25th Mar 2017 9:40:37 AM

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Photo's February 2007
Dorah's Future
Dorah's House
UK Visits 2002
Photo's May 2001
Photo's May 2000
Corneal Grafts
The Times
The Daily Mail, 2002
Leeds April 2004
About Dorah
Children of Fire The Future for Dorah

Our comittment to Dorah is to see her through her operations, hopefully most concluded within her childhood. Other people who have had severe burns or similar deformities to those that Dorah has, have had operations spread over many many years, because some aspects cannot be rushed and because the body and the mind need to rest and build between operations.

If Dorah is forever in hospital she has little chance of catching up on schooling, normal development and social interaction / family life. Most people who are injured during childhood or born with deformities, continue to have operations well into their adult life.

Here are some of our informed guesses on Dorah's timescale. The surgeons involved do not like to commit themselves far ahead because they are terribly aware of the potential for many a slip twixt cup and lip.

Age five - 1999 - corneal graft and cataract removal on right eye; improving shape of lips. Maybe starting another tube pedicle; maybe trying to move other tissue into place. MAYBE all the surgery fails and has to be tried again the following year.

Age six - 2000 - right upper and lower eyelid muscle work. Maybe moving more skin into forehead area to allow bone replacement technique in the future under better quality skin (this would not work now as there is not enough stretch in the skin that is there). There are bone replacement methods that now grow with the recipient.

Age seven - 2001 - maybe still needing to move tissue in the face or into the face (as Dorah's body gets bigger, she is more able to spare skin). One can elect to make a saline or air bag "pregnancy" under certain areas of skin to stretch them - but the UK surgeons seem not as keen on this method as their South African counterparts. The problem with delaying moving skin is that while Dorah's skull is now growing in a better shape than before, it is still not growing in the correct proportions and evey year skin / tissue movement is delayed, her head will grow more deformed and much of that may be irreversible. It is compensating for areas of tightness (all around the nose region, the forehead, the stretched deformed ears) by growing too much in other areas. The lip work in 1998 has allowed Dorah's jaw to start to move towards its proper alignment but she is still a long way off being able to close her mouth.

Age eight - 2002 - more work on hands. Prosthetic thumb implants. Opening left stump (though in fact this is likely to be tackled much earlier). Keratodontoprosthetic corneal graft to left eye using part of Margaret's jawbone and /or eye teeth to give Dorah's left eye a chance to see. (Christopher Liu pioneered this surgery in the UK.) Maybe if all is settled in well - then only eyelid muscle operations between age eight and ten.

Age 11 - 2005 - skin grafts into the chest area before Dorah starts to develop breasts. The skin there is too tight and following recent discussions with burns doctors in Cape Town it has become apparent to me that Dorah will suffer great unnecessary pain if her chest scarring is not improved before puberty.

Age 12 onwards - improvements to previous work; extra tissue movement to allow for growing body size. If all the trustees had time or inclination to read the considerable amount of text on the burns survivors websites (at least one is cross referenced to from our own site), it would be clear to them that the operations will have to continue for a long time but can decrease in frequency over the next couple of decades. The sort of aspects that are of great emotional importance to people with damaged faces are to be able to smile when they want to. And to be able to have the normal facial features like eyebrows. Dorah has no eyebrows. One adult male who fell into a fire when he was camping, lost his eyebrows. He was operated on to move hair into the eyebrow region, because this feature was important to him. What he hadn't realised was that his new eyebrows were of a different sort of hair that grows rapidly like the hair on one's scalp and so he will have to cut his eyebrows every single day for the rest of his life. Dorah does not have a normal hairline, so her face appears too big. Both eyebrows and hairline can be dealt with surgically.



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