Shafi Amani and his daughter, Yousra, 3, in Alexandria, Va., on Aug. 3, 2023.
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Shafi Amani and his daughter, Yousra, 3, in Alexandria, Va., on Aug. 3, 2023. / NPR

ALEXANDRIA, Va. — Shafi Amani holds his 3-year-old daughter Yousra outside the Casey Clinic in Alexandria, Va., where they go every couple of weeks for care. She has a tumble of curls and large brown eyes that roll back at times. Her legs are limp, like a rag doll. She can't walk or speak or chew food. The stem of a plastic feeding tube pokes out from her stomach.

Amani carries his daughter into their small apartment just down the street, inside a cluster of red brick buildings. Yousra was a healthy toddler when she and her family fled Afghanistan more than a year ago, taking a dirt road overland to Pakistan. That's where things got worse.

"When we were there, my daughter, her fever goes up," he says, holding Yousra on his lap in their small living room. "And we didn't understand. After some tests the doctor tells us this is a stroke."

Amani got some medicine for Yousra but decided to leave once more, getting a tourist visa for Mexico, moving a step closer to needed medical care.

"I thought Mexico is best place for me," Amani says.

Arriving in Mexico City with his wife, Frista, and their daughter, the couple quickly learned it wasn't enough for Yousra's needs.

"Mexico was not a safe place for me because it was very difficult," he says. Difficult he adds because he didn't speak Spanish — officials said he should learn. And he had to pay for health care but had little money. So his daughter got little medical help for six months.

"There was no assistance for my daughter," Amani recalls. "She needs some treatment, medication, doctors and these things."

Over the wall

He made a drastic choice. The family would be smuggled into the United States. In Mexicali, a border city in northern Mexico, he found a contact who directed him to a hotel and a secretive woman who would help. The woman asked for $500 to move each person across the border, an amount he was able to reduce to $200 each.

"That was the day, the hardest decision for me — because for my daughter and my wife and my life," he says.

Two men then showed up and took them to a border wall, nearly 30 feet tall, and fashioned a kind of harness. Amani and Frista just watched.

"In the wall they put something, like a rope," he says. "After that they told us come first, my wife."

Shaf Amani and his daughter, Yousra, in Alexandria, Va., on Aug. 3, 2023.
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Shaf Amani and his daughter, Yousra, in Alexandria, Va., on Aug. 3, 2023. / NPR

Frista went first, hoisted over the wall. Then Shafi, clutching his limp daughter to his chest, rose up the wall by the ropes, and over. They were now inside the United States just as the sun was setting. Standing on a long stretch of deserted road. In front of them was the New River, one of the most polluted in the nation, teeming with industrial and farm runoff. They got ready to cross.

"We didn't know what would happen. How much the water will be, the deep," he says.

Suddenly they could see headlights coming down the road. It was U.S. Border Control and an officer waved them away from the river. Shafi was able to communicate in broken English.

"He told me to stand up," he says. "And we come and we sit in the car. After that we went to the immigration camp."

Escaping the Taliban

Amani never planned to come to the U.S., even after the Taliban took over. And he admits he had a dim view of the United States, saying the Americans abandoned the Afghans.

That view took root the day in late August 2021 when the U.S. withdrew from Afghanistan. Thousands of Afghans surged toward the Kabul Airport to flee that day, stumbling and desperate to get through the gate. Eventually a U.S. military airlift brought some 124,000 Afghans out, and of those more than 80,000 came to the U.S. Amani was wary of making the trip to the airport and says the Taliban did not at first seem threatening.

"Because they told us everything is normal now," he says. "Stay in Kabul."

Back then he was 31 years old he was a building contractor, working on Afghan Army camps and delivering supplies. He and his family were living in Logar Province just outside Kabul. But after the Taliban froze his bank accounts and scoured his business records, Amani was afraid his government work would get him in trouble.

He joined those who escaped to Pakistan and then went on to Mexico. And there was plenty of company. The Department of Homeland Security says in the past two years, more than 2,500 Afghans have made the trip and crossed into the U.S. But that illegal route means they could be turned away, unless they could prove imminent danger or a medical emergency. U.S. immigration officials could quickly see there was a medical emergency with Yusra.

