Mustafa Ahmed Abed has a few words of English left from his time as a young child in the United States. These days, he doesn't have anyone to practice them with, so he repeats words to himself over and over as he walks home from school in Fallujah. With one leg, the journey on crutches takes him an hour.

Mustafa, now almost 15, was two years old at the start of the battle for Fallujah in November 2004. As the U.S. shelled al-Qaida fighters in a nearby neighborhood, he and his mother were hit by shrapnel.

"I was carrying him, and all of a sudden, Mustafa flew out of my arms," his mother Nidhal Aswad recalls. "My arm was badly injured and my side was injured ... He was on the ground ... All I could see of him were his intestines all over the place."

Aswad crawled to her baby in the deserted street. His left leg had nearly been severed. When relatives got them to a hospital, making their way through the fighting two days later, doctors amputated her son's leg at the hip.

They told her that Mustafa would likely die.

Her boy pulled through. But his kidneys were failing.

For the next four years, Mustafa's parents tried and failed to get proper medical help in Iraq. Mustafa's father, Ahmed Abed, says U.S. military doctors took an interest in his case and referred him to an American nonprofit. In2008, a group called No More Victims arranged to bring Mustafa, then five, with his father to Portland, Oregon, for treatment.

Medical teams at the city's Shriners Hospital removed one of Mustafa's kidneys and a bladder stone, and fitted him with a prosthetic leg. The little Iraqi boy became a local celebrity, showered with gifts and attention.

A few months later, after he'd recovered from his surgeries and treatments, Mustafa returned to Iraq with his father. And as time went by, the Portland group lost touch with Mustafa and his family.

Jane Arraf / NPR

/

NPR

"It was hard to get a cell connection ... and then it became impossible," Maxine Fookson, a pediatric nurse practitioner who founded the Portland chapter of No More Victims with her husband Ned Rosch, tells NPR. "We would keep trying, and nothing. Of course, our worst fear was that he and the family hadn't survived."

In Mustafa's lifetime, there have only ever been brief periods of peace in Iraq. By 2014, ISIS had taken over Fallujah. Phone lines were cut. The family was trapped.

"ISIS said, 'If you give us money, we will get you out. If you don't, you will remain here to die,'" Mustafa recalls.

His family couldn't pay the bribes. So they waited amid U.S. and Iraqi airstrikes until ISIS fled the city in the summer of 2016.

To escape the final fighting, and running out of food, Mustafa and his family walked 12 miles to a makeshift camp near Amariyat al-Fallujah. In the 120-degree heat, there was no electricity and not enough mattresses to sleep on. There was no real medical care. There weren't even enough toilets.

'Someone owes him a new leg'

In June 2016, I was at the camp reporting for the PBS NewsHour on the battle to retake Fallujah from ISIS, when a teenage boy walked toward me on his crutches. He needed colostomy bags and catheter tubes. He told me he'd been treated in the United States, but had outgrown the prosthetic leg that had been made for him years earlier.

I assumed he'd been sent back to Iraq after being treated and had simply been forgotten.

"Someone owes him a new leg," I tweeted.

But he hadn't been forgotten — at all.

Fookson and Rosch were in Portland watching the news when they glimpsed Mustafa in my NewsHour story.

"We just started screaming," says Fookson. "We were so ecstatic."

"Mustafa — Oregon sees you and we are here to help," Fookson tweeted. She started mobilizing people to help the family again.

"We were all watching what was happening in Fallujah, because Fallujah has, since 2008, had a very special meaning for us — because of Mustafa," she says.

The Iraqi city on the edge of the Western Desert holds an outsize meaning for a lot of people. The city was an al-Qaida stronghold, and the 2004 battle to free it was the deadliest of the war in Iraq. As a correspondent with CNN, I was embedded with U.S. forces as they entered the city in 2004 — around the same time Mustafa had been injured as a baby.

Humanitarian organizations say more than 800 Iraqi civilians are believed to have been killed in that battle. Thousands more, like Mustafa and his mother, were injured. More than 80 American and coalition troops lost their lives and at least 600 were wounded. According to military historians, it was the most intense urban fighting since the Vietnam War.

'I was afraid they would come and slaughter my entire family'

The ISIS years were unspeakably grim. Near the end, food in the city had become so unaffordable that families, including Mustafa's, had resorted to eating raw flour and expired dried dates sold as cattle feed.

