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01/23/2003
Guatemala's Little Marias Get Joyful Welcome Home From United States
Outpouring of support reaching out to formerly conjoined twins
Guatemala City -- For the first time in their short lives, the "Maritas" are home.
María Teresa and María de Jesús Quiej Alvarez arrived January 22 with their parents, Wenceslao Quiej and Alba Leticia Alvarez, to a new house in the Guatemala City suburb of Villanueva. The infants, born almost 18 months ago as conjoined twins, had never before lived outside a hospital.
Wearing sequined tiaras over bandages on their heads that covered where they had been born conjoined, the twins returned to Guatemala from the United States January 13 on a plane loaned by the Federal Express Corporation. Hundreds of well-wishers and a huge contingent of U.S. and Guatemalan press were on hand to greet them.
U.S. Ambassador to Guatemala John R. Hamilton joined Guatemalan First Lady Evelyn de Portillo in welcoming the Maritas at Guatemala City's La Aurora Airport.
"The twins' return was joyous for all the people in Guatemala who have taken these children into their hearts," Hamilton said. "Their story is a wonderful testament to the strong bonds that exist between the people of Guatemala and the people of the United States. I'm especially proud to see how American organizations and foundations contributed to the effort to help María Teresa and María de Jesús."
Hamilton added that "in both countries, medical experts and ordinary citizens alike joined hands to make sure these little girls got the best care available. Their recovery is nothing short of a miracle. This family now has the hope of raising their two daughters to have a happy, healthy, productive life."
The family's return to Guatemala ended a nearly seven-month stay in the United States, where specialists from Mattel Children's Hospital at the University of California-Los Angeles (UCLA) performed successful surgery to separate the twins.
The saga of Maria Teresa and Maria de Jesús, affectionately known as the "Maritas," or "Little Marías," began on July 25, 2001, when they were born at their parents' humble two-room home. The attending midwife realized the mother needed more advanced care and sent her to a hospital in Mazatenango, the closest city to the parents' home village near Santo Domingo in the department of Suchitepequez. The Maritas were soon moved to the Guatemalan Social Security Institute Hospital in Guatemala City.
Several months later, the Guatemalan Pediatric Foundation (GPF) learned about the girls, which led to efforts to help them.
"In January of 2002 we had a pediatric surgery mission here, which included a pediatric general surgeon," a GPF social worker explained. A local doctor asked the surgeon to visit the Social Security Hospital to treat another child needing surgical attention. It was at the hospital where the GPF learned about the conjoined twins. Foundation representatives soon afterward met with the parents and offered to try to help the girls.
The Foundation, which works extensively with U.S. organizations to bring medical teams to Guatemala to treat children, contacted counterpart groups in the United States. The first to respond was the non-profit international organization, Healing the Children, which helped GPF find a U.S. hospital that could assist the Maritas.
A few months later, Dr. Jorge A. Lazareff, director of pediatric neurosurgery at UCLA's Mattel Hospital, was told about the twins. Lazareff, originally from Argentina and now a U.S. citizen, spent three days with the girls, observing and photographing their behavior. He became involved in the drama through his volunteer work with Healing the Children, on behalf of which he has traveled to such countries as China, Romania, and Guatemala. Healing the Children, with headquarters in Spokane, Washington, has brought many other children to the United States for medical treatment.
Lazareff said in an interview that he had never before performed such an operation. Babies born conjoined at the head are extremely rare -- occurring once per two million live births, he said, although being conjoined at other parts of the human body, such as on the back or hip, is less rare -- once in every 250,000 births. Lazareff said the original prognosis for the two babies surviving such a delicate surgery was poor. Nevertheless, he proceeded because of the low quality of life the sisters would have to endure if they remained joined at the head. The bad odds for success were such that Lazareff received cautionary calls from colleagues, seeking to "protect" him from the possibility the operation could go wrong.
But being conjoined, "not having any form of privacy (for the girls) was unimaginable," Lazareff said. "So I said this is doable -- a procedure that UCLA, as with many other hospitals in the United States, has the technical ability to perform. You just needed to have the determination to go ahead." The doctor said he equates freeing the sisters from their conjoined condition with setting someone free from incarceration in prison.
A team of surgeons, technicians, and nurses, which Lazareff said totaled 50 in all, was assembled to perform what turned out to be a 22-hour operation in August. Surgeons were confident that, although the girls shared skulls and scalp tissue, their brains were separate, which gave the twins a good chance to survive. A few days after the surgery, María de Jesús -- "Chusita" -- opened her eyes. María Teresa -- "Teresita" -- suffered an infection and other setbacks, and had to undergo an additional operation.
Lazareff said the surgery would have cost an estimated $2 million, if the doctors had charged fees, but instead they donated their services for free. However, costs associated with the children staying at the U.S. hospital amounted to between $700,000 and $800,000. The Healing the Children Foundation donated almost $500,000, with many private individuals sending in contributions to UCLA to defray that cost.
A Foundation spokeswoman said her group hopes that all the worldwide attention about the twins will lead to enough charitable contributions to pay for establishing a new hospital in Guatemala devoted strictly to the care of children.
"There's a potential miracle attached to the twins that I'm hoping comes true," said the spokeswoman. "We have tried for many, many years to get a children's hospital started in Guatemala. And when we went to Guatemala, there was a building that was so phenomenally right for what we want to do. And we're hoping that the publicity for the twins will open up the doors for us to buy the building" -- what used to be a five-star hotel.
Now back in Guatemala, the girls are said to be recovering well from their ordeal. Doctors had expected the babies would need to remain in Guatemala City's Nuestra Señora del Pilar Hospital for up to three weeks. But after only a week and half, they were allowed to go home.
The Guatemalan Pediatric Foundation, which continues to coordinate the girls' care, found donors to build and furnish a new house for the family near the hospital to make it easier for the parents to check on their girls' continuing treatment. The girls' father, Wenceslao Quiej, formerly a banana packer, will be trained as a physical therapy aide so he can earn a better living and to assist in caring for his daughters.
The twins will receive physical, vocational, and occupational therapy, the GPF spokeswoman explained.
Although the girls' physical development lags behind that of other children their age, doctors and therapists are confident they will catch up, especially since Lazareff said they are now in the hands of an excellent Guatemalan medical team.
Lazareff said he does not want to be regarded as a "miracle worker" for his surgical skills. He says modestly that he was only doing his job helping two babies born with an unimaginable handicap.
(The Washington File is a product of the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)
