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JOANNA WEISS

For the life of Yahya

For one Palestinian boy, borders and politics were no barrier to a lifesaving transplant

Yahya Ahmad Masalma, 6, received a complex kidney transplant at Boston Children’s Hospital.

BRIAN FEULNER FOR THE BOSTON GLOBE

Yahya Ahmad Masalma, 6, received a complex kidney transplant at Boston Children’s Hospital.

This is not a story about geopolitics. This is a story about a boy.

But because the boy is Palestinian, his story is intertwined with geopolitics. The boy was born terribly ill. He got treatment, for years, at an Israeli hospital, financed largely by the Israeli government. And when Israeli doctors felt they couldn’t perform the complicated surgery he needed, they turned to Boston Children’s Hospital, and to a group of mostly Jewish benefactors.

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They came together, across borders and boundaries, to save a boy — but they were also well aware of the statement they were making. Politicians posture. Prejudices form. Bombs drop. Walls go up, literally and metaphorically. And even so, on both sides of an intractable divide, there are human beings searching for connection, eager to take part in an act as individual and meaningful as helping a child.

Yahya Masalma is six years old and gregarious; he makes friends effortlessly, loves to sing and play guitar, and until this winter, he was profoundly ill. He was born in a village on the West Bank outside Bethlehem with a genetic condition — a blocked urethra — that caused his kidneys to malfunction.

BRIAN FEULNER FOR THE BOSTON GLOBE

Dr. Heung Bae Kim, left, Dr. Courtney Loper, and Dr. William Harmon of Boston Children’s Hospital talk about Masalma’s kidney transplant.

His parents knew that local hospitals didn’t have the capacity to treat him. They tried to pay people to move him to Israel, where he could get better care. Much of the money went nowhere.

“At the end, I had to just carry the boy, without money, without anything, and just go to the hospital in Israel,” Yahya’s father, Ahmad Hassan Masalma, told me in Arabic through a translator, earlier this month. Yahya was 15 days old when he reached Shaare Zedek Medical Center in Jerusalem. The hospital treated him for free.

Yahya continued going to Shaare Zedek for six years, receiving dialysis three times a week, the care financed largely by the Israeli government, with the Palestinian Authority paying for some medication. To ease the complication of the border crossing, Jewish volunteers often carried him across the line, as they did with other Palestinian patients, Masalma said.

This went on for years. But after relentless poking, Yahya’s veins had clotted, one by one, and doctors were down to their last blood vessel. They couldn’t continue dialysis. He needed a kidney transplant.

Finding a donor was easy: Yahya’s father, Ahmad, was a match. But the procedure would be unusually complicated. All those years of dialysis and clotting had left Yahya’s blood pressure low. In transplanting an organ, the critical issue is getting enough to blood to pump through it. Yahya’s new kidney would need as much blood as his heart currently pumped out every minute, or the transplant would fail.

Doctors in Israel were worried, and gun-shy. Another group in Israel had recently performed a similar operation under similar circumstances — a Palestinian child whose care was financed by Jewish donors, a story that would excite the Israeli press — but the surgery had failed.

So a doctor on Yahya’s team started seeking technical advice. One of the people she contacted was a doctor she had studied with years earlier in Boston: Dr. Michael Agus, director of the critical care program at Children’s Hospital.

Agus described the outlines of the case to Dr. William Harmon, the chief of nephrology at Children’s, and Dr. Heung Bae Kim, director of the hospital’s pediatric transplant center. Children’s had performed 27 kidney transplants the year before, and the doctors seldom balked at a challenge. “We like to take difficult cases,” Kim told me.

“I basically said, well, send him here, we can do it,” Harmon recalled. “That’s when he happened to tell us that, ‘oh yeah, he’s Palestinian and he has no money.’ ”

Children’s has a history of treating international patients, with working with outside organizations to fund their treatment. Yahya’s case would require more groups than usual. Agus began by contacting Combined Jewish Philanthropies, a group he knew through his work on the board of a Jewish day school. Zamira Korff, CJP’s senior vice president of development, reached out to a donor she thought could act quickly: real estate developer Steve Fischman, who swiftly joined with his son, Ben, and his business partner, Steve Karp, to pledge $25,000.

Korff also got in touch with Randy O’Brien, the daughter of Ray Tye, the late Jewish philanthropist who had founded the Ray Tye Medical Aid Foundation to finance medical care for needy people worldwide. The foundation donated $100,000.

