Biniyam repeatedly begged Ariela not to go back to New Jersey for the surgery, as he was extremely fearful of history repeating itself. Biniyam -- who told ET that he was suicidal when his first wife left him and took their son back to America -- even went so far as to hide her passport from her.
"I was very upset and felt like that was like an aggressive act towards me," Ariela told cameras. "But I do understand that he's not acting like himself because he's so traumatized by what happened with his ex-wife."
In a big gesture to show how much she loved him and to assure him that she was coming back, Ariela "proposed" to Biniyam by getting down on one knee and giving him a ring.
Speaking in Amharic, she told him, "You are my family until the end of time."
Biniyam was clearly touched and wore the ring immediately, which was engraved with the words, "Forever family."
Ariela told cameras, "I'm hoping that by Bini seeing that I invested the time and the forethought to buy us matching rings, it'll reassure Bini that I am coming back, and maybe it will ease his suffering a little bit."
But when Biniyam dropped Ariela and Avi at the airport, it was clear that he was not OK. Biniyam was still destroyed over Ariela and his son going to New Jersey and remained extremely fearful.
"I mean, I'm feeling very heavy inside," he told cameras. "It's difficult to believe and accept. How can I send Ari and my child with love and peace?"
Meanwhile, Ariela had mixed emotions.
"Leaving Ethiopia is bittersweet. On the one hand, I don't wanna leave Bini and it's really hard to see him like this," she said. "But the doctor said Avi needs the surgery, and I'm also really excited to see my family and to see my friends and to experience all those things that I can't get from the U.S. in Ethiopia."
At the airport, Biniyam couldn't bear to see them go, and even called her back at the last second. Ariela was emotional as well.
"I feel so sad because, just one of the hardest things I have to do is just to leave Bini behind," she said. "But I hope he understands this is the right thing and that when I do come back, it will make us happier and stronger."
Biniyam broke down in tears while in his confessional.
"When I say goodbye to Ariela and Avi, I get flashbacks of my previous family," he explained. "Kissing them with happiness and love, and my ex saying they'd come back. When I lost my first child, when I really think about it, I really feel ... I really love my child. I haven't seen him in two years, at least."
"Like, with Ari I start again another American girl," he said. "And she's beautiful and she's talented. And then I don't want to lose her... And then I don't want to be hurt. Because when I lost [my ex], I'm so hurt. I'm so depressed. Even I tried to kill myself. So many things, situation in myself, so that's why I don't want it to happen with me inside. I don't want to lose her because I love her. She's given me a baby."