Every few weeks, Mustafa and his mother would set off on foot early in the morning and walk for three hours each way to get catheter tubes for him from the Fallujah hospital, also controlled by ISIS. Mustafa says he lived in fear that ISIS fighters would find out he had spent time in the United States.

"From the day ISIS came, they used to ask me about going to America, and I used to lie," he recalls. "I was afraid they would come and slaughter my entire family."

Life in the camp they fled to in 2016 was almost as difficult. The area was considered too dangerous for most international aid groups. Iraqi forces, worried about ISIS infiltration to Baghdad, tightly controlled access. Hundreds of families slept in the open in the middle of summer. Many of those with tents didn't have mattresses. There was little medical care.

Without enough toilets, people were using open pits. For Mustafa, who relies on a urinary catheter and colostomy bag because of his damaged intestines and kidney, there was no privacy, no supplies — and no dignity.

Jane Arraf / NPR

/

NPR

After a few grueling weeks, Mustafa returned home to Fallujah with his parents, two brothers and sister.

I visited them there this summer. While Mustafa's spirit is remarkably unbroken, his life remains circumscribed by his old injuries. In Iraq's dysfunctional bureaucracy, Mustafa has never been able to register as a disabled person, which would entitle him to government benefits.

On the day of my visit, he and his mother were going once again to the Fallujah hospital to get colostomy bags and catheter tubes.

More than a year after Fallujah was retaken from ISIS, only a small part of the hospital is open. Broken equipment is piled against the walls of dark, dirty corridors. Wires hang from ceilings charred in the fighting.

The head of supplies, Saddam Ahmed, leans across a battered desk and hands Mustafa a box of supplies. He's been seeing the boy and his mother here for 10 years.

"There were many more like him, injured in the second battle for Fallujah and the latest one with ISIS," says Ahmed, using a shaft of light from an open door to read the labels on the boxes. "We are trying to provide everything the patients need, but you can see the condition of the hospital. It's almost completely destroyed."

'Like a dream'

During my visit, it was summer vacation, and Mustafa's life consisted of watching television — when there was electricity — and walking to the corner store to hang out with friends.

He and his family live in a one-room home made of concrete blocks. His father supports the family as a laborer. Grueling work and his own poor health have worn down Ahmed Abed's movie-star looks from the photos taken years ago in Portland.

"I can't describe how helpful those people were to us," says Abed. "They were so kind and so hospitable. I saw love, I saw mercy, everything positive — I found it there."

On a wardrobe, there's a dusty suitcase given to Mustafa in Portland to hold some of the gifts he brought back. But the most valuable thing from the U.S. — a prosthetic leg — proved to be of little use for a young boy learning to walk on a dirt floor. And by the time the family upgraded to a concrete floor, the prosthetic was too small.

Mustafa doesn't seem to remember the surgeries and the fear and pain in Portland. He only remembers the comfort and the friendship.

"What can I tell you?" he says. "The landscape, the comfortable life that I lived there — the house that I lived in was like a dream to me."

His mother — who still has scars along her arm and has trouble closing her hand properly — leafs through a Portland photo album, now falling apart. There are birthday parties and climbing gyms. She has heard the stories so many times, she talks about the events as if she had been there. Almost all the photos feature a happy, sweet-looking, smiling little boy.

Although a lot of Iraqis tell him he should, Mustafa doesn't blame the U.S. for his injuries. He says only God can lay blame. His father says the military was following orders.

Mustafa knows education will be the way to a better future. He can't do physical labor and says he will aim to become a government employee to be able to support himself. But he dreams of being a doctor.

And he dreams of returning to the United States.

The Portland group disbanded after bringing Mustafa to the city, but many of its members have now reconnected to work on getting him and his mother back for medical treatment.

"It was very difficult to see the conditions that he and his family were in," says Mary Lynn O'Brien, a retired pediatrician and a member of the Portland group. "We really, really want to bring Mustafa and his mom here."

They've enlisted the help of a local member of Congress and senator to obtain visas – an increasingly difficult process in the U.S.

For now, "My life is separated into two parts," Mustafa says. "Look at our house – does it look like other houses? Would you think the person who was living there [in Portland] is like the person living here now? It's totally different."

Copyright 2021 NPR. To see more, visit https://www.npr.org.