Zambian orphan Beatrice reveals her reconstructed face to the camera.

CAPTION: ANDY SHARP / Staff "We wanted . . . to give her a chance for a normal life," said Atlanta craniofacial surgeon Dr. Joseph Williams of his huggable little patient, 8-year-old Zambian orphan Beatrice.

(Copyright, The Atlanta Journal and Constitution - 2005)