1: What are you trying to accomplish?
2: What's your evidence that you can accomplish it?
3: How is it possible that you can provide an open heart surgery in Iraq for less than $1,000? Is that the full cost?
4: So is that the same thing as saying that my donation doesn't really make a difference? That the "up to 85%" funded locally by those inside Iraq is all that is really necessary to make this work?
5: Any other costs?
6: What is the bottleneck to more surgeries: money or skilled labor?
7: I'm skeptical of non-profits and charities because they always seem to be asking for more money. How can I be sure that Preemptive Love Coalition has "room for more funding" and that I'm not paying into a huge savings account, "Rainy Day Fund", or something similar?
8: Do you have enough volunteer surgeons available for unfunded Remedy Missions? (i.e., are there trips that you could fund if you had more money, or is there a labor bottleneck?)
9: Many heart surgeries require follow-up treatment (including additional surgeries). Do you have a way of providing these to patients?
10: How do you assess whether surgeries are completed competently and appropriately?
11: What is the rate of complications during and following surgery?
12: How do you assess whether surgeons are performing additional surgeries that they would have not had the funding or motivation to perform otherwise?
13: How do you assess whether surgeons are charging their patients for the surgeries you fund?
14: Do you follow up with the surgeons you've trained to assess whether they are correctly applying their training?
15: What information is available on the activities - and competence - of the surgeons you've trained?
16: Where do surgeons work after completing training? Do they serve poor patients?
17: How much do you spend each year on "program" expenses and how much on "overhead?"


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 Q: What are you trying to accomplish?

A: Train Iraqi heart surgeons and nurses so they can eradicate the backlog of tens of thousands of Iraqi children waiting in line for lifesaving heart surgery. [Back to Top]

 Q: What's your evidence that you can accomplish it?

A: Each year we continue to increase Iraq's total number of pediatric cardiac surgeries with new surgeries in Iraqi centers that would not - indeed could not - have been accomplished otherwise. Ministry of Health (MOH) officials speculate 500 surgeries were accomplished in 2009 (of which we provided 23 - 4.6% - outside the country). The addition of our 82 surgeries in FY 2010 - to the 500 baseline - for a total of 582 approximated surgeries, represents an increase created by PLC of 14% over 2009. In FY 2011 we anticipate increasing Iraq's total number of pediatric cardiac surgeries to at least 719 (or another 19% over FY 2010 directly attributable to our surgeons and our training).

Each year the local teams with which we work will become more proficient, and each year they will independently take on a larger case load than they could have the year before. None of these figures yet account for that additional output.

In March 2010 the Iraqi Ministry of Health asked us to expand our work to three additional sites. In May 2010 we began additional discussions about establishing a fellowship program in which international surgeons and nurses would take up residence in the Iraqi system to train locally for 40 weeks out of the year.

Our model does not rely strictly on volunteers because the level of need in Iraq outstrips what we could reasonably supply through volunteer labor alone. Accordingly, we set our budgets so as to actually contract the international surgical and nursing staff we need to accomplish our mission.

Sure, this increases the cost-per-mission (and thereby, cost-per-child) over early "mission" models in which volunteerism was idealized and training was not necessarily prioritized. But our contract labor + volunteerism model is inarguably the only way to create a nationwide quarterly training program and fellowships inside Iraq with international experts across approximately 6-8 surgical sites. Moreover, our model does not face the same sluggishness of learning that other surgery organizations suffer because we do not have the same rates of turnover; we have incredible consistency across our programs and missions. [Back to Top]

 Q: How is it possible that you can provide an open heart surgery in Iraq for less than $1,000? Is that the full cost?

A: The "less than $1k" numbers we routinely publish represent the amount in "program costs" we spend from our international donor money. The figure does not necessarily account for every single management, overhead, or fundraising expense.

Our total expenditures for FY 2010 were $188,919. We performed 82 surgeries during the same period for a per child total of $2,304 (though this data is a bit moot moving into 2010-11 as we abandon our very expensive "surgery exports" program(s) in Turkey, etc. and focus henceforth on more cost-effective in-country surgeries alone).

When all of our Remedy Mission partners are taken into consideration - including the Iraqi Government, medical companies that donate medicines and supplies, and local organizations - the real Remedy Mission cost to all donors is in the range of $5,400 - $7,000. Put another way, up to 85% of the total cost of a single surgical/training mission is now subsidized by local, Iraqi constituent institutions. [Back to Top]

 Q: So is that the same thing as saying that my donation doesn't really make a difference? That the "up to 85%" funded locally by those inside Iraq is all that is really necessary to make this work?

