Abidzar and His New Jaw
Abidzar with Dr. Hendri after undergoing his second surgery to remove the distractor device. His condition has now greatly improved, and his parents can finally smile with much greater relief.
A soft little laugh can now be heard clearly. After months of undergoing mandibular lengthening and waiting for new bone to form, the distractor device in Abidzar Akbar’s jaw was officially removed in mid-2025. The smile of this five-year-old boy from Medan now shines much brighter.
For his mother, Erni Lestari Handayani, this moment felt like finally taking a long breath after a long journey filled with hope. A tremendous sense of relief washed over her, as if a heavy burden had been lifted from her shoulders.
“Finally, Abidzar can eat more easily, and his speech is becoming clearer,” she said with teary eyes. “I am truly grateful.”
Thirty Millimeters That Mean So Much
Abidzar Akbar, affectionately called Abi, suffers from mandibular hypoplasia, a rare condition in which the lower jaw does not develop properly.
“The prevalence is about one in 14,000 births,” explained Dr. Henri Mudjono, DDS, OMFS, an oral and maxillofacial surgeon at Tzu Chi Hospital.
This condition affects not only facial structure but also the ability to eat and speak. During the first two years of his life, Abi could only receive nutrition through an NGT feeding tube. Later, he was gradually introduced to soft foods, though chewing remained difficult.
Before performing the procedure, the medical team carefully explained the process to the family and reassured them.
According to Dr. Henri, Abi’s extremely small lower jaw prevented his upper and lower teeth from meeting properly. As a result, he had difficulty chewing and his nutritional intake was limited.
To address the problem, the medical team performed mandibular distraction osteogenesis, a surgical procedure that installs a device called a distractor to gradually lengthen the bone. The device was turned one millimeter each day until reaching three centimeters—the ideal jaw length for a child his age. This process lasted 30 days, beginning on October 16, 2024.
“With this procedure, we aim to stimulate the growth of his lower jaw so it can catch up with the upper jaw,” Dr. Henri explained.
After the lengthening phase, Abi entered a consolidation period for several months to allow the new bone to harden and function normally.
Four Years of Struggle and Hope
Behind this medical success lies a long story of patience from a small family in Medan. The COVID-19 pandemic in 2020 created major obstacles, from limited access to medical examinations to difficulties in accessing medical consultations. At the same time, the family’s financial stability was shaken when the family’s breadwinner lost his job.
Before they came to know Tzu Chi, Nazaruddin and Erni admitted they had felt hopeless because hospitals in Medan could no longer handle Abi’s condition and suggested continuing treatment in Jakarta. “They didn’t tell use where to go or which department to contact. We were completely lost,” Erni recalled.
During that time, they tried to stop and calm their hearts to look for a way out. It was Erni’s relative who later introduced her to Tzu Chi. Even though there was no relieving news, the companionship of the volunteers always brought happiness to them because the sincere and continuous attention from the volunteers.
“The encouragement from all of the volunteers also made us remain strong,” she said cheerfully. “Because all this time we have always been accompanied by them. They always embrace us. Even though they are not relatives, not friends. We are nobody, but we are treated so well,” Erni continued.
Doctor activating the distractor which had been installed on Abidzar’s lower jaw. This device was turned one millimeter each day for 30 days until it reached the number determined by the doctor.
During that search period as well, the number of consultation sessions with various hospitals could no longer be counted. They often attended medical event in Medan in order to find information about competent doctors who could help their child.
“There was once a doctor from the Netherlands who was a plastic surgeon. There was an event in Medan at that time so we came and asked directly. But indeed we got recommended to go to an oral and maxillofacial specialist,” Erni recounted.
There was also a doctor from India who stated he could treat Abi, but many things had to be prepared, starting from language to much larger accommodation costs. The volunteers then searched for other options again.
“At first we thought that once we found a doctor, they could immediately start working on the treatment. It turned out not as easy as we thought. There were also so many stages and it turned out the device was not available. What could we do then? Because we had not found a solution, Abi’s case was once closed. But even though it was closed, the Tzu Chi volunteers continued to look for other options,” explained Nazaruddin.
Until finally, in 2024, the door of hope opened through Tzu Chi Hospital in Jakarta. “After such a long effort, the right place was indeed here,” Nazaruddin said emotionally. “We are very grateful and thankful.”
