Medical Mission: 95 Kids in Need

Since Thien Nhan's first round of phalloplasty surgery, we've been inundated by requests for help from dozens of other families in Vietnam whose sons are suffering from malformations or traumatic loss of their genitals. In light of all that we have learned and experienced in the past five years, I feel a strong moral obligation to "give back" to others.

Thien Nhan has experienced complications and will require two more genital surgeries. In light of the prohibitive costs, we invited the Italian specialist, Dr. DeCastro, to come to Vietnam - and he generously agreed. In three weeks' time Dr. DeCastro will perform surgeries in Hanoi on 32 young patients - including Thien Nhan, at a cost of $1,500 per sugery. Fantastic!

This was a difficult decision for us, because it involves limiting the funds that could be given to Thien Nhan, who still has many unmet needs, including a working prosthetic limb, physio and educational costs. We hope that Thien Nhan's champions will continue to support him. That said, we also hope to find more donors to help other kids facing similar hardships. There are 95 children in Vietnam awaiting this surgery. Within the next nine months they could ALL receive this life-changing surgery - if we can find funding.

If you can help, please email me at gcraft001@gmail.com


Sincerely yours,

Greig Craft

Thien Nhan Video

Click on the title to see a video of Thien Nhan, taken nine hours after he got out of surgery. He continues to heal well and is looking forward to returning to Hanoi to play with his cousins and his 5-year-old brother, Little Minh.

Family Support

"Thien Nhan is able to sit up and is eating well," reports his mum, Mai Anh. Indeed, the 4-year-old is recovering so well that his doctors may allow him to check out early and fly home to Vietnam. "We hope to go home this coming weekend," says Mai Anh. This is good news for Thien Nhan's brother Little Minh, 5, who is back in Hanoi, where he misses his brothers and his mum.

An early return to Asia would also be good news for Thien Nhan's godparents, Greig Craft and Na Huong, who organized this child's life-changing medical mission and accompanied him to Italy. Over the years, Greig and Na Huong have repeatedly taken time off from their demanding jobs in Hanoi to organize and accompany Thien Nhan on trips to see specialists in the USA, Germany, Thailand, and now Italy. All of these journeys have been made at their own expense, and caused considerable disruptions to their busy schedules.

While Thien Nhan had a rough start in life, he is lucky to have found such fantastic godparents!

[Photo shows Greig Craft and Big Minh comforting Thien Nhan.]

Recovering

Thien Nhan spent two days in Intensive Care, but is now recovering well. He is in pain, but his discomfort is being managed with medication. A risk of complications remain, especially pulmonary issues, as fluid can easily accumulate in the lungs of youngsters of Thien Nhan's age post-surgery.

As advised before the surgery, an additional urological surgery will be required in 6 to 9 months. But the goal of this surgery - to rebuild the boy's genitals - seems to be an outstanding success.

"Without going into graphic detail, suffice it to say that he looks 100% normal," says Greig Craft, the American philanthropist who, over the past 4 years, has been instrumental in organizing Thien Nhan's medical care. "Because the revolutionary technique of Dr. De Castro involves creating a penis from the pubic area, where flaps are cut from the side and formed to create a natural-looking, age-appropriate and functioning penis, the end result is stunning. Because this is from his body it will grow with him through puberty, as would his original penis."

The child's scrotum was also rebuilt, and a prosthetic testicle inserted. When he gets bigger, another testicle will be added.

[Photo shows the surgeon who led Thien Nhan's reconstructive surgery, Dr. De Castro, changing the boy's bandages.]

Then and Now

Four years ago, shortly after birth, Thien Nhan was abandoned on the edge of a forest in Central Vietnam. He lay in the open for three days and was badly mauled by wild animals. Found by passerby, the horrifically injured baby was transported 2.5 hours by motorbike to the nearest hospital, where doctors performed life-saving surgery. Unfortunately, the child's right leg was lost and his genitals were badly damaged.

