Ruth Ngwaro lies listlessly in a Baltimore hospital bed days after a three-hour operation to repair a hole in her heart. She is 3 years old and a long way from her home in Nairobi, Kenya. Tubes connected to hospital machines protrude from her small chest and mouth. Her eyes are shut tight.
She was born with complicated heart problems and has spent a great amount of her young life sick and hospitalized. She came to the University of Maryland Medical center for help. She is one of the lucky ones.
Ruth was selected from among hundreds of children born with cardiac problems to receive free, open-heart surgery through the Heart to Heart program that helps sick children in developing countries.
"For every one child that we bring over here, there are at least 100 more who need help," says Dr. Elijah Saunders, a UM cardiologist and one of the program's founding physicians. "The needs are incredible."
The program, an offshoot of the International Society on Hypertension in Blacks, began in 1989. It was founded by Dr. Herman Taylor, a cardiologist at the University of Alabama at Birmingham.
While attending a hypertension conference in Kenya, Dr. Taylor was approached by a woman whose child was suffering from a heart condition that couldn't be fixed there.
The woman's only option was to come up with $20,000 for surgery in London -- or lose her daughter. "She was poor. A vegetable vendor. That $20,000 might as well have been a million," Dr. Taylor says.
When he returned home, Dr. Taylor set up a network of people -- from health-care providers to clergymen -- who agreed to treat the child for free in America and help with other arrangements. Then he wanted to do more. "I decided that it should not just be a one-time thing," he says.
bTC Ruth's mother, Mary Ngwaro, learned about Heart to Heart from her doctor in Kenya. Mrs. Ngwaro, a shy, soft-spoken woman, had never left Africa before January, when she brought her daughter here. Her eyes are sad as she looks at her sick child lying in bed. Spittle forms around Ruth's mouth. Mrs. Ngwaro catches the arm of a nearby intensive care nurse and points to her daughter's face. The nurse grabs a tissue and gingerly dabs around Ruth's mouth, careful not to dislodge any tubes.
Choosing which children come here for medical help can be agonizing. "The selection process is not an easy one," Dr. Saunders says. Doctors choose children with medical problems they believe can be cured with surgery, and whose parents are too poor to pay for the operation.
"[We pick] the ones who would die without it, but with surgery, they will be OK," Dr. Saunders says.
Ruth was born with a large hole between the pumping chambers of her heart and severe leakage of a valve. The two problems caused enlargement of her heart and elevation of pressure in her blood vessels, says Dr. Joel Brenner, one of the pediatric cardiologists who cared for Ruth. Also involved in her treatment was a team of cardiac surgeons led by Dr. John C. Laschinger, who performed her operations.
Ruth is the 12th child to be brought to the UM Medical Center courtesy of Heart to Heart. They have come from Kenya, Nicaragua, Belize and Honduras.
Other children in Heart to Heart have been treated at the University of Alabama at Birmingham. In Atlanta, St. Joseph's Hospital has agreed to participate, and hospitals in Philadelphia and New Orleans are planning to join the program, too.
Doctors at University hospital have been reluctant to "go public" about the program for two reasons, Dr. Saunders says. Inevitably, some in this country will say there are people here who need the help, he explains. "We didn't want to come under that criticism. But the facilities are here for anyone who needs them. People here can get help. The facilities are not [in the developing countries]," he says.
The other reason is doctors don't particularly feel comfortable talking about their humanitarian efforts, the cardiologist says.
The program is financed through donations. "The Lions Club International is the greatest [financial] contributor for the program," says Dr. Saunders. "They have raised funds, so have others."
To raise more money, the first annual awards banquet and fund-raiser will be held Friday at the Stouffer Harborplace Hotel.
"She began getting sick when she was 3 months old," Mrs. Ngwaro says of her middle child. "That's when it was discovered there was a problem. Eating was a problem. Drinking was a problem. She used to get pneumonia. She was admitted to the hospital six times before she was 1 1/2 . We were given free tickets to come here. We had been waiting a while to bring her over here. Then we got the chance."
The families find a way to get their children to America for the surgery. In some cases, entire villages have raised the airfare for the children and a family member. Civic groups, churches and other organizations help out. Ruth's father, Augustine, works in customs for British Airways in Nairobi. His company flew Ruth and her mother here for free.
Once they are in the United States, lodging is free. Families live with hospital staff, volunteers or sometimes at the Ronald McDonald House on Lexington Street.
Mrs. Ngwaro is staying with Dr. Iris Keys, who lives within walking distance of the hospital and has been a host to four families. Dr. Keys rarely sees Mrs. Ngwaro, though. The mother usually sleeps on a couch by her daughter's bed.
Ruth spends three days in intensive care before her condition is upgraded and she is moved to a private room. Now, she looks like a different person. She is sitting up in bed. She lets loose with a healthy howl as technicians draw blood for further tests. She is better every day, Mrs. Ngwaro says.
However, the doctors found another hole in Ruth's heart, and she had to have a second operation.
"There was a significant residual hole, separate from the original hole," Dr. Brenner says. After the second heart surgery, the doctors determined that Ruth -- although her condition is improved -- will never be completely well.
"Sometimes kids cannot be made completely better," Dr. Brenner says. "Sometimes all of these good intentions do not mean there is a cure."
Mrs. Ngwaro took her daughter home last week. She hopes Ruth will continue to improve. "She's eating well. She's drinking. She's sleeping well. I am encouraged about her health," the mother says. She says she is grateful that so many strangers cared and Ruth was given a chance.
"The program is really more than about health care," Dr. Taylor says. "It's almost diplomacy. The exchange between cultures is really very special. And it puts America in the very best light."
What: Heart to Heart/International Society on Hypertension in Blacks.
When: 6 p.m. Friday.
Where: Stouffer Harborplace Hotel, 202 E. Pratt St.
Cost: $75 for an individual or $750 for a table (seats 10).
7+ Call: (410) 328-4366 or (410) 298-1798.