: Even a Fever Ps Cause Seven months ago, the Siamese twins Altagracia and Clara Rod- riguez returned to the Dominican Republic after their famous sur- gical separation at Philadelphia's Children's Hospital. This is the second of two reports on how the twins, now 2 years old, are faring. By DONALD C. DRAKE Inorllrfr LIFdictl7 Ii.rrtfT `Shy JOSE de OCOA, Dominican Republic - A slight fever in a baby here usually does not cause great concern because most often the mothers are poor people who have other things to worry about. But Clara Rodrigue'z is no normaI child. She is one of the famous Sia- mese twins. And one day last week- end her mother, Farida, was getting nervous because Clara was listless and her temperature was climbing. Farida thought her little girl might have diarrhea. The disease is rarely fatal in the United States, but here, where the people are often malnourished, it causes IO percent of all deaths. E #reng children it is the leading :.: ' of death. !)la:rhea drains the water from the .ilildren's bodies and they become deh,ydrated. They begin to vomit, their skin loses its elasticity, and they die. Clara was particularly sus- for Fear ceptible because surgeons had to shorten her intestines, through which the body absorbs fluids, in the opera- tion that separated her from her twin sister, Alta. Clara started vomiting, and a local doctor was immediately summoned. It was only the second time that ei- ther of the twins had gotten sick since they returned from Philadel- phia in January. -4 few months ear- lier they also had come down with di- arrhea, but it was so mild that anti- biotics weren't even required.. The doctor came and determined that Clara was not seriously ill, but told Farida that she could take her to (See TWINS on 4-A) Farida carries Clara and the Rev. Louis Q&n holds Alta's hand in the hospital .>,_ :Twins Get tion Fit' for ,Cedebrities TWINS, From 1-A ianto Domingo if s.& wanted to. Farida has become very cautious about Dominican doctors. In San Jose they told her when her twins were born that they would die. And in Santo Domingo they said that the twins might live but that it was im- possible to separate them. Farida decided to make the trip to the capital. Orders were given to prc- pare both twins, and Farida decided that Marilin, the g-year-old who takes care of them, would go on the two- hour ride to the capital. Quickly the twins were made ready. All Dressed Marlin put on her very best pair of slacks and top, combed her long dark hair for the seventh time, and waited with the twins for the "pub- lice," one of the big Chevrolet sedans that ferry people back and forth to Santo Domingo. It's not a comfortable ride because a dozen people, along with baggage and animals, are crammed into the vehicle, but it costs only $2.50. The publico was jammed when it arrived. There was room for only Farida and the twins. Farida got in and Marilin handed her one twin. The other was placed in the lap of a woman passenger. The car drove off and Marilin re- turned to the porch of the family's new house and sat in the chair. The twins were gone, and the house seemed empty There was nothing to do but watch the people walk by. She would change out of her best slacks and top later. San Jose has 13,000 people, five physicians and a SO-bed hospital that cannot take care of serious medical problems. Severely ill people are taken to the capital if they can afford it. Dr. Laboy, a specialist in pediatrics, examines Clan I; Marilin holds Alta's hand while trying to -4ntrol a &&m&g Clara Phlladilphia In&ircr ?EARNEST S. EDDoWt& ., Staff of Nuns The San Jose hospital, where the twins were born two years ago, is staffed partly by a group of IUXIS from a Canadian order, the Religious Hospitalers of St. Joseph. They are a delightful bunch of women who do not wear habits and who enjoy their work. Among them is Sister Mary Joe, a big woman who loves a beer with dinner, and the rare treat of %2.50-a- half-dozen apples from the capital, as well as telling visitors abotd the time she marched down te the jail and freed one of the nospital em- ployes who had been jailed for driv- ing a motorcycle withvut a helmet. Sister Ruth Rash is the leader of the group of nuns, but she is an unas- suming woman who seems to be jnst one of the group. She runs a clinic for inoculations, and on this particular morning had seen 85 chil- dren. Sometimes she and one assist- ant will inoculate a couple of bun- dred in a day. Sister Cecilia Smith is the nurse most closely associated with the twins. Sk did not really know them or their mother before they, went to Philadelphia. But after hearmg about the operation she wrote a letti to the surgeon, Dr. C. Everett Kaop. of- fering her services. She explained that she was a pediatric