Last week, Thien Nhan, now 4, underwent another life-changing surgery in Bologne, Italy. Surgeons worked for more than 8 hours to rebuild the boy's penis and insert prosthetic testes. "The surgeons say everything went well and he is recovering," reports Thien Nhan's relieved mum, Mai Anh. Full recovery is expected to take three months.

[Top left photo: Thien Nhan recovering from surgery in Bologne, Italy. Top right photo: Thien Nhan in Intensive Care as a newborn in Central Vietnam.]

Best Big Brother

While Thien Nhan's recovery seems to be progressing smoothly, he remains in considerable pain and is on strong medication. Whenever the 4-year-old wakes up, he immediately looks for his beloved brother, Big Minh.

Here, Big Minh is helping Thien Nhan to get a drink of water.

Good news

After about eight hours in surgery, Thien Nhan, 4, is recovering well. The surgeons are confident that the procedure to insert prosthetic testicles, extract the child's penis from beneath a covering of skin, and extend it was a success.

"His penis will be normal size for his age and look normal in about three months," said Thien Nhan's mum, Mai Anh. "It should be able to grow with him and have sensation."

Obviously, it had been a long day for Mai Anh, who was very relieved that the surgery was a success. Speaking at around midnight last night (Vietnam time), she said: "Thien Nhan is still groggy. When he woke up from the surgery his eyes were full of tears. He saw me there and he said: 'I didn't cry, Mummy. It doesn't hurt so don't worry. 'Since then, he's woken up a few more times and told me that he didn't cry."

Thien Nhan must remain in hospital in Bologne Italy for another two to three weeks, to recover from this major procedure.

At the Hospital

After a long trip, Thien Nhan arrived safely in Bologne, Italy. "He was a good boy on the flight and ate and slept well," says his mum, Mai Anh. "We are all tired but happy to be here."

This morning, Thien Nhan will see doctors for a pre-surgery consultation. The surgeon needs to be sure that he is healthy enough to withstand such a lengthy and difficult operation.

Bon Voyage

Along with trip organizers and longtime supporters Na Huong and Greig Craft, Thien Nhan, his mom Mai Anh and his 12-year-old brother Big Minh boarded a flight to Paris last night at midnight. Their final destination is Bologne, Italy, where Thien Nhan, 4, is to undergo genital surgery on January 29th.

As the group sat waiting at Hanoi's Noi Bai airport, Mai Anh admitted to being nervous about Thien Nhan's upcoming surgery. "I'm sure that Thien Nhan will sleep on the plane," she said. "But I doubt that I will."

[Photo: Thien Nhan (right) and his brother Little Minh check out some new toys that Thien Nhan will bring on his trip to Italy.]

Getting ready

Because Thien Nhan is leaving for Italy tomorrow (Tuesday) night - and nobody wants him to catch a cold at school - he is staying home today. His mum, Mai Anh, is busy collecting warm clothes and packing for their trip.

Mai Anh, Thien Nhan, and Thien Nhan's eldest brother Big Minh will spend Vietnam's biggest festival, the Tet Lunar New Year, in Italy. Following his genital surgery, Thien Nhan must spend two to three weeks in hospital.

To prepare for the Lunar New Year, everybody in Vietnam gets a haircut, buys new clothes and makes themselves look as good as possible. Here's a photo of Thien Nhan's maternal grandpa or Ong Ngoai helping Thien Nhan to look extra handsome.

Italy: one week to go...

The countdown is on! In just one week, Thien Nhan will fly to Bologna, Italy, to undergo the most important surgery of his young life.

Dr. Roberto DeCastro, one of the world's leading experts in genital reconstruction, will rebuild an age-appropriate sized penis and scrotum and insert prosthetic testicles. Because some nerves in Thien Nhan's groin are undamaged, the penis should have sensation, and should continue to grow as he matures.

This complex surgery will take seven to nine hours. Recovery time is estimated at 14 to 20 days. All being well, this is the most difficult surgery that Thien Nhan, who's now four years old, will have to endure.

After a sizeable discount the surgery will cost US$45,000. Travel and three weeks' accomodation in Italy will add around another US$20,000.

