Courtesy photo Karen Sellers-Myers hugs her newly adopted 4-year-old daughter Sophia. The orphan child was born with a cleft palate in the Republic of Georgia and is now receiving the medical care she needs.

Sellers-Myers, a nurse with the U.S. Army Medical Research Institute of Infectious Diseases’s Medical Division, has made nine trips to the region since 2004 as part of an ongoing effort to train Georgian scientists in the latest research techniques. The program was created by the Defense Threat Reduction Agency to revitalize the scientific community and public health infrastructure in the former Soviet Republic.

As a member of the USAMRIID team, she is working to help scientists in the region learn to conduct research that meets the standards of Good Clinical Practices. It was through contacts in the Republic of Georgia that she first learned about Sophia.

‘‘Last spring, the wife of the DTRA country manager—the office that assists Americans working there—asked me to come see a child at the orphanage, or ‘baby house’ as they call it,” Sellers-Myers recalled. ‘‘She was small for her age and had facial deformities that made it hard for her to eat and drink without help. I thought what they were describing was a child with a double cleft palate.”

Sophia had indeed been born with a cleft lip and palate, a condition that occurs during early pregnancy, when separate areas of the infant’s face develop and then join together. If some parts do not join properly, the result is a single or double cleft or separation in the lip, palate or both. Sophia’s condition was severe—she lacked proper suction for drinking, so there was always a danger of milk entering the nasal cavity and being aspirated into her lungs. She was also at risk for ear infections, and her speech had not developed normally.

When Sellers-Myers visited the orphanage in July, she instantly bonded with Sophia, who was 4 years old and weighed less than 20 pounds.

‘‘She turned around and made eye contact with me, and then she came across the room and held up her arms to me,” she recalled. ‘‘That moment when we connected—it just felt like she was mine.”

Later, Sellers-Myers learned that because Sophia had been shunned her whole life, it was even more unusual for her to reach out to someone. The moment was especially touching for Sellers-Myers, who also was born with a double cleft palate and underwent the first of several surgeries when she was just 2 days old.

‘‘My heart was just breaking,” she said. ‘‘It’s a Third World Country...they do their best but [the staff at the orphanage] didn’t have time for a special needs child. It’s difficult for someone who’s been a...tourist to understand how little they really have.”

Three concrete buildings, some lacking running water, housed the children of the orphanage, who subsisted on a diet of oats with cornmeal or rice donated by the World Health Organization. Because social programs are nonexistent there, the organizations that do provide services largely depend on donations and goodwill.

‘‘Once I’d met her, I said I would do whatever I could—we had to get this child some help,” Sellers-Myers said.

At first, she and her husband wanted to medically adopt Sophia. This meant the child would stay in her native country but the couple would pay all the costs associated with her medical treatment—including surgery, dental work and speech therapy.

They tried to find a surgeon in the country but were unsuccessful. Other inquiries, to organizations like Doctors Without Borders and Smile Train, didn’t pan out either.

‘‘By the end of July, [my husband] Curtis looked at me and said, can we just adopt her?” she recalled.

The Georgian adoption process is ordinarily difficult for outsiders, but Sellers-Myers was pleased with their progress. The couple filed their application in early August and by the second week of October they had a letter of approval from the U.S. The Republic of Georgia gave them a court date in December, and they picked up Sophia at 5 p.m. on Christmas Eve.

She has three grown daughters and two grandchildren, ages 5 years and 7 months. She says she never considered adopting until she met Sophia, but says it was ‘‘meant to happen” and that her family, co-workers and friends in the community have been very supportive. Within weeks of her arrival, Sophia was seen at the Johns Hopkins Cleft Palate Clinic in Baltimore, and her first surgery, which went well, was performed Feb. 7.

‘‘Sophia now has an upper lip and front teeth,” Sellers-Myers said. ‘‘The doctors were able to save the bony protuberance and place it in her mouth, where it was meant to be. She also now has tubes in her ears and can hear...the specialist was amazed at the amount of impaction both in the ear canal and behind the eardrum. She has surgeries planned for every three months until the end of the year.”

Sophia also will have several tests to determine if she will benefit from growth hormone. Although she is 4 years and 9 months in age, she is developmentally closer to a 2-year-old.

‘‘She is already trying to form sounds, and we are confident that she will speak,” Sellers-Myers said. ‘‘She’s up to 25 pounds now and is adjusting really well...she has really come out of her shell and is warm and friendly to almost everyone she meets. She’s really bright and has very expressive eyes. It’s rare that she doesn’t smile...she wakes with a smile.”

Asked what Sophia’s situation would be like had she not been adopted, she simply said, ‘‘We are saving her life. The conditions in that orphanage are so dire that (personnel) only give care to the ones who are going to make it. Not that they are harsh—the needs there are just too great. One cold or sinus infection without extra attention could have killed her.”

Sellers-Myers, who wants to do everything she can to honor Sophia’s birth country, has assembled an album with photos she took at the orphanage. The child enjoys flipping through it and seeing pictures of her friends.

When asked how she thinks Sophia sees herself, she pauses.

‘‘Will she look at the ‘before’ pictures? Everyone responds differently. My hope is that she’ll tape one to her mirror—and no matter where she is in the process, she will say, ‘I am beautiful.’”