The moment she and her host mother, Linda Nugent, set foot in the King Kullen supermarket in Wading River, 13-year-old Saline Otieno made her desire for junk food abundantly clear.
“Oh! Chips?” the girl asked excitedly.
“No,” Ms. Nugent said, gently diverting the girl’s attention to the store’s produce section, where she paused her shopping cart in front of a display of shiny Red Delicious apples. “What else do we need?”
It’s an ordinary scene that plays out along Route 25A every day: family members deciding what groceries they’ll buy for the week.
But Saline, for all her youthful spirit, has had anything but an ordinary existence.
Born in a remote village in southwestern Kenya, Saline shared a mud hut with her mother and sister. Her father died of complications from AIDS last year, and she had another sibling who also died.
At some point in Saline’s life, probably during toddlerhood, her face became severely deformed by noma, a rare type of flesh-eating bacteria caused by malnutrition and unsanitary living conditions. In Saline’s case, the noma ate away the tissue surrounding her mouth and jawbone, creating a hole in her face that made eating and speaking difficult.
“Noma is usually fatal,” said Dr. Leon Klempner, the East Setauket orthodontist who learned of Saline’s case two years ago through his work with Smile Rescue Fund for Kids, a nonprofit that raises money to provide surgery for children afflicted with facial deformities. “She happened to survive.”
In late 2011, Smile Rescue Fund for Kids raised money for Saline to undergo two surgeries in Kenya. A skin graft was made to cover the hole in her face, but the graft, which lacked an adequate blood supply, failed.
To donate to the Smile Rescue Fund for Kids through PayPal, visit smilerescuefund.org.
This summer, Dr. Klempner, who is also a Doctor of Dental Surgery and assistant clinical professor in the Department of Children’s Dentistry at Stony Brook University School of Dental Medicine, received the approval of the Kenyan government to bring Saline to Long Island for medical care. She arrived in June with her tutor and translator, a Kenyan government employee named Duncan.
Saline has undergone one reconstructive surgery at Stony Brook University Medical Center to close the hole in her face, Dr. Klempner said. She will need at least two more surgeries to shape her nose.
Dr. Alex Dagum, Stony Brook’s chief of plastic and reconstructive surgery, is donating his medical services to Saline.
“Her case was pretty severe,” Dr. Dagum said. “Reconstruction is usually complex because [noma patients] are missing a lot of tissue, skin and bone.”
In addition to his role at the hospital, Dr. Dagum frequently travels overseas to donate medical services to other children in need. He treated his first noma patient in China about nine years ago.
“I always wanted to travel the world and help people,” he said. “That was the main reason I went into medicine — I felt I could help people and do good in every corner of the globe.”
While she recovers from her multiple surgeries, Saline divides her time between three local host families: the Nugents, who live in Rocky Point; Mike and Kerri Tame of Selden; and Doug and Diane Muller, also of Rocky Point. Saline’s tutor, Duncan, recently returned to Kenya to care for his family.
Despite a language barrier — Saline’s native language is Dholuo, one of several dialects of Luo, a widespread language of east central Africa — she understands a fair amount of English and is learning more words every day, Ms. Nugent said.
“She wants to be a regular American teenager,” she said. “She wants to watch TV, play on the iPad and eat junk food.”
A shy, bright girl, Saline is skilled at crafts and delights in playing with Ms. Nugent’s grandchildren, especially 11-year-old Heather Tepper.
Heather, who lives in Wading River with her parents, Steve and Michelle Tepper, raised $900 in donations to help bring Saline to the U.S. in 2011 after learning about her story at Dr. Klempner’s orthodontic office.
“There was a jar [for donations] and I said, ‘Mom, I want to do this,’ ” Heather said.
On a recent afternoon, Saline visited the Tepper home with Ms. Nugent, Michelle Tepper’s mother. Saline’s affection for Heather was immediately apparent from their interactions.
At one point during the visit, Saline, dressed in stylishly patterned peach pants and a cozy-looking pullover, positioned herself behind Heather on the family’s living room couch and began braiding the 11-year-old girl’s long, dirty-blonde hair.
The serenity of the moment changed several minutes later, however, when, during a discussion about Saline’s medical condition, Ms. Tepper logged on to Smile Rescue Fund’s website and brought up a photo of the girl taken before she had any corrective surgeries.
Curious to see what was going on, Saline turned from her spot on the couch and glanced at the computer screen.
When she saw the photo, she covered her mouth with both hands and gasped.
Back when that photo was taken, Dr. Klempner said, Saline used to veil her face in public to avoid being socially ostracized. She was a recluse.
Not anymore: In the six months she’s been in the United States, he said, Saline’s self-confidence has markedly increased.
“She holds her head up higher,” he said. “She’s not ashamed of her face. There are almost four million children in the world that could benefit from surgery at any given time. We were just happy to be able to help one.”
Dr. Dagum, who said Saline will return to Kenya once she has recovered from her remaining surgeries, is optimistic about how her life there will significantly improve.
He plans to keep in touch with the girl via email exchanges with her translator, Duncan.
“Hopefully she’ll go back and be able to live a normal life and not be embarrassed about going out because she looks so different,” Dr. Dagum said. “That is my primary goal — to restore her face and sense of self.”