A: There is not a single site across Iraq for which our Remedy Missions are fully funded. If we fail to provide our 15-19% of the overall budget, Remedy Missions fail, surgeons and nurses do not get trained regularly, on-site audits from our international team do not happen, up to 20 children are delayed from receiving surgery, and a few may even die or become inoperable. Your role in funding the remaining 15-19% is as critical in the short term as any other entity. A single Remedy Mission is binary - it either happens or it doesn't. Your money makes it happen. But our goal is to continue to graduate all our programs so they are 100% funded locally in the next 5-10 years. [Back to Top]

 Q: Any other costs?

A: Our numbers per Remedy Mission do not account for "indirect costs," such as the cost (or value) of our volunteer medical staff from around the world, costs to local healthcare systems, the cost of a family to travel to the surgery site, the opportunity costs of lost income for families as they wait for surgery, etc. The reason we think it's important to note this here is because lifesaving is actually quite difficult. Building a pediatric cardiac surgery system for the entire country of Iraq is laborious and full of complexities. [Back to Top]

 Q: What is the bottleneck to more surgeries: money or skilled labor?

A: People often assume that the biggest need is more Iraqi heart surgeons. We could use a few more, but the real bottleneck is skilled nurses, technicians, and non-surgical physicians. A surgeon is only as good as his support staff. One of our biggest challenges is training pediatric cardiac intensive care nurses. To date, we haven't found a better model than our Remedy Missions through which we bring quarterly hands-on training to local nurses (and surgeons) in Iraq. Rather than exporting the nurses to Europe or the USA for training (whose medical systems barely resemble the Iraqi system), we train them with what they have on hand in their local environment. [Back to Top]

 Q: I'm skeptical of non-profits and charities because they always seem to be asking for more money. How can I be sure that Preemptive Love Coalition has "room for more funding" and that I'm not paying into a huge savings account, "Rainy Day Fund", or something similar?

A: For the record, we are skeptical of non-profits as well! In 2012 PLC needs $350,000 on hand at any given time to cover our cash flow needs for up to three Remedy Missions per quarter. We are still 30% under-funded against that goal. In addition to cash flow needs, we still require 15-19% funding on most of our missions after local sources contribute their portion; we have un-funded pilot programs in new cities where local doctors have been requesting our help (but where weve yet to woo local philanthropists or health directors); and we have research and social service initiatives through our Followthrough program that require funding at present because we have not yet sought local funding for those initiatives (seeing as how they relate mostly to our Monitoring & Impact Evaluation objectives). Please see our "Funding Gap" page to look deeper into our anticipated program costs, the sources of funding we are counting on, and the funding gap between the two for the next few years. [Back to Top]

 Q: Do you have enough volunteer surgeons available for unfunded Remedy Missions? (i.e., are there trips that you could fund if you had more money, or is there a labor bottleneck?)

A: Great question! We use a hybrid volunteer/staff model. Roughly 25-30% of any one of our Remedy Mission teams is employed by the International Children's Heart Foundation (typically the surgeon, scrub nurse, anesthesiologist, ICU doctor, and often a part-time ICU nurse). The remainder of the team typically comprises volunteer physicians, technicians, and nurses from across the world. Because the hardest-to-come-by positions are contract labor for us and NOT volunteers, we have never failed to run a mission for lack of personnel. We have only cancelled or turned down a request for a future mission due to lack of funding. [Back to Top]

 Q: Many heart surgeries require follow-up treatment (including additional surgeries). Do you have a way of providing these to patients?

A: Yes, we do. Our model dictates quarterly visits to each program site (a hospital inside a regional hub). Our reliance on local cardiologists ensures that the local team prioritizes and almost entirely sets the agenda for patient selection (within a development curricula) - after all, Iraqi doctors are the ones who are most intimately connected to the patients and their daily progress! When a local cardiologist sees a child who has either (1) deteriorated and requires another intervention or (2) advanced as expected to the next step of a complex, staged intervention, the child is prioritized for follow-up treatment. [Back to Top]

 Q: How do you assess whether surgeries are completed competently and appropriately?

A: Because we are a broker and play a combination administrative and financier role in the coalition of partners working in Iraq to develop pediatric cardiac care, we are able to stand in-between the local surgical team and the international surgical team (whom we contract as a third-party to train and perform surgeries in Iraq). If the local team or health directorate suspects a lack of competence in the international team, a cavalier attitude, or a single poor judgement call, our role is to be the go-between - to be the advocate for the local healthcare providers vis-a-vis the international surgical team.

