A 4-month-old Iranian girl in need of life-saving heart surgery, who was stuck in Tehran after President Donald Trump's travel ban went into effect last week, was granted an exemption and cleared to come to Portland for the procedure on Friday.
But with the political hurdles seemingly overcome, what lies next for young Fatemah Rashad?
A team of doctors and a lawyer representing her family gathered at OHSU Doernbecher Children's Hospital Saturday morning and gave an update on her condition, the family's imminent trip to Oregon and the problems they encountered in getting the care she needs to treat the complex heart disease she was born with.
The doctors made clear the high stakes for Fatemah and her family if the fight for clearance to come to the United States had failed.
"This is a fatal condition without treatment," said Laurie Armsby, interim head of the hospital's Division of Pediatric Cardiology. With surgery, however, Armsby said Fatemah can be expected "to live a full and active life."
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Fatemah's travails began last Saturday when her parents were scheduled to fly from Tehran to Dubai, said her uncle, Samad Taghizadeh, who lives in Portland with the young girl's grandparents. He had helped the family fill out a tourist visa application and set up an appointment with the U.S. Embassy in the United Arab Emirates.
The travel ban had gone into effect the previous day, however.
"I got the email and everything was canceled," Taghizadeh said. "I was in shock."
The family was told they would have to wait for the ban to expire, 90 days away, and reapply for the visa. Her condition worsens with time, however, and Taghizadeh was worried that she might not have time.
Fatemah's story gained publicity and lawyers, politicians and doctors began working on multiple fronts to gain access for the infant. Oregon Sen. Jeff Merkley assigned a caseworker to the family and Oregon lawmakers sent a letter to Secretary of State Rex Tillerson imploring the government to grant her an exception.
On Friday night, it was granted and, by coincidence, a judge in Washington state imposed a temporary restraining order on the bad almost simultaneously. Soon after, Trump vowed to fight the restraining order, but Fatemah's exemption was independent of those legal wranglings, so her status should remain regardless of what the courts decide.
The weeklong delay in treatment she has had to endure was "something we can manage," Armsby said.
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The doctors were given permission by the family to talk about Fatemah's condition and laid out the details of exactly what she is facing.
The form of congenital heart disease she has is rare, Armsby said, affecting roughly two out of every 10,000 children.
In a normal heart, blood pumps to the body and returns to the heart, Armsby explained, then is pumped into the lungs where it picks up oxygen before again returning to the heart. In Fatemah's heart, blood flows from the body into the heart, but instead of flowing into the lungs, it is pumped back into the body without the oxygen the lungs are meant to provide.
Under normal circumstances, the heart circulates blood in a series -- heart to body to heart to lungs and back to body -- but Fatemah's heart works more like two parallel circulations, with one circulating blood in the body and another in the lungs, but without the two ever intermingling.
Irving Shen, head of Pediatric Cardiothoracic Surgery at the hospital and the doctor who will perform the surgery, said he would essentially be reconfiguring Fatemah's heart so that the blood would follow the proper path.
In the U.S., a child born with this condition would have undergone surgery in her first weeks, Armsby said, and would have likely recovered in a couple weeks. The fact that Fatemah didn't receive that immediate care has complicated her condition and the defective blood flow from her heart has likely injured her lungs, but Armsby said they believe that any damage is reversible, though with a slightly longer recovery phase.
Armsby said the doctors at Doernbecher have committed to working with Fatemah's medical team in Iran to collaborate on continuing care once she is released and returns home.
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Dana Braner, physician-in-chief at Doernbecher, said that the cost of the surgery would be waived by the hospital and Becca Heller, director of The International Refugee Assistance Project, which is helping with the family's trip, said a law firm had volunteered to cover the travel costs.
Heller described their departure from Iran as "imminent" Saturday afternoon, but said the exact details of their trip were being kept confidential. Jennifer Morrissey, a lawyer representing Fatemah's family, said they were expected in Portland sometime in "the next several days."
Still, she said this was a situation that never should have occurred in the first place.
"I think this was the clearest illustration of why the travel ban was poorly thought out, poorly implemented and had significant humanitarian impacts," she said.
-- Kale Williams
kwilliams@oregonian.com
503-294-4048
@sfkale
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