On a remote mountaintop village in Honduras last fall, Dr. Ron Coleman noticed something different and alarming about one of his patients, 15-year-old Dunia.
Coleman had been monitoring little Dunia’s big heart since she was about 8. The surgeon didn’t need a stethoscope to tell him that the girl’s heart condition had gotten much worse.
“You could see her heart thrusting in her chest,” said Coleman, a surgeon from Cleveland, Tenn., who makes monthly mission trips to the Central American country.
A faulty valve was allowing blood to leak back into Dunia’s enlarged heart. Coleman knew she needed open-heart surgery to repair or replace the valve. Without the surgery, she would likely die in five years. With it, her heart would work properly and she could live a normal life.
But Coleman is a general surgeon. Dunia Peraza-Ramirez needed to see a cardiologist, but there wasn’t one in the nearby small mission hospital.
Dunia, a quiet, doe-eyed girl with a shy smile and long, black hair that has never been cut, remembers being short of breath since she was about 5. She has never been able to run and play like other children. But except for Coleman’s monthly mission trips, Dunia rarely sees a doctor.

Dunia Peraza-Ramirez,15, is a heart patient in Memphis from Honduras. She was diagnosed with Mitral Valve Stenosis. When she arrived in Memphis, she was a very sick and frightened girl. The valve couldn't pump blood as quickly as it should from the heart, which made living daily life in the mountains difficult. (Karen Pulfer Focht / The Commercial Appeal)
She lives with her parents and younger brother and sister in a 15-by-30 foot wood-frame house with a tin roof and a cement floor. The house sits on a steep incline along a rutted dirt road. The terrain makes it impossible for land line phones but almost everyone has a cellphone.
Dunia (pronounced DOON-yuh) walks to her eight-room village school house, where she is in the ninth grade. She cares for her 5-year-old sister, Ebelni. She cooks over an adobe stove making tortillas or fried banana cakes. She sews with her mama, Deisyi Ramirez, making aprons to sell. Her papa, Erasmo Peraza, is a pastor.
The family owns a refrigerator and a television. They carry water in containers from a nearby spring. An outhouse sits behind their house. Dunia, Ebelni, and her brother, Brayan, 12, sleep in one bed. Their parents sleep in another nearby. They rarely leave the mountain. The prospect of getting Dunia’s heart repaired was as remote as their village.
“The image I have of Dunia is disparate puzzle pieces and all of a sudden God putting it all together, and lo and behold we are saving Dunia’s life,” Rev. Anthony Burdick, pastoral care director for Baptist Memorial Health Care Corp., said last month.
“It’s not serendipity . . . My image of that is God putting the pieces together.”
***
Coleman found the next piece of Dunia’s puzzle after he returned to East Tennessee last fall.
Because of a family history of heart problems and as a precaution, he decided to see a cardiologist. He called Teresa Dawson, his former nurse and mission partner, to get a recommendation. Dawson is the nursing director of Baptist Hospital’s Cardiovascular Services in Memphis.
She suggested Dr. David Wolford, a Memphis cardiologist who had seen her husband and who had gone on a medical mission to Honduras the previous January, through Woodland Presbyterian Church.
“It gets in your blood,” Wolford said. “It’s something you hunger for. I get so much more out of it than I give. It affects me in the way I deal with life, my family and my patients. I re-prioritize what is important in my life.”
Wolford said that some of the patients in Honduras walked three hours to see him. One day, he and other mission members took flour, eggs and rice to the home of an elderly woman. When they arrived, the woman raised her hands in joy, saying, “Hallelujah. Thank you, God for sending these angels.”
Wolford examined Coleman in late October and the two men talked about their love for mission work. Wolford said he was going back to Honduras in January. Coleman was, too. Wolford agreed to see Dunia.
On Jan. 21, Coleman brought Dunia and her parents to San Pedro Sula Airport to meet Wolford. Amid the savory smells from the airport’s Dunkin’ Donuts and Wendy’s, Wolford took his stethoscope and listened to Dunia’s heart.

Dunia and her parents met Dr. David Wolford at San Pedro Sula Airport where Wolford took his stethoscope and listened to Dunia’s heart. “The murmur was so loud. You could hear the swooshing sound,” he said.
“The murmur was so loud. You could hear the swooshing sound,” he said.
“It radiated from her chest to her arm and through to her back. It was causing a vibration throughout her chest. At a point, if you don’t fix this, it’s irreversible. You get winded walking across the room. You can’t climb stairs. She has to be quiet and sit around.”
