When Amina was only 45 minutes old, before she even had a name, several gunmen stormed the maternity ward operated by Médecins Sans Frontières (MSF) in Kabul, on May 12, 2020, where she was born. Somehow Amina survived the indiscriminate shooting that killed her mother and 23 others — women, nurses and newborns.

No one knows for sure how Amina survived. Afghan forces discovered her mother's body crouched on the hospital floor clutching her daughter's baby blanket. These first responders, who rescued the baby, speculated that she had likely been shielded by her mother.

The child suffered severe injuries to her right leg and was moved to another hospital, where she received the first in a series of surgeries over the next two years along with physical therapy. The goal was to give her full use of the leg, which was kept in a protective brace.

"Amina's case was complicated," said B.N., a surgeon who is one of the doctors who has treated the child. (He asked to be identified by his initials lest the Taliban detain or punish him for his work with international organizations. The Taliban have known to be suspicious of Afghans who've work with foreigners, labelling them as traitors and at times even harassing and detaining them.)

The doctor explained that Amina sustained three bullet wounds in the leg, causing critical vascular damage and impairing nerves. With such injuries, he said, amputation is a common outcome. He managed to save her leg with the initial surgery and three follow-up procedures, including a nerve graft to improve blood flow.

Gradually, she learned to walk using both legs. But because she is a growing child, B.N. said she needs regular monitoring.

The child's family goes into hiding — and medical care is scarce

Amina's medical care was deeply compromised in the chaos that followed the Taliban takeover in August 2021. Her father, Rafiullah Sharifi, was a police officer in the Afghan forces. Worried that he might be detained by the Taliban and that family members, particularly Amina, might be at risk of harm, he went into hiding and moved the family frequently to avoid being caught.

"Because of my work in the previous government, I was in hiding from the Taliban and couldn't take Amina for her therapies," said Sharifi. "Her doctor had also left the country, and we had no financial resources left. Our family was barely making ends meet."

Meanwhile, the country's health system was on the brink of collapse after the Taliban takeover. International sanctions led to an unprecedented humanitarian crisis for a government largely dependent on foreign aid. Thousands of health facilities funded by the World Bank ceased operation.

The crisis in Afghanistan – along with Taliban restrictions on girls' education — has prompted many of the country's doctors to leave the country, B.N. said.

"For a lot of the medical community, they have their own children, especially daughters, and are worried about their future," he said. He, too, is no longer based in Afghanistan but returns regularly to see his patients and perform surgeries.

New concerns about Amina's leg

The child's condition worsened in December 2021.

"Amina had developed a deformation in her injured leg which was placing pressure on the arteries and restricting blood flow. We needed to get her urgent medical help [to save the leg]," said Ivett Zsuro-Luz, a volunteer with an aid group that helps evacuate Afghan families and a Hungarian veteran who did three tours of duty in Afghanistan. Zsuro-Luz, who now lives in Portugal, learned of the family's situation after their request for a medical visa for out-of-country treatment was denied.

Medical teams working with the aid group said there were no longer any vascular surgeons in Afghanistan.

When Amina's grandfather took her to be examined at a clinic run by the Taliban government, the doctor there told the family that Amina didn't need surgery.

"They said she only needed physiotherapy, but the other doctors in Afghanistan who checked Amina, and even those abroad whom we sent the reports to, said that physiotherapy is not correcting the deformation or the vascular problems she was facing," her father Sharifi said.

So Zsuro-Luz started a campaign to get a medical visa for Amina, emailing governments and reaching out to charitable groups for support.

Success – at last — in the campaign for care

At first Zsuro-Luz got nothing but rejections. Eventually, an American charity called Heart of an Ace provided funding to cover Amina's medical treatment. With this support, Amina and her family traveled to neighboring Pakistan in June in the hope of getting the surgery there – it was a more affordable option than Europe or other countries. But there were issues finding a surgeon with the appropriate skills as well as problems in transferring funds for the surgery to Pakistan.

"But while we were getting her checked there, we also received a positive reply from [the] Portuguese government that granted Amina and her family medical visas," Zsuro-Luz said. The family could also apply for permanent asylum in Europe.

So Sharifi made the decision to move his four children, along with the woman he married after Amina's mother died, to Portugal.

"Amina is now being tested for her upcoming surgeries and has been given the vaccines she missed in the last one year," he said, adding that his older daughter, age 6, will soon be starting school. He also has two sons, one age 4 and the other just a few months old.

Despite the encouraging medical situation, the family has had a hard adjustment to their new home.

"It is a new country, we don't understand the language, different culture and there are no Afghans around. I don't know how the future will be like," Sharifi said.

Zsuro-Luz greeted the family when they arrived in Portugal. She reports that the 2-year-old, despite the brace on her injured leg, is "extremely loving and energetic, jumping and climbing furniture, smiling at everyone." But she shows signs of the trauma she has experienced. Her father says that the child often awakes in the middle of the night, screaming and shaking. She calls out for her grandmother, who remains in Afghanistan.

"But I am hopeful that she will get better now that she is away from the explosions, murders and terrorists," he said. "She is a strong child."

Reflecting on the journey from despair in Afghanistan to hope in their new home, he says: "God will never forgive me if I don't give my children what they deserve, and she deserves a lot of happiness after what she has been through."

Ruchi Kumar is a journalist who reports on conflict, politics, development and culture in India and Afghanistan. She tweets at @RuchiKumar

Copyright 2022 NPR. To see more, visit https://www.npr.org.

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