With the benefit of hindsight, Djamshid Popal — the fragile Afghan child whose life-saving heart procedure in 2004 made headlines across Canada — wishes he had never left the strange country that saved his life.
Ten years removed from being flown overseas on Canada Day, eventually landing in an Ottawa hospital, the now-19-year-old Popal suffers constant nosebleeds and struggles to obtain an education in his dusty village outside of Kabul.
More concerning, his family routinely receives death threats from suspicious Taliban supporters and all because the nine-year-old benefited from Canadian compassion and medical expertise.
Canadian Forces doctors came upon Popal's desperate plight while conducting a medical clinic in Mohla Mahmad Khail, a bumpy three-and-a-half hour ride northeast of the Afghan capital.
Popal, nine at the time, was frail and having difficulty breathing, recalled Maj. Americo Rodrigues, the army doctor from Toronto who initially treated him.
"He was nine years old, but he looked like he was six," said Rodrigues.
"He was very frail, he was very short of breath, he looked very sick."
A fund-raising effort was organized in Hamilton and brought together the city's Muslim and Jewish communities to jointly help finance the journey and medical expenses.
Three of four heart valves were damaged by rheumatic fever
At first it was believed the boy had a condition known as patent ductus arteriosus, a birth defect where blood from the left side of the heart circulates back to the right side without taking its normal course through the body.
But after being diagnosed at the Children's Hospital of Eastern Ontario in Ottawa, doctors said it appeared that three of the nine-year-old's four heart valves had been damaged during a severe bout of rheumatic fever.
He was later transferred to Toronto's Hospital for Sick Children, where he underwent surgery to repair his heart.
Once he started to recover, Popal became extremely homesick for his mother Sohaila and other family members.
Despite efforts to keep him in Canada by supporters like Saddique Khan of Hamilton, Ont., who financed his original journey, Djamshid was determined to go home, and his father Shafiullah respected his wishes.
The two flew back to Afghanistan in late November of 2004.
Since they have lived reclusively in their small, remote mud brick home on land that to this day is dotted by landmines.
Looking back, Popal said he believes life would have been better had he remained in Canada.
'They think we're spies of the Canadian government,' Popal says
"I was only nine years old, had a big surgery done, and I missed my mom so much and wanted to meet her," Popal said in an exclusive interview with The Canadian Press.
"But I really didn't know that if I had chosen to stay in Canada, my mom could have also visited me."
The slightly built Popal now breathes more easily, but his movements are laboured, and is plagued by nosebleeds brought on by warfarin, the blood-thinning medication he takes to stay alive.
Six years ago, he suffered a stroke and never fully recovered. Then, two months ago, Popal's foot was broken when he was run over by a car.
All of that may be the least of his problems.
Taliban supporters in his village have made threats against Popal's father, forcing him to find work breaking rocks to sell from the mountains around their village.
"They think we are the spies of the Canadian government," Popal said in an interview with a translator in Kabul.
"If I knew this would be my situation, I would never come back to Afghanistan again and would stay (in Canada) to continue my studies."
As he did a decade ago, Popal still dreams of becoming a doctor, although he said his health is making it hard to complete high school.
"I can't go to school regularly because its almost two hours' walk up and down the hills," he said. "And my nose sometimes bleeds and I feel so scared because the bleeding doesn't stop very easily."
Salma Ataullahjan, who was instrumental in raising funds for the Popal family after they arrived in Canada and for a time following their return, isn't surprised that Djamshid wishes he had remained.
"I knew he would regret it," said Ataullahjan, who was appointed to the Senate in 2010. "And I got that sense from his father after they had been back (in Afghanistan) for a few months."
The Popal family likely knew years ago that, once they left Canada, there would be no coming back, she added.
For his part, Djamshid said he still recalls the help he and his family received, and is constantly telling people about his days in Canada.
"I remember almost everything because I have been telling my stories to my friends almost every month."