As a cardiologist, Wolford can diagnose heart problems and treat heart disease. But Dunia needed a cardiovascular surgeon to repair her leaky valve. She needed to come to Memphis.
Over the years, Coleman has brought 20 ailing children to Tennessee for advanced medical care. He would find a hospital willing to offer its services as charity, and a family to care for the child. But times have changed.
“Finding a hospital that would be willing to do that is quite difficult,” said Coleman, who noted that declining reimbursement rates for TennCare and Medicare patients and lower profit margins have caused hospitals to be reluctant to take on too many charity cases.
When Wolford returned to Memphis, other pieces of the puzzle began to fall into place.
Dr. Ed Garrett Jr., a cardiovascular surgeon, agreed to operate on Dunia at no cost. Dr. Vince Samuel agreed to be her anesthesiologist for free. Baptist Memorial Hospital-Memphis, where Wolford practices and Dawson works, agreed to provide free hospital care.
But Dunia didn’t just need medical care. After the surgery, she would need a place to stay during her recovery and rehab. Wolford talked to his wife, Gwen, a former critical care nurse.
“Well, she can stay with us,” Mrs. Wolford replied.
On Feb. 21, Coleman and Dunia flew to the Chattanooga Airport. It was her first airplane ride and her first trip to America. She marveled as people patiently waited in line for tickets or luggage. As Coleman drove Dunia to his home in nearby Cleveland, she noticed that cars and trucks were going in the same direction on her side of the road.
“There is so much more organization here,” she told Coleman.
On Feb. 27, Coleman and his wife, Shelley, drove Dunia to Germantown to meet the Wolfords — David and Gwen and their two daughters: Hanna, 16, a junior at Houston High, and Halle, 11, a fifth-grader at Dogwood Elementary.
Mrs. Wolford had four years of Spanish in high school, but Dunia’s host family decided to use an iTranslate app on their iPad to help them communicate.
“Today is my birthday,” Mrs. Wolford told Dunia in Spanish. “You are a gift.”
The Wolfords live in an ample, two-story house. Outside there’s a tennis court and a swimming pool. Inside there are six bedrooms and seven bathrooms. Mrs. Wolford told Dunia she could have any bedroom in the house. She chose a nook in Hanna’s room that had a tiny twin bed with a hot-pink blanket.
Hanna and Dunia are just a year apart in age, but it was Halle who gravitated to the girl with the big heart. Dunia keeps a photo of her family near her bed. At first she was so homesick she cried when anyone mentioned her family. Sometimes, Halle would stay in Hanna’s room with Dunia until she fell asleep.

Before and after her hospital stay, Dunia has been at the home of cardiologist, Dr. David Wolford. Language is a barrier but Wolford’s daughters Hanna, 16, (left) and Halle, 11, are able to play numbers-based games with Dunia. They also use an iPad translator to communicate. (Karen Pulfer Focht / The Commercial Appeal)
While Dunia waited for her operation, she played games with her new sisters. They assembled a 500-piece flower puzzle. They watched “Ice Age” and “Shrek” in Spanish. They took turns painting smooth, round rocks.
On one rock, Dunia painted a flower and wrote Dios es Amor (God is love) and TKM Halle. TKM is her abbreviation for “Te quiero muchas” or “I love you.”
After Halle finished painting her rock, she said, “It’s kinda funny you become best friends and you can’t even speak their language.”
Dunia’s heart surgery was scheduled for March 3. She arrived at Baptist Memorial Hospital-Memphis East at 6 a.m. Mrs. Wolford held her hand as nurse Cristina Colamonici, a native of Uruguay, played comforter and interpreter.
At 7:32 a.m., Coleman, David and Gwen Wolford, nurses Dawson and Colamonici, and anesthesiologist Samuel formed a circle around Dunia’s bed. They joined hands, closed their eyes and bowed their heads.
“Thank you for Dunia and her love,” Coleman prayed in English and then in Spanish. “Protect her and give her strength. Give the doctors and the nurses strength and wisdom. Let her be a blessing to her family and all those she comes into contact with. Amen.”
Garrett, the surgeon, appeared in the hallway.
“We’re all set,” Coleman replied.
“I’ll call you when we’re done,” Garrett said.
***
Three hours later, the surgical team rolled Dunia into the intensive care unit. The operation had gone as planned. But just as nurses were weaning her from the ventilator, her blood pressure plummeted. Her heart raced at 160 beats per minute.