Luckily, Thien Nhan's champion, Singaporean cartoonist CC Lee http://chewonitcomics.blogspot.com/, has come through yet again. From May to December 2010, CC Lee raised an astounding US$13,755 towards Thien Nhan's medical care. As usual, he topped up the donations with his own money and handed over US$14,000.

In all, CC Lee, his readers and colleagues have donated US$77, 600 to help Thien Nhan. We are overwhelmed by the generosity of CC Lee and his fellow Singaporeans!

Thank you, Singapore!

[Photo shows Thien Nhan and his schoolmates doing their morning exercises].

Merry Christmas!

Happy Holidays!

Here's a photo of Thien Nhan (shortest, in center) celebrating Christmas with his preschool classmates.

Sorry for the long blog-silence but Elka, who runs Thien Nhan's English blog, has had vision trouble. Health-wise, this has also been a tough year for Thien Nhan's mum Mai Anh, but the whole family is looking forward to a healthy, happy and succesful 2011!

In just a few weeks Thien Nhan, 4, will be heading to Italy, where he's to undergo reconstructive surgery with one of the world's leading experts in male genital reconstruction. In preparation, Thien Nhan has been getting hormone injections for some months.

Thien Nhan and his family wish all of you a festive Christmas & New Year!

Surgery at NUH Singapore

In late July 2010, Thien Nhan will return to Singapore to undergo reconstructive genital surgery at National University Hospital (NUH). Urologist Dr. Prabhakaran, who is also a professor at National University of Singapore, has kindly offered to waive his fees for this complicated procedure, which will involve the reconstruction of a scrotum and the insertion of prosthetic testicles. The surgery is scheduled for Friday, July 30th.

Many thanks to Pam and Kim Odhner, who have offered Thien Nhan and his "entourage" free use of their home, during their stay! Thien Nhan will recover at their place from August 2nd to 7th.

We are still seeking leads to cheap accomodation (2 rooms) near NUH from July 28th to August 1st -- please email Elka at elkeray@yahoo.com with any tips!

This surgery is possible due to the tireless efforts and generosity of Singapore Straits Times cartoonist CC Lee - chewonitcomics.blogspot.com/- and the many Singaporeans who have contributed towards Thien Nhan's care.

Still Waiting...

We are still waiting for news of the results of Thien Nhan's medical tests, which were performed in the US way back in late September in a bid to determine whether or not he has functioning testes.

Due to patient confidendiality laws, the hospital cannot answer queries by phone, and reports that the results are "in the mail"...

We're increasingly anxious and hoping for good news in time for Christmas!

5-Year Plan

After examining Thien Nhan, urologists and plastic surgeons in Texas are optimistic that the reconstruction of a functioning penis can begin in just 5 1/2 years, when Thien Nhan is 9. The reconstruction should be made easier thanks to the fact that a portion of the boy's penis (now tucked under the skin) remains intact.

"Nhan just wants to be like his big brothers and the other boys in his class," says the toddler's mom, Mai Anh. "The older he gets, the harder it will be for him emotionally. We are very happy that these doctors are able to help him."

[Photo: Thien Nhan undergoing a pelvic exam at Texas Children's Hospital while his mom comforts him.]

Testing, Testing

Yesterday and today, Thien Nhan underwent various tests and exams in Houston to determine the extent of the damage to his genitals. "I think we have found the right doctors here," reports the toddler's mom, Mai Anh. "Dr. Tue Tinh is very kind and genuine. All of the doctors answer our concerns very clearly and logically."

Unfortunately, preliminary tests suggest that Thien Nhan's undescended testicles are unlikely to be viable. This would be a major blow. If the boy's testicles no longer produce testosterone, he will require hormone replacement therapy for the rest of his life, and be unable to father biological children. More tests will be performed this week. "We just have to wait and see," says Mai Anh.

[Photo, left to right: Thien Nhan's grandma, the poet Mrs. Kim Anh; surgeon Dr. Tue Tinh; Mr. Son Michael Pham of Kids Without Borders; Thien Nhan; mom, writer Mrs. Mai Anh; trip organizers Ms. Na Huong and Mr. Greig Craft.]

