Orphan's 'time bomb' bullet

A five-year-old African orphan, who had a bullet behind her right eye had been living with a "time bomb ticking away" inside her head, the surgeon who successfully removed it said yesterday.

After a weekend of tests, doctors at the Norfolk and Norwich hospital operated on Tenneh Cole from Sierra Leone because there was a significant risk of her dying through a brain infection.

Yesterday, a team of three surgeons performed a two-and- a-half-hour operation on Tenneh to remove the 2cm bullet by cutting out a wedge of bone on her right cheek.

The bullet, from an AK47, was lodged in the child's sinus and pointing upwards and doctors are still not sure how it had entered her head. They assume that it was a spent bullet which had hit the top of the head then turned around as it made its way through her brain.

Geoffrey Cheney, who led the team, said he had first attempted to remove the bullet by making an incision through the roof of Tenneh's mouth. When that failed he had made a second cut in the cheek, but that was also unsuccessful and finally he had had to remove a half- inch wedge of bone from just underneath her right eye. He inserted a titanium plate into her face and in time the operation scar should be very minor.

"We have actually, I hope, significantly reduced the risk of infection," said Mr Cheney. "There was already infection behind her eye and that infection could have led to [a lethal] infection of the brain.

"It was a bit like a time bomb," he said. "It could have gone off at any time."

Tenneh was hit by a stray bullet 16 months ago during the civil war in Sierra Leone which claimed the lives of her parents.

She was found cowering in a derelict farmhouse by a couple who were also fleeing from the rebels. After Tenneh was wounded in the crossfire, Malomoh Cole and his pregnant wife carried her 250 miles to the country's capital Freetown, dodging rebel patrols.

There, a British couple, Colonel Mark Cook and his wife Caroline, who run a children's home in Sierra Leone, arranged for her to be brought to England and doctors at the Norfolk and Norwich agreed to treat her without charge.

Mr Cheney said Tenneh had been very lucky not to have been killed outright. "If that was a high velocity bullet and if it went into your head it would normally blow your face off," he said.

Doctors will also try to find out why she is deaf. "From what we have been told her deafness was relatively recent and started after a small fever," Mr Cheney said. "It seems that probably it is not related to her injury."

Mr Cheney said Tenneh's face was badly swollen after the operation but when he had last seen her she was coming round and "gently complaining". She is back on a children's ward.

"I would not mind betting that by tomorrow she is up and about," Mr Cheney added. "I am very impressed at the way she has settled down on the ward over here."