as printed in The New York Times, November 7, 2006

Keeping a Girl Breathing
Becomes Her Family’s Mission

By Anthony Ramirez

Maribel Saavedra, 30, is a young mother in the Bronx who has passed on her ready smile to three of her four children.

Her fourth, Jasmine, does not often smile.

Jasmine, 2, has been in almost unbroken pain since she was born at Lincoln Medical and Mental Health Center in the Bronx with a heart defect, and she needs constant attention. Her mother, who came to New York from Mexico City, learned cardiopulmonary resuscitation at the hospital in case Jasmine stopped breathing, which she has on occasion.

Ms. Saavedra speaks little English, and the family’s social worker, Margarita Colon, acted as her interpreter on a recent visit.

When asked whether Jasmine’s health problems seemed overwhelming at times, Ms. Saavedra replied with a soft sigh that needed no translation. “Sí, sí.” she said. She caught her breath and added, “I had to watch her and be very vigilant because she could die in her sleep.”

The body of a child with a congenital heart defect does not get enough oxygen, and the job of watching each breath of that child falls on every member of the family.

Jasmine’s brothers — Anthony Flores, 4; Andy Flores, 5; and Fernando Flores Jr., 10 — take turns watching Jasmine when they are not doing their schoolwork. They are all healthy.

Jasmine’s father, Fernando Flores Sr., 33, a baker, lost jobs because he watched over Jasmine and did not show up for work on time, Ms. Saavedra said, adding that he had recently sought counseling for depression.

Ms. Saavedra had to quit her job as a seamstress in the garment district to take Jasmine to numerous doctors’ appointments and consult with nurses and therapists. On a good day, Jasmine may tire easily and want to sleep all the time.

On bad days, she has trouble breathing, especially when eating or crying. She weighs 21 pounds; a girl her age should weigh about 30 pounds, or more. Even so, her face appears puffy and her limbs swollen, like a newborn. Jasmine sweats often and her pigtails are damp and her skin cool and moist. In addition to her other medical problems, she is being treated for ruptures in the small veins of her eyes that doctors say were caused by the stress of her illness.

When Jasmine cries, her mother’s lower lip begins to tremble.

In her short life, Jasmine has had two major operations to increase circulation in her heart, and she was expected to need at least one more. With all of the family’s problems, including the parents’ spotty employment, the typical challenges of housing, clothing and feeding four children have grown even larger. That’s why the family sought help and found some relief from The New York Times Neediest Cases Fund.

The family’s clean, tidy apartment in the Tremont section of the Bronx costs $743 a month and has two small bedrooms. Seven people live there.

One bedroom is for the three boys, who use bunk beds, and for Saul Flores, Mr. Flores’s brother. He sleeps during the day, while the boys are at school, and works at night.

The other bedroom and the tiny living room next to it are for Jasmine and her parents.

In August, the family turned to Mosholu-Montefiore Community Center in the north Bronx, a beneficiary agency of UJA-Federation of New York, and met Ms. Colon, a social worker at Mosholu. UJA-Federation, one of the seven agencies supported by The New York Times Neediest Cases Fund, gave the family $2,000 from the fund.

With the money they were able to buy a small dining room table about the size of a large suitcase, a kitchen cabinet, and a new mattress.

Mr. Flores and Ms. Saavedra are in and out of work (he is currently working as a grocery store clerk). Despite careful shopping, said Ms. Colon, the social worker, “The lion is always at the door.”

As Jasmine grows older, she needs physical therapy so that she can learn to use her hands and walk properly and a speech therapist so she can develop language skills, which have been slowed by the pain of the heart disease.

The anxiety over Jasmine’s health problems seems to have slowed the language skills of Andy, the 5-year-old, and he, too, is undergoing therapy.

The family has other needs, like winter coats and shoes. But Fernando Jr., the eldest boy, fidgeted during a recent visit as the adults discussed the family’s needs.

Ms. Colon noticed the restlessness and asked young Fernando what he thought. He smiled and looked at the floor and was slow to answer. Go on, his mother coaxed. Go on, Ms. Colon said again.

“A computer,” he said, in English, with a smile. “And a printer. For book reports.”