A Good Boy

"Thien Nhan hardly slept at all on the plane," says the toddler's mom, Mai Anh, speaking about their 36-hour trip from Hanoi to Houston.

"He is exhausted and jet-lagged but has been very well-behaved. I think he understands that we are here to help him. He is worried about the hospital but is trying his best to be a good and brave boy."





To view a video about little Nhan's visit to Houston, go to http://www.myfoxhouston.com/dpp/news/local/090927_miracle_baby_help

Prepping for Round 2 of Surgery

We are hoping that Thien Nhan, now 3, will go to the United States this fall for major genital surgery. Details are still being worked out, but Dr. Tue Dinh, a renowned plastic and reconstructive surgeon from Houston, Texas has agreed to oversee the procedures. Dr. Tue specializes in genital reconstruction.

Thien Nhan's surgery would likely involve extracting the remaining third of his penis, which is currently covered by skin; creating a scrotum; and moving the undescended testes into the newly-built scrotal sack. While the viability of Thien Nhan's undescended testes remains unknown, the longer that these organs remain tucked inside his body, the higher the chance of damage.

These procedures are extremely complex, and Dr. Tue has set the estimated cost for this round of surgery at US$100,000. That's a lot of money! While enough money has been raised to cover this round, repairing the terrible genital damage that Thien Nhan suffered when he was abandonned at birth and mauled by wild animals will require several additional surgeries.

Like Thien Nhan's trip to the US for urethral surgery last fall, this journey will be organized by Hanoi-based philanthropist Greig Craft and Seattle-based Son Michael Pham of Kids Without Borders.

Please keep following Thien Nhan's progress and helping this brave little boy in his fight for recovery!

Preparing for Round Two of Surgery

The recent discovery that Thien Nhan, who will turn 3 in July, has two undescended testicles has lent new urgency to his situation. If left inside the body for too long, his testicles may become damaged. Most infants born with this condition undergo corrective surgery within their first year.

When Thien Nhan was attacked by wild animals at birth, he suffered so much genital damage that doctors were unaware that his testicles remained inside his body. "That he still has his testicles is another miracle," says the boy's mom, Mai Anh. "We hope that this will enable him to forego hormone replacement drugs, and even to father children one day."

Spurred by this stunning discovery, Seattle-based charity Kids Without Borders and American philanthropist Greig Craft are working hard to arrange for Thien Nhan's next surgery. His first genital surgery took place at Dartmouth, NH in the USA last August.

All being well, this autumn surgeons will construct a scrotum from Thien Nhan's own skin, bring down his testicles, further dilate his urethra, and extract the one third of his penis that is now tucked up inside his skin. This is major and highly specialized urethral and plastic surgery. The expenses and logistics are considerable.

Ongoing fundraising efforts are being led by Kids Without Borders and the Asia Injury Prevention Foundation, which is founded and managed by Greig Craft. For more information, please visit http://www.kidswithnoborders.org/ or http://www.asiainjury.org/.

To date, much of the financial help received by Thien Nhan has hailed from Singapore, largely thanks to the heroic efforts of Singapore Straits Times cartoonist Lee Chee Chew, who has raised more than US$50,000 for the tot. To see Mr. Lee's artwork and donor list, please visit: http://chewonitcomics.blogspot.com/

6 Weeks To Go...

Last week, Thien Nhan got his new, longer leg at VietCot, and is now back to his daily lessons learning to perfect his balance. His grandma (left) and his Uncle Hoan oversee his walking sessions.

Only 6 weeks remain until Thien Nhan's trip to Dartmouth, NH and Chicago, USA, where he'll receive urethral surgery and advanced prosthetic care. Excluding medical costs (which are being subsidized by the surgeons), this trip will cost an estimated US$7,500. Do you have any leads to organizations or companies that might be willing to set out a collection box, donate items to be raffled at fundraisers, or donate air tickets, etc.?