MEDICAL MARVELS 'LAS MARITAS' HEADING HOME HEALTHY.

Byline: Amy Raisin Staff Writer

No one realized that a laborious and risky act of separation - twin baby girls who were joined at the head but who are heading home to Guatemala as two separate individuals - would inspire such unity in their native land and across the world.

``Las Maritas,'' as the twins are called in their central American homeland, have become national treasures to people still recovering from nearly 40 years of deadly civil war.

When the donated corporate jet arrives on Guatemalan soil Tuesday, carrying Maria Teresa, Maria de Jesus and their young parents, those who have experienced the fervor since the Aug. 5 surgery predict a reception surpassing those for world leaders.

``This is a phenomenon that nobody here expected,'' said Henry Kawamoto, director of craniofacial surgery for UCLA's Craniofacial Clinic. ``They captured everyone's attention. (They're known) in Sicily, Australia, France.''

They are so celebrated that when the UCLA surgeons arrived in Guatemala a month after the surgery for a previously scheduled visit unrelated to the twins, they were surrounded by people offering thanks and whispering of miracles, from peasants to those in the presidential palace.

Kawamoto recalls a porter at the airport in Guatemala City who, without words, conveyed the superstar status the medical team had attained in the agricultural country.

``He was a small man, and he came up and pointed at me. He didn't say anything. He just pointed at me and did this,'' Kawamoto said, waving a flat hand over his head in one clean swoop. ``It was pretty easy to understand.''

Also easy to understand was the standing ovation the medical team received after its plane from Guatemala landed in Los Angeles. A flight attendant welcomed the passengers to LAX and informed them that, seated among them, were the doctors who separated the baby girls.

Now 15 months old, the babies arrived in Los Angeles in June and began numerous tests leading up to the $1.5 million surgery at Mattel Children's Hospital at the University of California, Los Angeles - a marathon 23-hour procedure that had been attempted only a handful of times before.

Without the help of Healing the Children, a group co-founded by Valencia resident Cris Embleton that matches ailing children in poor countries with advanced medicine and volunteer doctors, the lively, animated sisters would have lived in a condition that one surgeon called ``horrible.''

Unlike conjoined twins attached at the waist, chest or even at the side of the head, the little Marias were fused at the top of the head and faced opposite directions, making it impossible for them to ever walk, sit or even pull themselves upright in their crib.

Craniopagus twins - joined at the head - are the rarest form of conjoined twins.

Faced with such a grim future, the twins' parents, Wenceslao Quiej Lopez and Alba Leticia Alvarez, who lived with relatives in a small house with a tin roof and cement floors in the village of Belen, put their faith in God and in the medical specialists in Los Angeles.

``By the grace of God,'' said the babies' father, a 21-year-old farm worker, as the lengthy surgery stretched on, ``we are waiting and hoping that everything turns out well.''

Just hours after the medical team of more than 50 finished with the separation, Maria Teresa, the slightly larger and more outgoing of the sisters, was rushed back into surgery to relieve bleeding in her brain.

Maria Teresa would suffer other complications over the next few weeks that put her recovery behind that of her sister. However, Jorge Lazareff, the head neurosurgeon for the twins, said he expects both girls to live full, normal lives.

``They will essentially maintain the same personalities they had before the surgery,'' Lazareff said Wednesday. ``Maria de Jesus is closer to the ideal outcome, but that doesn't mean Maria Teresa is further from that outcome.

``I still believe that they will be normal 5-year-old girls, absolutely,'' he said, confirming the prediction he made before the girls were separated.

Lazareff admits he and the rest of the team will miss the girls when they leave, but knows the girls will be buoyed by the adoration of the Guatemalan people - some of whom insist Lazareff come back for two weddings in about 20 years. Long before the girls celebrate such adult milestones, however, they will return to the hospital - perhaps at UCLA, perhaps in their own country - at about age 6, when doctors will build and implant skull caps from the girls' own skull bones.

Kawamoto said a child's head is 95 percent developed by then, clearing the way for plastic surgeons to cover the area that was once the meeting point for the sisters' brains.

Naomi Bronstein, co-founder of Healing the Children and director of Children's International Foundation in Guatemala, said the twins will spend their first few weeks in the hospital when they return, to monitor the condition of the skin grafts healing on their heads.

``Everywhere I go, people ask about 'Las Maritas,''' Bronstein said. ``There will be plenty of people to care for them. These kids became not only the kids of Guatemala, but of the world. These little girls were like a little miracle.

``It's like the world, with all the bad stuff happening, needed a little injection of faith.''

THE ``TWO MARIAS''

--July 25, 2001 - Conjoined twins Maria Teresa and Maria de Jesus Quiej Alvarez are born in a rural Guatemalan village.

--September 2001 - The Valencia chapter of Healing the Children approaches Dr. Jorge Lazareff, one of its volunteer neurosurgeons, for help in accepting the twins' case.

--June 7 - The ``Two Marias'' arrive at Mattel Children's Hospital at UCLA for evaluation by doctors for separation surgery.

--June 15 - Test results indicate the twins can be safely separated.

--June 24 - Surgeons complete skin-expansion procedures in preparation for surgery.

--July 25 - The twins celebrate their first birthday.

--Aug. 5-6 - Marathon 23-hour separation surgery takes place.

--Aug. 6 - Maria Teresa returns to the operating room with bleeding on the brain, a not-unexpected complication.

--Aug. 22 - Maria Teresa again undergoes surgery for bleeding on the brain.

--Aug. 29 - Maria de Jesus undergoes nonemergency routine follow-up surgery.

--Sept. 18 - Synthetic skin is applied to the twins' scalps. Permanent fixes won't be made for years, until the girls' skulls are fully developed.

--Oct. 29 - Twins are scheduled to return home to Guatemala.

CAPTION(S):

4 photos, box

Photo:

(1 -- color -- ran in SAC edition only) Wenceslao Quiej Lopez plays with his daughter, Maria Teresa, in the pediatric ICU at UCLA's Mattel Children's Hospital. Maria Teresa and her sister, Maria de Jesus, were born joined at the skull before a radical operation at the hospital in August.

Reed Hutchinson/UCLA

(2 -- color -- ran in SAC edition only) Maria de Jesus, right, plays with the feeding tube of her sister on Wednesday at UCLA. The twins eat solid food, but Maria Teresa has been unable to consume enough calories.

Scott Quintard/UCLA

(3 -- ran in SAC edition only) Maria de Jesus turns her head to watch visitors. ``This (the twins' worldwide popularity) is a phenomenon that nobody here expected,'' said Henry Kawamoto, director of craniofacial surgery for UCLA's Craniofacial Clinic.

Reed Hutchinson/UCLA

(4 -- ran in Valley edition only) Maria de Jesus Quiej Alvarez shares a laugh with a visitor on Wednesday at UCLA Children's Hospital.

Scott Quintard/UCLA

Box:

(ran in SAC edition only) THE ``TWO MARIAS'' (see text)