nurse and would be only too happy to do what she could. Dr. Koop immediately ac- cepted the offer. The nuns were brought to San Jose, a few years ago by the Rev. Louis Quinn, a remarkable priest from Ca- LIZ&I who has served in San Jose for the last 22 years as a member of the Scarboro Foreign Mission. Father @inn is a tan, thin man of 47 hvhu usually wear5 only a sport shirt crvet his pants arxi has bug gray hair that curls bebind his ears. Frequently his semmns urge tie people to work together and defy the "intermediams" who me ~tiinp th fruits of their cowtry frc4n them. The intermediams are the big middle men, who drive the new air-condi- tioned Chevrolets and Mercedes. They buy rice , and beans at low psices and then store it, in a co!9 where people die from m-n, until the export price is advan- tageous. Father Qu&& distie for the in- termediaros is matched by their dis- like for him. The nuns are convinced that Lui, as tiey call him, eventu- ally will be killed, as another Cana- dian priest wa,s a few years ago. Fa- t-her Quinn has gotten threatening let- ters, and he always ties to get home before the electricity is shut off thmughout the town at 3 a.m. to con- serve energy. "Si D&s q&w" &e people are al- ways saying. "If God wishes." Fa- ther Quinn .- or Padre Lui, as the peopie call him - is always fighting this fatalistic mentality. He fights it with his seMl5us and his meetings with the people and the colored pit- tures painted on the front of his dmrch showing a little ctidd with a pacifier working in the fields with a. machete bigger than be is. And he has fought it by organizing a housing ump and an agricultural coop to help the-people be independent. Both Had Fevers By the time Farida reached the ca- pital, both twins had fevers. She went straight to the Central Birth Clinic, a private hospital in a new building, which is proriding free medical care for the twins until they are 18. When Farida comes to the capital, she stays with the t+ns in a private r55m in this haspital, sleeping on a cot. For two months she lived this way while the- twins were bein? taught how to walk at the nearby Re- habilitation Center. Each day t& ambulance would pick up the twins and take them to the center, where physical therapists spent an hour doing exercises with hem to strengthan their muscles. &on the twins were walking and ev- eryone was delighted. The twins' doctor in the capital is I?r. Ntida Nunez de Laboy, a styl- ishly dressed, urbane woman who specializes in pediatrics and has a file of letters and other records from Dr. Koop and Children's Hospital. Dr. Laboy said the children were a littie thinner than she would like and a bit shorter than normal, but all in all had been in excellent health. They don't tant much, but the doctors think it is because they are confused from being exposed to only English- speaking people for four months in Philadelphia. No Love Lost The Twins may bave endeared themselves to &e doctors and other professirmak in sanbo Domingo, but Farida has noL The physical thera- piststboq&shey&edtoomuchat her daughters when they didn't waIk right away. And Dr. Iaboy doesn't like the way Farida is always challenging the things doctors here do because it isn't the way it way done in Wiladel- phia. Once she refused to let Dr. Labuy give one of the twins intrave nous fluids, saw* incorrectly, that this was never done in Philadelphia. Farida was forced to leave the room and the child was given the flu- ids. Some say Farida isn't careful enough about changing diapers of the twins' cleanliness in general, thcugh no one questions her devotion. For two full months she lived day and night in a single room with her be- loved daughters, watching them con- stantly. What td people even in Santo Domingo lose sight of is that Farida and the twins are in a very abnormal setting when they are in the city. Yarida is always alone with thz twins OII such occasions. At home their q&hrmther and M&Iti, Ueir cousin, and a host of other people are available to take care of the twins' slightest n& Thexe is no question in the nltfls' minds or in Father Quinn's that the twins get constant and loving atten- tion. Treatment Begun The doctors at the hospital in Santo Domingo immediately started treat- ing the twins far diarrhea as their temperatures continued to climb. X- rays were ordered to make sure that thejr did not have pneumonia, and an- tibiotics were administered. Intrave- nous fluids were started for Clara. Their temperatures edged past 103. But soon the twins' bodies mounted an attack against the virus that had gotten into them. Their tempera- :ures started to drop and by last Mondav were normal. There was still some &rrhea, but the vomiting had stopped and all the I3h `ests were good. Father Quinn d@ve I,,larilin m so she could be with bz: ctlarges. Farida had intended to give a birthday party in San .