There is limited medical infrastructure in war-torn Afghanistan, so severely wounded children are sometimes brought to the U.S. for medical care. Doctors in America say that for one little girl, her struggle to stay alive for three years until finding her way from central Afghanistan to a hospital in Los Angeles is nothing short of a miracle.
Her name is Arefa, and she's 6 years old. Like a lot of girls her age, she loves coloring, animals and ice cream. But this small girl in Hello Kitty shoes is from a nomadic tribe in Afghanistan, and for her entire life, she's known nothing but war.
When she was 3, her family's tent in Afghanistan was engulfed in flames from an IED. She was severely injured, suffering third-degree burns over much of her body and a life-threatening wound on the top of her head. Her family kept her alive for three years with very little medical attention.
"As the family moved from place to place, they often spoke of the wounds of the child, and this finally reached the ears of someone who told them Americans might help," Patsy Wilson of Solace for the Children writes in an email to NPR.
When U.S. troops saw the girl earlier this year, they got in touch with Solace for the Children, a group that has been working to bring wounded children of war to the U.S. for medical treatment.
"Some soldiers found her and said she was in a lot of pain still," says Jami Valentine, who along with her sister, Staci Freeman, have been Arefa's host family in Southern California since June.
Neither Arefa's mother, who was also injured in the blast, nor her father came with her to the U.S., as parents of children involved with the group do not make the trip with their kids.
Valentine says at first she didn't think she was up to the task. And then she saw Arefa's picture.
"Somehow her eyes connected with me even through the pictures. And it was this picture of sadness and strength all the same time, and I thought, 'How could I say no to this little girl?' " Valentine says.
She says that according to Arefa's doctor, it was just in time. "He has a very tender spot for her because he feels like she's unique, she's special, because medically she shouldn't be here," Valentine says.
When she arrived in the U.S., Arefa needed skin-graft surgery for the top of her head. The sisters recall the morning when she was able, for the first time, to touch her head and not feel pain.
"She laughed like this kind of joy laugh, and then she said, 'Thank you, doctors, and thank you, Staci and Jami,' " Freeman says.
Valentine says the girl is a continuing source of amazement. For instance, she marvels at the amount of English Arefa learned in just three months. "We were sitting in the car one day, and out the blue she goes, 'Come on, let's go!' " Valentine says. "It makes me laugh. It catches me off guard every time."
Healing takes many forms. Her host family says the night terrors have thankfully ceased, but they still closely monitor the television. One day early in her stay, a news story came on that showed soldiers with guns. "We couldn't turn the channel fast enough," Valentine says.
In her native Pashto and frantic pantomime, Arefa told them her story of what happened the day of the blast.
"Staci and I would sit, and we would listen, and we would just feel brokenhearted. We know she was unleashing everything she'd been through," Valentine says.
Arefa is scheduled to return to her family in Afghanistan soon.
"There's an element where we desperately want for her to be united with her family, because she talks about them, and I know she misses them. And then there's this real reality where I feel our space is going to get really quiet," Valentine says. "So somehow it all combines together, so I have no doubt it's going to be very sad."
Arefa will still need medical care. The fingers on her hands are disfigured, and scar tissue prevents her from being able to close her eyes when she sleeps. And she returns to an uncertain future in her war-torn homeland.
The women caring for Arefa see that the little girl — who only knew war and who was in pain for half of her life — is experiencing a childhood that she has fully embraced. While in California, she has grown to love swimming, the beach and her nearby playground.
"She walks though each day with joy," Valentine says.