Similarly, if the international surgical team feels pushed by the local surgical team to perform procedures with which they are uncomfortable or for which they think the local system is ill-prepared, they are able to refuse children for surgery and/or use us (PLC) as a go-between.

The checks-and-balance between the two teams helps us ensure surgeries are performed in a competent, appropriate manner. [Back to Top]

 Q: What is the rate of complications during and following surgery?

A: We report our in-hospital and 60-day mortality after each Remedy Mission. You can finds those numbers here. We also produce reports after each Remedy Mission detailing the trip, including data on intraoperative complications, post-operative complications, and mortality. You can find those reports here. We are also deliberately raising the funds necessary to help us bring our various heart hospitals into compliance with the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing Countries. If this kind of quality improvement and reporting initiative interests you, we are currently looking for financial partners for our Followthrough program. [Back to Top]

 Q: How do you assess whether surgeons are performing additional surgeries that they would have not had the funding or motivation to perform otherwise?

A: Pediatric heart surgery in Iraq is almost nonexistent without our work. There are two active programs for relatively simple surgeries (one in Erbil and one in Baghdad). Local surgeons claim that combined they perform no more than a few hundred pediatric surgeries a year. In every location where we work, pediatric heart surgery is effectively nonexistent. Therefore, every surgery performed at our program sites (both when we are present and when we are not) are "additional surgeries" that they would not have had the SKILL to perform without the FUNDING we employed to train them in their local environment. [Back to Top]

 Q: How do you assess whether surgeons are charging their patients for the surgeries you fund?

A: Because we work in public (government) hospitals - and because healthcare in Iraq is provided almost entirely free of charge - it is widely known that any cardiologist, surgeon, or administrator seeking compensation for services is acting outside of Iraqi law. [Back to Top]

 Q: Do you follow up with the surgeons you've trained to assess whether they are correctly applying their training?

A: We see them quarterly in their local environment and perform real-time audits of their skills, recollection of past training, application of new techniques, etc. Additionally, our international surgeon remains on call at any time via phone, Skype, or email for consultation. [Back to Top]

 Q: What information is available on the activities - and competence - of the surgeons you've trained?

A: Because our Remedy Mission training program only began in late 2010 - and pediatric heart surgery at our sites across Iraq is the same age - there is still relatively little independent practice to report, and therefore little data on the activities and competence of our surgeons and their teams. But as they begin performing more surgeries independently, we are trying to align each site/surgical team with the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing Countries (a data collection and tracking initiative of Children's Hospital Boston and Harvard University). [Back to Top]

 Q: Where do surgeons work after completing training? Do they serve poor patients?

A: As of Q2 2011 there was only one private hospital in Iraq (to our knowledge) providing pediatric heart surgery (and those surgeries were on the lower end of the complexity scale). Our work does not necessarily mean to exclude private hospitals as they continue to come online and become viable options, but at present the government system has a better equipped foundation for training local surgical teams. As we look to fully graduate our local surgical teams in the next 5-10 years, we imagine that most of them will stay in the public sector for all of the stability, pensions, and benefits of loyalty provided to those who stick with it. But, undoubtedly, some will seek positions at private hospitals (assuming private hospitals are willing to invest in the requisite capital purchases necessary to establish a credible program). In the public sector, rich and poor are served alike. In the private sector, poorer patients would be at an obvious disadvantage. [Back to Top]

 Q: How much do you spend each year on "program" expenses and how much on "overhead?"

A: As a rule, we do not adhere to the model that claims that "overhead" is somehow bad and "program" is somehow good. There are very bad program expenses. There are overhead expenses that are excellent investments. We agree with Paul Brest, President of the Hewlett Foundation, when he said, "Achieving a low overhead ratio drives many charities to behaviors that make them less effective and means more, not less, wasted dollars." Therefore, we spend as much on overhead as we need to accomplish our mission. The mission itself is our North Star - not arbitrary (even harmful) standards about overhead-vs-program expenditures. For the record, however, you can find a current pie chart of our expenditures here (and if you're into that sort of thing, you'll probably be impressed!). [Back to Top]

Jeremy Courtney Founder, Executive Director Twitter: @Jeremy_Courtney

“I'd love to hear any critique or questions you might have!”