Meanwhile, Harmon reached out to the Ohio-based Palestinian Children’s Relief Fund, which enlisted local volunteers to take care of the Masalmas while they stayed in Boston, and to provide prenatal care for Yahya’s mother, who was three months pregnant.

Most of the donations came together within two days, and more would come. Doctors reduced their charges. Genentech donated medication. The pitch, to everyone, was simple, Agus said: A Palestinian boy has reached the end of the medical line, and “the only thing standing between him and a reasonably healthy life is some fundraising. Unsaid was how incredible it is to be able to cross these uncrossable bridges with human connection and medical care and saving a life.”

But that message came through, Korff said. “Whatever politics may be going on on the ground and whatever conflict there is, we pride ourselves in being able to rise above it.”

Yahya and his parents arrived at Logan Airport on Friday, January 13. They had left another son, a three-year-old, with relatives in Jordan. A team from Children’s met them at the airport and took them to the hospital, where doctors and nurses were surprised at how energetic Yahya was, given how close he was, technically, to death.

BRIAN FEULNER FOR THE BOSTON GLOBE

Yahya Ahmad Masalma plays with, his mother Basima Mohammed Masalma, and his father, Ahmad Hassan Masalma, who was his donor.

They fed him a meal of chicken and rice and took him to dialysis, where he settled in comfortably; he was used to the process, and easily distracted. “It’s impressive what an iPad can do,” Harmon said.

The operation was scheduled for two weeks later, but doctors weren’t sure it would happen. Ahmad had a past medical complication that could have made him an ineligible donor, but doctors decided to bend the rules. Yahya needed a complicated anesthesia technique to keep his blood pressure as high as possible.

But the doctors moved forward, and Kim described the surgery matter-of-factly, in that way surgeons have of making the incredible sound blasé. The father’s kidney was removed at Brigham and Women’s Hospital. Kim walked down the street to pick it up, carried it back to Children’s in an Igloo cooler, and sewed it into Yahya.

On the recovery floor, Yahya’s new kidney made urine almost instantly. The boy woke up and asked his mother for a banana, something he hadn’t been able to eat when he was ill.

On the10th floor transplant unit, Yahya became known as “the mayor.” Courtney Loper, the nurse practitioner who coordinated his care, said that when she stepped off the elevator, she could often hear him singing. He slept in a little room marked with a Berenstain Bears mural, but he often wandered to a nearby playroom, where he would clunk out tunes on an electric keyboard, strum a guitar, and sing, loudly and terribly.

When I met Yahya this month, he had been transferred to Yawkey Family Inn, a Victorian mansion in Brookline that houses families of Children’s patients. His vascular issues had left him with a swollen face, which gave him the look of a middle-age man, grafted onto a small child’s body.

He was striking poses in the lobby, trying to grab a photographer’s camera, sitting down every few minutes to scribble, with stubby fingers, in a Disney coloring book. At one point, he nestled in his mother’s lap and lay down his head, as if falling asleep. He had picked up a fair amount of English over three months in Boston, but spoke to me only once, when prompted to name the person he wanted to meet before he went home. In a high-pitched voice, he chirped, “Obama!”

A meeting with the president was not to be. The doctors at Children’s, acutely aware of geopolitics, knew the family should return home before Yahya’s mother gave birth. They were concerned at one point when Yahya’s parents balked at going back, until they figured out the reason: the Masalmas were worried that their son’s medical care would cease.

By the time I met Ahmad Masalma, he was reassured: The Israeli doctors had promised to pay out of their own pockets, if they needed to. “He grew up with them,” he said. “They felt like he’s one of them.”

Americans, he said, had been equally supportive. “I was greatly surprised when I met the people of the United States,” he told me. “Very respectful, they respect your privacy, very kind. I can’t say anything different for the people of Israel. They’re just as nice. I have to admit that they did their best for us.”

Masalma was reluctant to delve into issues of war and peace: “You don’t interfere in politics, you stay away, you have a good life.” Still, I asked him whether Yahya’s story had changed things in his village, altered perspectives about the Israelis across the border or the Americans overseas.

“I’m sure it affected them positively,” he said. “But there’s always the red line. There’s always the red line.’’

Yahya, who returned home earlier this month, doesn’t understand the meaning of that line. He has grown up in a world where strangers are universally kind, where borders are virtually meaningless, where people go to heroic measures because they can.

What does his story mean? What does it foretell? For geopolitics, probably nothing.

But for one boy, it means everything.

Joanna Weiss can be reached at weiss@globe.com. Follow her on Twitter @JoannaWeiss.
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