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Winter 1998
Hearts Afire
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In a land renowned for its revolutionaries, a handful of UCLA-led doctors may be waging the most critical battle for the hearts of a new generation of Peruvian poor
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By David Greenwald
Photography by Marilyn Young

The young mother is frantic as she pushes through the doors of the emergency room on a chilly, gray morning, cradling a tiny baby in her arms. She looks to be in her early 20s, but a hardscrabble life of poverty on the streets of this capital city has added many more years to her features. She has little comprehension of what is wrong with her child, just that he is desperately sick.

Indeed he is.

The infant, a black-haired, brown-eyed boy just a few weeks old, is conscious but listless, an emaciated, sad skeleton swaddled in loose skin, his rib cage clearly visible, a sharp outline under the shell of his body. He struggles for air, his breaths coming in short, rapid bursts.

He was born with pulmonary atresia -- the vessels to ferry the blood from his heart to his lungs had not formed -- and the small duct present at his birth that had been keeping him alive by allowing some blood exchange is closing. His blood-oxygen levels, which in a normal individual would be at or near 100, have dropped into the 30s; his tiny body is starving for oxygen, giving his skin and lips a mottled bluish cast.

Had this been UCLA Medical Center or any other large hospital in the United States, the baby would stand a good chance of surviving.

"We could have saved him," Dr. Juan Carlos Alejos says sadly. "If we had had the right medicine, we could have stabilized him enough to get him to surgery to fix the problem."

"We could have saved his life."

But this isn't a hospital in the U.S.; this is more than 4,000 miles from Los Angeles, in the heart of Lima, Peru.

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