DROP A NOTE OR DONATION BY MAIL: Preemptive Love Coalition 1300 Darbyton Dr. Hewitt, TX 76643 GIVE BY PHONE: To make a gift over the phone, using your credit card (Visa, MasterCard, American Express, or Discover), please call +1 (806) 853-9131 during normal business hours. IRAQ OFFICE: +964 770-355-6298 (local)

From My Heart to Yours—An Intern’s Personal Encounter With Congenital Heart Defects

June 26, 2012 by Tyler · Leave a Comment 

Hey guys! I want to tell you a story…
My cousin’s daughter, Madi, was born with a congenital heart defect (CHD). Seeing my cousin suffer wasn’t the only reason I chose to work with PLC this summer, but it was a major one.

Madi’s fight for her life began the day she was born, and it serves as a constant reminder of how important my work is here in Iraq.

Madi (short for ‘Madison’) spent the past 9 months in the world-renowned Texas Children’s Hospital receiving constant care and, for the past 4 months, she has been kept alive by a “Berlin heart,” an artificial device that pumps blood for her heart until she can get a transplant, technology that does not even exist in Iraq. Since Madi began treatment with the Berlin Heart, her name has been at the top of the heart transplant list in Houston. Through all that has happened, I have seen the complexity of CHD and the importance of having a well-trained medical staff.

I’m happy to report that, on May 29^th, Madi received a NEW HEART! And this past week, after over 220 days in the hospital, Madi is now at home and ready to start the life she is supposed to live.

Our family spent months in prayer for Madi, and now we’re rejoicing, grieving, and praying through all that has happened. Although God has brought Madi and her family far, their journey is by no means over.

I hope you can join me in the celebration of a saved life, realizing that this is how families all across Iraq are affected when their child is saved. To date, PLC has saved hundreds of lives and will continue to save more. But each child has their own story and their own friends and family who are deeply involved in their battle with CHD.

So, wherever you are, try to enter into their story; see, feel, and think as they do, and then thank God if you have healthy children and great healthcare! You can also join us in our battle to fund surgeries, build infrastructure, and raise awareness for Iraqi families who aren’t as fortunate as my own by giving toward our brand new Remedy Fellowship campaign—help us save 300 little lives!

Want to hear more of Madi’s story? Check out stories by ABC or Fox News to learn more about this amazing little girl.

“No longer will she have to struggle to catch her breath every hour of the day or feel like she can’t stand and play with her toys because she’s too tired. Our baby girl will get to experience what life is meant to be, not what it has had to be for the past 22 months.”
—Tabitha Fleak, Madi’s mom

Hamma Is In Surgery!

February 11, 2012 by matt · Comments Off 

Remember super-sad-faced Hamma?! He’s getting surgery now!

I spent much of the day running in and out of the operating room to check on him. His father kept poking his head in from the hallway and whispering, “Psst! Mister! Photo Hamma?”

I felt like an image delivery boy with all the running back-and-forth, but letting Hamma’s dad ‘watch’ his son’s progress through surgery was extremely rewarding—at one point he even side-hugged me!

Here are a few of the photos I showed dad throughout the day:

(The boy isn’t alone here, the nurse just stepped away from the window)

As you can imagine, each picture I showed them brought on strong emotions, and by the end of the day his parent’s eyes were bloodshot from lack of sleep and crying. But the doctors report that the surgery is going well.

More to come…

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In the News: “Rebuilt Iraq hospital plans surgery on infants”

September 1, 2011 by Craig · Leave a Comment 

Photo credit: AFP

A hospital in Iraq is back up on its feet after years of getting knocked down and now it’s better and bigger than ever!

Rebuilt after many years of violence in Iraq, the Ibn al-Bitar Hospital for Cardiac Surgery in Baghdad is beginning a new program to teach its doctors how to better operate on children who need heart surgery.

“”Until now, we have not been able to conduct heart surgery on infants,’ said Doctor Hussein Ali al-Hilli, director of the Ibn Bitar Hospital for Cardiac Surgery in Baghdad.

‘We receive 80 children a day with various heart-related birth defects that we cannot treat. We need three years to learn because such procedures are complicated,’ he added.”

Want to know more about this amazing project? Check out the full story here and tell us what you think in the comments section below!

Why Heart Surgeons Are Like Rock Stars

August 22, 2011 by Lydia · 1 Comment 

I’m in an Iraqi hospital room, surrounded by five conservative, Muslim women, discussing Michael Jackson. Wait–what?

