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Rogers Ssembatya’s story is complicated.

But here’s a simple truth: If the ailing Ugandan youth hadn’t finally gotten permission to return to Montana for medical care, he probably wouldn’t be alive.

That Rogers is being treated at St. Vincent Healthcare is due to the persistence of two people who wouldn’t take no for an answer as well as to the generosity of others who helped them along the way.

Rogers arrived at the Billings airport Thursday night from Uganda, accompanied by Terry Fettig, his American guardian. Paralyzed from the waist down, Rogers was admitted to the hospital on Friday to treat pressure sores and a bone infection.

That’s only part of why Rogers traveled back to Billings, more than 3½ years after he first came to Montana. And the explanation for the other reason goes back eight years.

Nadine Hart, a physician assistant at St. Vincent, first saw Rogers in 2006. Hart, who helped to found the Billings-based Hope 2 One Life ministry, was part of a team on a Ugandan mission trip.

She and the others treated patients at a Buggoge village clinic in the east African country. That’s where she saw Rogers, soaked in feces and urine, his legs contracted underneath him and covered in wounds.

The boy was hungry, in pain and wrapped in blankets. Rogers had never owned a set of clothes. He weighed 38 pounds, was severely malnourished and his age was unknown.

He was the child of a mentally challenged woman. He was often the last to be fed because no one thought he would live long because of his condition.

Hart did what she could for Rogers, teaching village nurses how to treat and heal his wounds. And when she came home, she couldn’t forget him.

She told Fettig, then president of Billings chapter of AIDSpirit USA, about him. Fettig, a Billings contractor, traveled to Uganda in 2007 to help start a sponsorship program for children to go to school.

While there, he met Rogers, and made sure the boy had both clothes and a new wheelchair. Hart and Fettig teamed up to get Rogers admitted to a rehabilitation hospital in Uganda, where he was treated for fractures he had sustained.

He also was diagnosed with TB of the spine, and he spent nine months at the hospital where practitioners attempted, but failed, to stabilize his spine and keep his chest deformity from restricting his lung capacity.

Hart and Fettig sought help for Rogers from St. Vincent Healthcare. After the hospital agreed, Fettig raised $5,000 to bring Rogers to Billings and agreed to be his guardian in the U.S.

Rogers was granted a B1 tourist visa, and he arrived in February 2010. For the next 18 months, physicians evaluated and treated Rogers.

He lived with Fettig and attended school at Riverside Middle School while he was in Billings. Rogers, who has an infectious smile, gained friends both in and out of school.

All of the care, by doctors and the hospital, was donated. By the time his stay ended, St. Vincent had donated $211,000 in care, and that didn’t count the doctors’ donated fees.

Physical therapists helped relieve Rogers’ contractures — an abnormal shortening or shrinking of the muscle and tendon — to make it easier for him to sit in a wheelchair.

His lung capacity, which was only at 35 percent by that point, would have limited his life span if untreated. At the behest of Billings orthopedic surgeon Gregory McDowell, Dr. Oheneba Boachie, a renowned spinal surgeon from New York City, traveled at his own expense to Billings in October 2011.

With McDowell assisting, Boachie performed a delicate surgery in which a portion of Rogers’ spine was removed and the spine was realigned and fused. After the surgery, Boachie predicted his young patient would have a better quality of life.

“If he had been left in Uganda, he probably would not be around,” the surgeon said at the time.

By the spring of 2012, Rogers hadn’t yet been released from medical care, needing doctor visits to check the hardware and prevent infection. And he needed to continue his physical therapy.

Fettig, as part of his work with AIDSpirit, had agreed to go to Kayunga Town in central Uganda in the summer of 2012 as general contractor for the construction of a building to house the Tender Mercies orphanage. He intended to be there for three months.

He chose the summer months so Rogers could go along and visit his mother, who was very ill, and in fact died while he was there. Fettig figured he would have no trouble obtaining another visa for Rogers to return and continue his medical treatment.

But when Fettig completed the paperwork at the U.S. Embassy in Kampala, the application was denied. Before the denial, Fettig spoke with a worker there who asked if Fettig intended to adopt Rogers.

Fettig said no, but the embassy official made an offhand comment that it’s easier to adopt on the Uganda side. To help Rogers, the worker said, Fettig would have to find a way other than the visa.

Fettig assumed that meant adoption, and he moved forward on that front, without seeking advice from an immigration attorney. Fettig started the process on the U.S. side, which included home study, and also initiated proceedings on the Uganda side.

With everything seemingly in place, including the adoption approved by a Ugandan judge, Fettig returned to the U.S. Embassy in Uganda in February 2013 for final approval.

But that’s when everything unraveled. The embassy said the documents seemed to indicate Rogers was older than 15, and the law called for adoptions to be initiated before a child turns 16. The adoption was denied.

