UCSF Team Performs Surgery to Restore Iraqi Boy's Hearing

By Robin Hindery

Ghazwan Al-Nadawi holds his 3-year-old son Mustafa before the boy’s cochlear implant surgery at UCSF Medical Center.

Ghazwan Al-Nadawi hasn’t heard his elder son speak in 19 months, since the day a missile attack in their native Baquba, Iraq, robbed the 3-year-old of his hearing and abruptly halted his nascent speech development. But thanks to cochlear implant surgery performed on Friday by UCSF ear disorder specialist Lawrence Lustig, MD, the young boy, Mustafa Ghazwan, will soon be making up for lost time. “He had started saying a few words [before his hearing loss], like ‘mama’ and ‘baba,’ but since then, we have used signs with our hands to communicate,” Al-Nadawi said through an interpreter on Friday, his hands shaking as he waited for Mustafa’s 90-minute surgery to end. Cochlear implant surgery is a low-risk, outpatient procedure and the prosthetic unit is designed to last a lifetime. The implant — an electronic device that converts sound into an electric impulse to stimulate the auditory nerve — does not restore normal hearing, but can provide more access to speech information than a hearing aid can, according to the UCSF Douglas Grant Cochlear Implant Center, where Lustig serves as director. Mustafa’s implant will remain turned off for about three weeks while the swelling in his right ear goes down, Lustig said. It is not known how well the boy will respond to the device, but Lustig expressed optimism. “Our goal is just to get him to hear,” he said during a press conference after the surgery. “There’s a huge range in terms of people’s response to the implant.” Al-Nadawi said his son was aware when he arrived at the hospital Friday morning that he would be undergoing a procedure, and that UCSF Medical Center staff had used dolls and other props to act out a mock cochlear implant surgery. But Mustafa did not fully understand the connection between the surgery and his ability to hear, Al-Nadawi said. Mustafa’s hearing was destroyed in June 2007, when a US explosive device hit the building next door to where he lives with his parents and younger brother. The story of his condition eventually made its way to Cole Miller, a Los Angeles writer and founding director of No More Victims, which obtains medical sponsorships for Iraqi children injured in the war.

Cochlear Implant. Source: National Institutes of Health

  • A microphone, which picks up sound from the environment.
  • A speech processor, which selects and arranges sounds picked up by the microphone.
  • A transmitter and receiver/stimulator, which receive signals from the speech processor and convert them into electric impulses.
  • An electrode array, which is a group of electrodes that collects the impulses from the stimulator and sends them to different regions of the auditory nerve.
Miller sent Mustafa’s medical records to Bay Area specialists, who determined that the boy was an ideal candidate for a cochlear implant. Lustig and his team agreed to donate their medical services to perform the surgery, and Dan Lowenstein, MD, professor and vice chair of UCSF’s Neurology department and a leader of the Iraq Action Group at UCSF, secured a donated implant device from a private company. No More Victims then teamed up with Ruth Group, a Marin County-based coalition of peace activists, and the Tiburon, California-based Westminster Presbyterian Church to raise $32,000 to cover travel and medical expenses and other costs related to the family’s care during their stay. Mustafa and Al-Nadawi arrived in San Francisco on Dec. 31. Amy Skewes-Cox, the Ruth Group member who first contacted No More Victims, said the coming together of the previously unassociated organizations was the result of “the Internet combined with compassion.” Al-Nadawi called the outpouring of support “beyond my imagination,” and said he never expected so many strangers to take up his son’s cause. “It takes a lot of work and effort, but it’s not rocket science,” Miller said of Mustafa’s transformation from a symbol of tragedy to one of hope and inspiration. “None of this is beyond the doable.” However, he added, for every Mustafa, there are “hundreds of thousands of children in similar situations” who are not receiving top-quality care or media attention. Mustafa and Al-Nadawi will remain in San Francisco for roughly six months of follow-up care, including intensive hearing and speech therapy, which will be covered by donations from Westminster Church. The father and son are staying at the Ronald McDonald House in San Francisco free of charge. A few hours after Mustafa’s surgery on Friday — with a baseball-size white bandage covering his right ear — he was sitting in his father’s lap, playing with toys. For Al-Nadawi, it was like seeing the child “alive again,” he said. And though he struggled to find words to express his many hopes for his son’s now-brighter future, Al-Nadawi said he had just one simple hope for himself. “I’m hoping he will call me ‘baba’ again,” he said. Related Links: Frequently Asked Questions About Cochlear Implants UCSF’s Role in Developing the Cochlear Implant UCSF Douglas Grant Cochlear Implant Center No More Victims Ruth Group Westminster Presbyterian Church Photo by Susan Merrell