"When they told us, 'We are transferring your daughter,'" he says. "And after that I understand. They are human. And they will assist us, they will help us."

After a month of treatment at a San Diego children's hospital, he decided to head to Northern Virginia, where there's a large Afghan community.

"They told us we contact with Children's National Hospital in Washington, D.C., after that we will give the paper and the documents and you will go," he says.

That's where the family met Dr. Karen Smith, a one-time Army nurse turned pediatrician at Children's. She remembers the first time she saw Yousra.

"She's a beautiful little girl suffering from a metabolic disorder ... She's weak, she's unable to kind of move a lot for herself, unable to eat. But also knowing that I'll say there's such great hope if we manage that well," says Smith.

And the prognosis?

Dr. Karen Smith at Children's National Hospital in Washington, D.C., on Aug. 2, 2023.
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Dr. Karen Smith at Children's National Hospital in Washington, D.C., on Aug. 2, 2023. / NPR

"So if it's managed well and early on, the prognosis can be very good of a very functional, you know, active individual," she says, adding there could be problems because of the delayed care. "She will have delays, most likely motor. She may have in learning, because [of] the time that she went where she wasn't able to get the right diet. But you know what's beautiful about the child's brain it's kind of still growing and making new cells. So there's an opportunity that she could recover and do very well."

Smith and others, including nonprofit groups faith-based groups like Christ Church in Alexandria have helped the family settle in.

She co-signed for his apartment, which is financed by donations that run out in October. Alexandria is expensive, and many Afghans have moved to the more-affordable Virginia outer suburbs such as Woodbridge and Stafford. But Yousra must be near a large hospital with pediatricians who are well qualified in metabolic disorders. Meanwhile, Smith's friends provided dishes and silverware, a couch, while the church provided food and baby items.

The chaotic evacuation from Kabul Airport two years ago, Smith says, hit her hard. She spent more than two decades as an Army nurse. Her husband did combat tours in Iraq as a Green Beret.

"It's just frustration. It's just frustration. Sadness," Smith says. "And again, I think the Army kind of puts into you is, you know, we're one family, we're a team. We work together no matter what. When you're in a foreign country that they're supporting you, helping you, helping you stay safe, you don't leave your comrade behind ... that's the credo that's there."

Afghans who arrived some two years ago in the American airlift got three months of government assistance, Medicaid and a work permit. Amani got none of that because he came here illegally. Back in April, he filed an application for asylum, a status that would allow him to work.

'Right now, he has no Social Security number. A work permit would be great," says Yurika Cooper, Amani's immigration lawyer.

Yurika Cooper at Cooper Immigration Law in Washington, D.C., on Aug. 1, 2023.
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Yurika Cooper at Cooper Immigration Law in Washington, D.C., on Aug. 1, 2023. / Catie Dull/NPR

Cooper says even though Amani was able to get an expedited process, he's still waiting approval. That's because there's a huge backload in cases, with large numbers of Ukrainians, Venezuelans and Colombians. She also says she's seeing an uptick in Afghan refugees coming across the Mexican border. Still, she's hopeful about Amani's future — just not sure how long it will take.

Amani "has a very good case based on his past work defending the U.S. mission and the Afghan government," says Cooper. "So it's a bona fide meritorious case. There's a humanitarian component because of his daughter. "

Amani hopes to become self sufficient before too long. He plans to become a mechanic one day. And his wife? She dreams of becoming a doctor, but English classes will come first.

"Today I'm happy. Yes, I'm happy in the United States," he says.

Amani hands Yousra to his wife, and cuddles their second child, a chubby 6-month-old with alert eyes. He named her in defiance of a Taliban regime that is opposed to educating girls.

"Her name is Iqra," he says, explaining that it means "read."

Copyright 2023 NPR. To see more, visit https://www.npr.org.

Shafiullah Amani and 3-year-old Yousra and 6-month-old Iqra, on Aug. 3, 2023.
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Shafiullah Amani and 3-year-old Yousra and 6-month-old Iqra, on Aug. 3, 2023. / NPR