The surgical process of installing the distractor that Abi underwent became the first step of a long series of treatments. However, the journey did not end there. After the device successfully lengthened the lower jaw bone, there was sill the next important stage, namely the surgery to remove the device. This stage was carried out after new bone had grown perfectly and hardened, ensuring that the jaw structure could function normally without the assistance of the device.
The Awaited Result
After the distractor device lengthened as far as 30 millimeter, the lengthening process was declared successful. The next phase, the second surgery to remove the device, was carried out on July 29, 2025.
“Since the device was installed, Abidzar’s lower jaw gradually moved forward. The total increase in length reached three centimeters,” explained Dr. Henri. “Now after it has been removed, the bone is solid like normal bone.”
The changes are also real, Abi’s voice is now clearer, his airways is more open, and he has already begun to be able to chew soft foods. His face appears more proportional, and his small smile now blooms more easily.
This happiness is also felt by the volunteers who accompany him.
Volunteers in Tzu Chi Hospital visited Abi after the surgery. They also brought a big doll to cheer Abi who was still in pain.
“We feel very happy when we see Abi. He already feels like my own grandchild,” said Juniaty, a Tzu Chi volunteer from Medan while smiling. “Before his speech was unclear and he only consumed liquid food. Now he can already eat soft rice and his speech is fluent.”
For Juniaty, accompanying Abi was not merely a duty, but a good karmic connection. She believes every meeting is a lesson about love and sincerity. Because of that, every time Abi underwent medical procedure, the volunteers always came, not only for companionship, but also as a source of strength for both of Abi’s parents.
“We also feel how it is to become Abi’s parents,” Juniaty said softly. “That is why we want to be present to give strength.”
The happy faces of Tzu Chi volunteers from Medan from left to right: Juniaty, Dolivien, and Desnita, who always accompany Abidzar and his family. The presence of the volunteers adds strength and confidence to the family in the recovery of their beloved son.
Small Steps Toward the Future
At the end of the story, a soft voice full of gratitude from Erni sounded warm. “Thank you very much to all doctors, volunteers, donors, and the Buddhist Tzu Chi Foundation. Because of the sincerity from all of you, Abidzar can reach this point. I can only pray that all of this will be repaid with multiplied goodness,” she said.
That expression was born from the long emotional journey they had gone through. Since the first time they left Medan until the second surgery process in Jakarta, there have always been hands full of compassion accompanying them. The Tzu Chi volunteers never grew tired of being present at every step, from the temporary residence to the operating room, from prayers to small attentions that strengthened them. That sincere support made this family feel that they were never alone, as if they had found a new family that embraced them with love.
That sense of gratitude also flowed sincerely from Nazaruddin’s heart. He never stopped expressing thanks for all the kindness they received throughout Abi’s treatment journey.
“Hopefully Abi will become a strong child who loves to help others, like what the Tzu Chi volunteers have taught us,” he said. “They helped sincerely, from energy, time, to attention. Without expecting anything in return, without seeing ethnicity or religion, they still helped us with love.”
Abidzar’s development can be seen significantly after the installation of the distractor device in his jaw. Now he can speak more clearly, and most importantly he is able to chew food better.
Erni who sat beside him nodded slowly, her eyes filled with tears. For her, every word spoken by her husband was a reflection of the gratitude she also felt. All the fear, exhaustion, and tears now feel paid off every time she sees Abidzar smiling and growing stronger. She believes this long struggle is not only about physical healing, but also about planting the spirit of life and gratitude from an early age. She hopes that in the future Abidzar will grow up healthy, confident, and able to bring happiness to many people, just as so many good people have brought happiness to her family.
“Hopefully everything that has been gone through will not be in vain,” she said softly. “I want Abidzar to grow into a good child who can make many people happy, just like the good people who have made us happy.”
However, Abidzar’s struggle does not end here. The installation and removal of the distractor device are only part of the long series of recovery that he will continue to undergo. In the future, Abidzar will still require further medical procedures and gradual adjustments so that his facial structure can grow more balanced. Even though this path is not entirely smooth yet, Erni and Nazaruddin have learned that every small step, every smile, every prayer, and every support are important parts of the healing itself. With full conviction, they move forward, carrying the hope that Abidzar’s future will grow as bright as the compassion that has accompanied his journey until now.
Written and Photographed by: Metta Wulandari
Translator: Putri Millenia Hadinata (Tzu Chi Palembang)
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