Frustrated and not knowing what to do, Fettig left Rogers in Uganda, at the Tender Mercies orphanage. Fettig returned to the U.S., and he and Hart contacted immigration attorney Christopher Flann, who practices in Shepherd.

Flann advised Fettig to apply again for a B1 visa, and if that was denied, to seek humanitarian parole. Fettig returned to Kampala in August 2013 to apply for the visa.

He brought with him two letters from Boachie. One explained that Rogers’ actual birth date was unknown, but having studied X-rays of Rogers taken at St. Vincent, the surgeon was certain the youth was 15 years old.

If the visa was denied, Boachie also pleaded for humanitarian parole for Rogers, listing a number of medical reasons why it was critical for him to return to the U.S.

“At this time, he faces life-threatening complications,’ Boachie wrote, adding that the care that Rogers needed was only available in the United States.

Flann also advised Fettig and Hart to seek help from the Montana congressional delegation, which they did. Representatives from those offices contacted the embassy, to no avail.

The visa was again denied. In an interview, Flann explained that Section 214 of the Immigration and Nationality Act assumes that everyone who is coming to America is assumed to be “an intending immigrant.”

“So people from Western Europe who have homes and good jobs and would like to vacation in America, it’s pretty obvious they’re not intending immigrants,” Flann said.

But for someone like Rogers, who is an orphan, lacks a job and school ties, there appears to be little incentive for him to return to Uganda.

“America says it looks like you’re moving here and have no intention of going home,” he said.

In November 2013, Rogers had pressure sores that required surgery. A European doctor operated at a Uganda hospital, where Rogers had to remain for three weeks for healing before returning to the orphanage.

Meanwhile, to apply for the humanitarian parole, Hart had to secure a promise of donated care from St. Vincent, Dr. McDowell, Dr. Timothy Dernbach of the St. Vincent Wound Healing Center and the other physicians.

Fettig provided Flann with documentation of all he had attempted on Rogers’ behalf. Flann took all of that, along with his legal arguments, and submitted the application this spring to the United States Citizen and Immigration Services.

Normally the process takes about 120 days, and Flann, who did all his work pro bono, became cautiously optimistic when he got a request for more information. Authorities asked how Rogers would get to the U.S. if the application was approved.

They also wanted to know how to contact him.

“I thought that was very encouraging,” Flann said.

Estimating the end of 120 days, Hart flew to Uganda in September, with Terry set to come later. Hart figured she’d do Hope 2 One Life and spent time with Rogers while waiting.

“It was felt that because of Rogers’ medical condition, he should have someone accompany him who had medical knowledge,” she said.

But then Sept. 19, the 120-day deadline, came and went and nothing happened, and Hart was scheduled to leave on Sept. 28. She told Fettig he should plan to come to Uganda because she didn’t want to leave Rogers alone.

“The night before Terry left on a plane for Uganda, an amazing phone call came that it had happened, we got it,” Hart said. “I was crying, and Terry was ecstatic.”

Rogers didn’t believe the news at first. Then, when it finally set in, Hart said, “he was overjoyed.”

Hart took a photo of Rogers holding up his passport, a smile on his face. Hart returned to Billings, and then Fettig and Rogers flew together, landing in Billings on Thursday night.

It wasn’t all smooth sailing. When Hart was with Rogers in Kampala, she did a medical checkup and saw that his pressure sores had again grown severe.

On the plane, Fettig said, Rogers wasn’t running a fever, but he was sweating and shivering by turns.

“I knew something wasn’t right,” Fettig said.

It was just another indication that Rogers needed the medical care he could only receive in the U.S., Hart said.

Rogers is on three different antibiotics to heal the infection. Hart thinks the treatment came just in time, adding if he had stayed in Uganda, he likely would have faced a life-threatening infection that over took his entire body.

“We would have gotten a phone call one day saying he’s not here anymore,” she said, standing next to Rogers’ bed on Saturday afternoon. “It was just an absolute miracle that he got here when he did.

Rogers will begin a battery of doctor visits and tests in the coming weeks. The good news is X-rays show the hardware from the surgery previously performed in Billings is in good shape.

Fettig, sitting next to Rogers on the bed, said he is grateful for the generosity of the hospital and its physicians. Asked how he feels after a two-year battle to get Rogers back to Billings for care, Fettig said, "Actually, Rogers said it the best way. When we finally got to Minneapolis, he said, ‘is this a dream?’ ”

For his own part, Rogers is mostly quiet during the interview. It was hard for him to leave his friends and his brother in Uganda, he said.

But once he got to the Minneapolis airport, he realized how far he had come.

“It was like, OK then, let’s move on,” he said. “Once I feel better, it will be better.”

Then Rogers smiled, and he said he is grateful for the prayers he knows have been said on his behalf.

“I think the prayer went well because I came back,” he said. “I wish I could do something. I thank them very much for everything they’ve done for me.”

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General Assignment and Health Care Reporter

General assignment and healthcare reporter at The Billings Gazette.