During our last Remedy Mission in southern Iraq I became curious about what these families think when they see me. When they meet a young, white, American girl do they take me for who I am, or do stereotypes and reality TV characters precede me? What kind of reputational baggage have American media, troops or aid workers left in Iraq that I don’t even know I’m up against?

Needing to get to the bottom of this, I grabbed a translator and headed to the hospital ward to ask these mothers, “Who or what represents ‘America’ to you?”

The first few answers were easy– “democracy”, “freedom”, “independence.” But these were not the answers I was looking for. I wanted to hone in on who was the singular “face” of America. So we started asking just that, “Which single person represents the United States to you?”

The most popular answer? Michael Jackson. I couldn’t help laughing out loud. Really? Michael Jackson? I was expecting Lady Gaga, Brad Pitt or perhaps Katy Perry (or President Obama, at the very least). But MJ? And I got this answer from not one but several Iraqi families. Pretty interesting, right?

But the resounding response I also kept hearing was….Dr. Novick! Our very own, world-renowned, rockstar heart surgeon from Memphis is revolutionizing the way Iraqis see Americans.

Many of the women agreed that this ICHF team had completely exceeded their expectations on the kindness of the West. I guess saving their child’s life leaves a stronger impression than “American Idol.”

Dr. Novick–Michael Jackson’s got nothing on you!

Noor’s Heart Is Mended And There Are Teethmarks To Prove It!

July 6, 2011 by Cody · 2 Comments 

The doctors fully repaired Noor’s heart!

She’s thriving in the hospital ward right now as she shows us a side of her that we’ve never seen before. The difference between the Noor before the surgery and the Noor now is unmistakable. Before, we could barely get photos of her awake and active, but now we can’t catch her holding still.

Little Noor has left her mark on all of us…including our hospital equipment! We admit that this is NOT how you show the doctors how well you’re breathing after your surgery. But her teethmarks are another good sign that Noor can’t wait to get out of the hospital and back to being a kid!

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Noor Is Heading Into Surgery!

July 4, 2011 by Cody · Comments Off 

Noor’s wait is over!

She’s made it into the operating room and the doctors are hard at work making sure that they send Noor away with a strong and healthy heart!

If they’re able to accomplish all they hope to accomplish with Noor, it will be the 9th lifesaving heart surgery this trip.

Thanks for making this possible! More news to come…

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Mohammed Is Here For The Remedy

June 29, 2011 by Alex · Comments Off 

Today, I hesitated outside the entrance of the hospital ward in southern Iraq. Kids spend most of the day waiting for surgery in this room.

Mothers and their children filled the room, and I didn’t want to barge into a room that these families might have thought were off-limits to outsiders.

But as I stood there, recognizing that I was the outsider, looking confused and out-of-place, a 6-year-old boy named Mohammed walked up, smiled, and took my hand as if he knew exactly what I was going through.

He safely escorted me to the back of the room so I could meet the family I had come to see.

Mohammed never left my side, but just kept holding my hand and making me feel more at-ease until he felt that his duty had been completed.

We couldn’t speak to each other and even though we interacted for only a few minutes, I can’t help but to look forward to spending more time with Mohammed.

What makes me more excited is that Mohammed isn’t just here to help out this goofy foreigner; he’s here to have his failing heart restored.

He’s here for the Remedy.

The doctors are still unclear as to how complicated Mohammed’s heart condition is, but they’re beginning the tests that will help them know what needs to be done to reclaim his heart.

In the meantime, we’ll just keep waiting.

Stay tuned for more updates on Mohammed.

While you wait check out Rokya’s Mom documenting her daughter’s Remedy in Iraq on our Facebook page.

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How One Family Returned Looking For Their Belongings And A Second Chance

June 27, 2011 by Cody · Comments Off 

Today was our first day in the hospital, but it felt more like the first day of school. The hallways were filled with families and their children, deliveries were made, rooms were assigned, tours were given, and in the midst of all that we were looking for little four-year-old Noor.

While we were on the hunt for Noor, her family was looking for the lost and found in search of all their belongings that they left behind from the last Remedy Mission.

Noor was scheduled to receive surgery last Remedy, but on the last day her family received news that there wasn’t any more time left to operate on their child. It would have to happen the next mission. Heartbroken that their daughter wouldn’t be given a chance this time around, they held Noor close and returned home – forgetting all of their belongings on the hospital floor.

Today, they returned for all that was theirs to claim: their belongings and a second chance.

Noor’s on the schedule again for what we all hope will be a lifesaving surgery. Until then, we’re enjoying another opportunity to love on Noor!

