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Our beautiful, strong 14-year-old daughter Kali is fighting a battle no child should ever have to face. She has Superior Mesenteric Artery Syndrome (SMA) and left renal vein compression known as Nutcracker Syndrome—two rare and debilitating vascular compression disorders that have taken away her childhood, her health, her hope and her joy.
SMA Syndrome occurs when the duodenum is crushed between major arteries, blocking food from passing normally. This causes severe abdominal pain, constant nausea, vomiting, and an inability to eat or maintain weight. Every day is agony for Kali. Her suffering has become so overwhelming that she has told us she doesn’t want to keep going living a life of pain. No parent should ever hear their child say this.
Kali loves to dance more than anything. It is the one place she feels free and alive. Her biggest dream is to be able to dance again without pain.
A Heartbreaking Reality: No Care or Specialists in Australia
SMA Syndrome is not well-recognised or understood in Australia. In Melbourne, there are no specialists who treat SMA at all.
We have spent months going from appointment to appointment, searching desperately for help, yet we have received very little meaningful care. Kali’s condition has continued to deteriorate while we have been left with no answers and no
treatment options.
Her doctors have now acknowledged that there are no effective treatment pathways available in Australia for her.
Why Dr. Domingo Alvear Is Kali’s Only Real Chance:
Kali urgently needs the Alvear Procedure, performed by Dr. Domingo Alvear at his dedicated SMA Syndrome Clinic in the Philippines—one of the only specialised centres for this condition in the world.
This procedure works by repositioning and securing the duodenum, relieving the arterial compression and restoring normal digestive function. For many SMA patients, it has been life-changing. For Kali, it is her only realistic hope of eating again, gaining strength, living without daily pain—and being able to dance care free and pain free.
Why we’re taking Kali to the Philippines to have Dr. Domingo Alvear fix her SMA syndrome:
- SMA syndrome is extremely rare and almost no one in Australia truly understands how to treat it surgically
- Only a handful of cases are diagnosed in Australia each year.
- Most Australian surgeons have never performed a duodenojejunostomy or duodenal derotation in their entire career.
- The few who have tried usually do a full open laparotomy (big midline cut) or a generic laparoscopic version — both have longer recovery, more pain, and higher failure rates in teenagers.
- Dr. Alvear literally wrote the book on the modern operation
- He has personally operated on more teenagers with SMA syndrome than every Australian surgeon combined (over 100 documented cases).
- He invented the “Alvear procedure” — a tiny 4–6 cm muscle-sparing incision that was specifically designed for thin, growing kids.
- His published success rate is 95–98 % complete cure with almost no recurrence. The Australian case reports (when they exist) are closer to 60–70 % and often need second operations.
The Philippines clinic is purpose-built for exactly this
It’s not a “third-world hospital” — it’s the World Surgical Foundation hospital that Dr. Alvear set up with modern operating theatres, western-trained anaesthetists, and a paediatric team that only does these cases.
Many families from the USA, Canada, UK, and Australia have already had the surgery or are attending the clinic now and there are many glowing reviews and photos in the SMA support groups of their successful outcomes. Furthermore,
- Cost and wait time are way better
- Even with flights and accommodation, the total cost is far less than doing it privately in Australia or going to the USA (and you avoid a 12–24 month public waiting list where the surgeon may have done only one or two cases ever).
- She can have surgery within weeks of deciding, not years.
Why We Need Your Help:
I attempted to access my superannuation on compassionate grounds, but because SMA Syndrome does not fit the strict eligibility criteria, I was denied. With no specialist care in Australia and no financial support available, we have nowhere left to turn.
The costs of surgery overseas are significant and include:
• Surgical fees for the Alvear Procedure
• Two weeks of acute hospital care
• Four weeks of outpatient rehabilitation and follow-up treatment
• Specialist appointments and diagnostic testing
• Flights and accommodation for Kali and a parent
• Post-operative care once we return home
Because Kali’s recovery will be long and difficult, I will need to be by her side full-time. This means I will be off work for at least 6 weeks, resulting in a substantial loss of income for our family at a time when expenses are at their highest.
This entire journey—medical, emotional, and financial—is far more than we can
manage alone.
Without this surgery, Kali’s condition will continue to worsen, placing her in a life threatening situation.
With the Alvear procedure, she has the chance to live pain free, eat again, grow again, smile again—and dance again.
How You Can Help Kali
Every donation, no matter the size, brings us closer to giving Kali the life she deserves: a life without constant pain, without fear of eating, and without losing the dreams she has fought so hard to hold onto.
If you cannot donate, please share her story. Your kindness could help save her life.
From the bottom of our hearts, thank you for caring about Kali.