( Tose for lhe twins on Sunday. But tiat was on?- five days away and `Dr. Laboy didn't want to reizase the tv7ins until every- thing was normal for at least two days. She promised Farida a party in the hospital if they could not go home in time. The twins are ven' special down here. will be decided next month,lwhen the brins return to Philadelphia. On that trip, undenvrjtten by the Ladies' Home Journal magazine, which bought the exclusive rights to the twins' story, Dr. Koop and the other ddctors will examine them and decide whether anything more should be done. In addition to unanswered medical questions, there is the problem of the house pmmised to the family by Pres- ident Joaquin Balaguer but not yet constructed. Farida's attempts to de- termine its status have been unsuc- cessful. An Inquirer photographer and reporter went to the palace to try to find out. A score of people - old, poor and desperate--crowded around the gates to the palace, stopped from entering by the military men with machine- guns and carbines. The scene is part of the way wel- fare is dispensed here. People send telegrams requesting help and then go to the gate to wait for an audience with someone important. Sometimes they get it. Dr. T,sbr?r sai!l she waas assembling a team of surgeons and other ape- &lists s:lould the t7vins need care again. The idea was that at least one member of the team would be on hand in the hospital any time of the d?y or n&n: ii the tams shollld be brought in suddenly. The iioztor? here feel that the girls mny nzd more operations. One nnssibility they have discussed is in- ctllline a me;h to hold in Alta's beliy (the separation left her with no abdominal muscles) so she would not hr doomed to wear a corset all her life. The palace is a huge, beautiful rose- colored building with a long, graceful flight of steps and impressive col- umns. Inside, more soldiers with ma- chineguns and women clerks and sec- retaries in red uniforms and polka-dot blouses walked about. The Inquirers' appointment was with the president's _ 4 t-c,. nii7ht @perate on C!Va to close her pe!vis further and im- p:.ove her walk. But these matters Room for Father administrative secretary, Dr. Jose A. Quesada. Dr. Quesada was sitting under a portrait of the president at a desk with a top covered by red velvet pro- tected by glass. Three unsmiIing men stood at the door, and a soldier with a pistol in a hoister strapped to his waist stood at Dr. Quesada's shoul- der. When the phone ran, the soldier would hand it to Dr. Quesada, then hang it up when it was handed back. "The president is very interested in the two girls," Dr. Quesada said through an interpreter as soon as the visitors were seated. He said that the president had given them an allot- ment of $150 a month for 18 years and saw to it they would get medical care at any hospital. And he offered to build them a house. When? he was asked. Dr. Quesada pushed a button and soon an engineer appeared, carrying an armload of papers and architec- tural plans marked "Urgente." These were the plans for the ,Rodriguez house. The house will cost about $11,000, according to estimates from the engi- neering office. Again he was asked when it would be built, but Dr. Que- sada continued to discuss the plans, pointing out all the rooms that they called for. 11 vx2cid na1.e tnree oenrooms, a living room, dining room, bathroom, kitchen, and a porch. The plans also included space for a store. Farida had never mentioned this, but appar- ently her husband, Salvador, can move his little store to San Jose from Las Auyamas, the twins' native vi]- lage 10 miles away where he spends most of the week. When will it be built? "It's a modest, low-cost home," Dr. Quesada explained. "But it will have the important comforts so the girls will have a clean, comfortable house to live in. We in the Dominican Re- public are very grateful for the hu- manity the American people have shown." Do you intend to start building soon? "The house will be completed by the end of the year," he said finally. For the moment, at least, things look good for the twins. The affliction that seemingly doomed them to a tragic life at birth has abruptly been turned to their advan- tage and to the advantage of their family. The Dominican people, especially the poor country people, find it hard to understand why so many things have been done for the twins. So often babies are born deformed and so often they die for petty rea- sons. The people wonder why an ex- ception to life's cruelties should be made in this case. Considering the good fortune it seems to bring, Father Quinn said, :rery Dominican woman wishes she :ould give birth to Siamese twins.