But Nicaragua is like the United States 50 or so years ago. Berrios is one of only two pediatric cardiologists in the country. Here, and in other developing nations lacking money and expertise for such surgeries, untreated heart defects have a snowball effect. The inefficient heart muscle often enlarges grotesquely from overwork. Growth is stunted.
Lungs become progressively less effective.
Fingers and toes become clubbed, often turning blue from lack of oxygen. The defects steal the children s quality of life then life itself. Nicaraguans have been tempered for millennia by upheavals, disappointments and setbacks. They seem resigned to running a gantlet of tropical insects and diseases, warring tribes and political factions, cruel dictators, earthquakes, floods, volcanoes and hurricanes. But that hardening under fire doesn t ease the wrenching need for these medical specialists and the healing they represent.