Join us this week as we follow her second chance.

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Why Father's Day Means So Much to Hafez And His Son

June 15, 2011 by Jeremy · Comments Off 

At exactly this time last year, Hafez (pictured above) was facing down the worst Father’s Day of his life as he desperately worked against the clock to save his son’s life.

At exactly this time last year, we asked for your help… and you came through in a huge way, raising more than $30,000 in just a few weeks so we could launch our first-of-its-kind Remedy Mission inside Iraq.

At exactly this time last year, you made this father’s day and helped secure for him a happier life than the one he was facing without you.

Meet Abdul Kareem – the son of my friend, Hafez. When I met them, they did not have the money to pursue surgery outside of Iraq like all the rich people, people with political clout, or the lottery winners.

I’ll never forget Hafez’s plea to me – certainly the same plea I would make on behalf of my son – “Just do something for him. He’s just a little boy.” He got so emotional that he excused himself from my office. This father, having done all he could for his son, walked away from the office crying. Abdul Kareem needed heart surgery before his first birthday or he was likely to become entirely inoperable – “a lost cause.”

But you weren’t about to let that happen!

The day our surgical team arrived from all over the world for Remedy Mission I, Hafez must have seen us on the news because he called me ten times: “Is my boy going to surgery? Mr. Jeremy, just do something to help my little boy!”

His boy was going to surgery, thanks to those of you who gave in response to our request last year’s for Father’s Day and our Remedy Mission launch!

There is another moment with my friend Hafez that I won’t forget – the day his son Abdul Kareem had surgery. I remember it so distinctly because after the surgery Hafez grabbed me, kissed me, and gave me an

tearful “thank you” for keeping our word; for saving his son’s life.

Once Abdul Kareem was discharged to return home, Hafez sent me a message from the road. The message said something like, “Thank you so much for your organization and for helping my little boy. We will not forget you.“ With tears running down his face, he wanted to thank you each by name. You made a father’s dream come true. And you prevented his big brother, Abbas, from growing up without a soccer-buddy.

Dad, I love all the great memories we’ve made together. This year, I wanted to add, “saving a child’s life in Iraq” to the list, so that another child and his father can make great memories together too.

We want to make it easy for you to honor your dad this Father's Day and help save the life of baby Ghazel. A simple $10 donation will help us save her life and cover the cost of two hours of hands-on training with local Iraqi surgeons! A $25 donation will accomplish that and add hours of training in Iraq for an additional three Iraqi doctors and nurses! If you like, we'll even provide you with a free downloadable card that you can print and give to your dad this Father's Day!

Finding Familiarity In An Unlikely Place | An Intern’s Perspective on Followthrough

June 10, 2011 by Adam · Comments Off 

Yusuf is a brave 1-year-old who underwent heart surgery this past March. When his family brought him to the hospital, Yusuf blood had low levels of oxygen that had already tainted his skin blue. The surgeon needed to fix four heart defects for Yusuf to survive.

But thanks to caring donors and local support, Yusuf is very much alive!

You helped Yusuf receive a heart surgery, and, because of you, I was able to visit and make sure his recovery is going well. This is what we call Followthrough. CLICK HERE to learn more on the importance of Followthrough.

As we sat down with Yusuf and his family I was overwhelmed with all the cultural differences around me, but there was a strange sense of familiarity as well.

Shortly after we sat and talked in Yusuf’s living room, his family rolled out a giant feast for us. We ate until we were full, and there was still enough left to feed us for dinner! Then we drank tea, and the refills seemed to be endless.

As we drank tea and took photos of Yusuf, his older sister played with him and entertained us with her hilarious faces. Yusuf’s grandfather would toss his phone across the living room floor while Yusuf would scoot across the room to return it again and again.

The familiarity I recognized during my visit was the same warm family dynamic and rejoicing I experience with my own family.

Even though we ate sitting down on a concrete floor, followed a completely different set of manners, and understood very little of the words spoken, the joy and relationship between these family members was the same as many American families I know.

We laughed and enjoyed the fact that their son’s life had been rescued. At this point in the visit I began to see these faces as my family and friends rather than as distant strangers.

This family was so grateful for us, for their son, for his surgery, and for a community willing to come together to provide a solution for their needs. I felt the warmth in their home through photos of Yusuf, endless cups of tea, a floor full of food, and a room bursting with smiles.

No matter how great the cultural barriers there are some values and moments humanity can rejoice in and enjoy together. These shared moments and values are the most significant puzzle pieces of our own identity.

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