They left Guatemala seven months ago, tiny patients conjoined at the head, born into poverty and facing an uncertain fate.
They returned Monday from the United States as independent little heroines, tiaras perched atop their bandaged heads, their dark circumstances transformed by the perseverance of young parents and the help of well-wishers in both countries.
At UCLA's Mattel Children's Hospital on Monday morning, Maria de Jesus and Maria Teresa Quiej Alvarez, 17 months old, were brought into the sunshine for the first time since they arrived there June 7. Wearing matching dresses and frilly white socks and surrounded by doctors and nurses fighting tears, they soberly studied the flashing cameras.
Being outdoors thrilled the girls, nurse Margo Goldman said as she prepared to go to Guatemala with them.
As their van drove to Burbank Airport, Maria Teresa, the more subdued twin since the surgery, peered out the window at the trees and buildings whizzing by. Suddenly, the baby of few words exploded into excited babble, making her parents gasp and then laugh with joy.
"She has a new lease on life, this precious child," Goldman said. "And now she's saying, OK, world, I'm ready.... It gave us chills."
Their plane landed in Guatemala City about 6 p.m. At the airport were First Lady Evelyn de Portillo and U.S. Ambassador John Hamilton, 15 relatives from the twins' hometown, representatives from the Pediatric Foundation of Guatemala, and dozens of journalists, many in tears. The twins' grandparents enveloped the family in a giant hug.
But things at home have changed.
A Guatemalan home-building company has donated a home to the Quiej family. It will have new appliances and will be among the nicest in their impoverished village of Belen, at the foot of a volcano, nurses said. The twins' 21-year-old father, Wenceslao Quiej, who earned $2 a day bagging bananas, has a new job waiting for him at the Pediatric Foundation, which also has arranged for a place for the family to live in Guatemala City while the girls recuperate.
"I give thanks to God," the twins' grandfather, Wenceslao Quiej Sr., 50, said as he prepared to welcome the girls home. "God has performed a miracle, and I hope that God grants them a great future."
Many in the strife-torn country, where the girls are considered miracles, said the new house and job are the least that can be done for a family that, through patience and determination, "has opened a path to hope, a sense that things can change," not just for the family but for the nation, said Father Hugo Reyes Velasquez, a village priest. "The parents struggled ... and they knocked on doors and opened hearts."
The doors that swung widest were those at UCLA, where doctors performed the $2-million separation and nurses and social workers took care of the girls, helping the distressed parents and bandaged children become a family.
When the little Marias, as they are known in Guatemala, arrived at UCLA, their bright brown eyes peered in opposite directions and their mother, Alba Leticia Alvarez, 22, could not care for them alone. It took two sets of hands to help the girls do anything. Though healthy, they could not crawl or sit up. When one was bathed, the other had to be held upside down.
The girls were brought to the United States by the international charity Healing the Children. UCLA covered the cost of the medical care, although donations defrayed about $500,000, most of which came from a single anonymous donor.
They were accompanied by their terrified mother, who speaks almost no English and cannot read or write. Nurses and social workers said she suffered severe culture shock. She missed her family, Guatemalan food, and waking at sunrise to grind corn and watch the hills grow light. Elevators frightened her. She never became comfortable with the media that pestered the family constantly, and she refused almost all interviews.
In early August, officials arranged for the twins' father to come too. They wanted the family to be together, and they thought that it would help Alvarez to have her husband near.
On Aug. 5, after a 23-hour operation, the girls were separated.
At first, doctors didn't know whether the girls would suffer brain damage or whether they would ever fully recover. Such a separation had been attempted only a few times, and not all the twins had survived. Before the surgery, doctors warned parents that they might lose a daughter.
But the girls recovered. In the first days after the separation, nurses noticed them reaching to the tops of their heads, feeling for each other's warmth. Now, nurses said, the girls are fascinated by each other's faces.
At the end of September, they moved from the intensive care unit into a room on the pediatric floor. Their parents moved in with them, and began day-to-day care of their daughters for the first time.
In Guatemala, the parents lived a five-hour bus ride from the hospital where the babies had spent most of their lives. They could visit only a few times a month. Their mother, who had diapered or fed her babies only on those visits, began doing both at UCLA.
The twins blossomed. Maria de Jesus, who was the quieter sister before the surgery, became ebullient, delighting in exchanging high fives with nurses and being pulled in a red wagon down the hallway of the pediatric ward.
Recently, she learned to hold her head straight by herself, flexing neck and shoulder muscles unused before and to roll over. Maria Teresa eventually held her head up too.
Plastic surgeon Henry Kawamoto said Monday that he was moved when Quiej took him aside and, in careful English, thanked the doctor for all he had done.
"I know he was practicing forever," Kawamoto said. "He said, 'I want to thank you very much.' It was quite touching."
Quiej also spoke briefly to the media Monday, profusely thanking the hospital, the company -- Construindico, S.A. -- that had given his family a house, and Federal Express for donating the plane that would fly them home.
The Marias still face a hard road of physical therapy and more surgery to remove skin grafts from their scalps. A team of seven doctors and nurses from UCLA accompanied the family to ease their transition. The girls will be in a private hospital in Guatemala City for at least three weeks.
On Wednesday, hundreds are expected at a thanksgiving Mass in Guatemala City's cathedral to welcome the twins home.
Back at UCLA, medical personnel Monday were struggling with empty-nest syndrome.
"It's bittersweet," said Kawamoto, the plastic surgeon. "I'm sure the cardiac surgeons will be very busy next week, repairing the nurses' hearts that were broken."
Times staff writer Jessica Garrison reported from Los Angeles and correspondent Alexander Renderos reported from Guatemala City.