As physicians and nurses worked on Dunia, Wolford wondered if they might have to take her back to surgery.
Mrs. Wolford and Coleman stepped out of the room. “Oh God. Your will. Your will,” Mrs. Wolford prayed.
Dunia finally stabilized two or three hours later. Her blood pressure increased and her heart slowed. Her left ventricle was working properly, possibly for the first time in her life.
Several hours later, the nurses insisted that Dunia sit in a chair. Nurse Colamonici and former nurse Wolford asked Dunia to rate her delor (pain) on a scale of “nada to grande.” Both expected her to say grande.

Dunia Peraza-Ramirez,15, was recovering from her heart surgery when she was visited by Dr. David Wolford during his rounds. Dr. Vince Samuel, who came in on his day off to do her anesthesia also stopped by to check on her post surgery progress. (Karen Pulfer Focht / The Commercial Appeal)
“Zero,” Dunia replied.
“He’s letting us know who’s in control,” Mrs. Wolford said.
A few days after the surgery, Dunia was walking and sitting up to eat but she couldn’t bear to look at the 7-inch scar that runs down the center of her chest.
Janet Allsopp, a former heart patient, learned about Dunia’s surgery and visited her in ICU. While Dunia listened through an interpreter Allsopp told her that she had the same surgery three years before.
“The scar is what makes us special,” Allsopp said. “Don’t be scared to look at it. It is a part of you. We will always carry that. If someone makes fun of you, you tell them, ‘I’m special. I went to the States. I was sick, and they made me well.’ ”
Dunia listened in silence.
“Would you like to see my scar?” Allsopp asked.
Dunia nodded.
Allsopp pulled up her shirt.
“See? Now I don’t have anything. Would you like to touch my scar?”
Dunia nodded, then gently ran her index finger down the nearly invisible and smooth 8-inch scar. She smiled.
As Allsopp was leaving, Dunia asked her about the pain.
“Your pain will get better,” Allsopp told her. “Your scar will heal. Be proud of your scar.”
***
Six days after Dunia’s surgery, Coleman was back in Honduras on another medical mission trip. While there, he arranged for Dunia’s parents to make an Internet phone call to Dunia via Skype.
When Dunia saw her mother’s face, she cried.
“Give me a smile,” her mother cooed. “Give everybody a smile.”
Dunia tried. She showed her mother her scar.
“You are special. You are in my heart,” her mother said. “I will see you in May. The time is going to fly by.”
The corners of Dunia’s mouth turned into a smile.
“Be strong,” her mother said. “God has a very big purpose in your life.”
Dr. Wolford spoke briefly to Dunia’s parents, assuring them that she will be all right. “You can call and check on Dunia whenever you want,” Mrs. Wolford told them.
“We know she would have died without the surgery,” Dunia’s mother said. “God gave her the chance.”
Dunia was discharged from the hospital a few hours later. Since then, her appetite has been picking up. She’s gained almost 2 pounds. She sounds like a chatty teenager when she talks to her mom on the phone.
Her activity level also is picking up. She’s getting out more. She visited the Memphis Zoo. She ate a West Coast burger at Huey’s. She’s been to church.
One recent Sunday, Dunia, Hanna and some of Hanna’s friends attended Iglesia Bautista Nueva Vida, a Hispanic congregation that meets in Kirby Woods Baptist Church. About 35 people sat in the four rows of folding chairs.
During the service, pastoral care minister Manfredo Contreras asked Dunia to come to the front of the church. He gave her a Spanish language Bible along with a gift card to a local Christian bookstore.
“I want to thank God for everything, for putting you in my life here,” she told the congregation. “I thank God for your help. I am very blessed.”
Dunia is spending three days a week in cardio rehabilitation walking on a treadmill, riding a bike and building up strength in her arms and chest. On her first day of rehab, she walked 1,100 feet. “That little girl is our miracle,” one of the nurses said.
If all continues to go well, Coleman plans to take Dunia back to Honduras in mid-May and monitor her repaired mitral valve during his monthly visits. She should be fine.
Today, Dunia will join the Wolford family as they celebrate the hope and new life of Easter at Woodland Presbyterian Church. Dunia and Mrs. Wolford have been reading a devotional called “Jesus Calling.” One day recently, they read a passage from Isaiah 40.
“But those who hope in the Lord will renew their strength,” they read, Dunia in Spanish, Mrs. Wolford in English. “They will soar on wings like eagles; they will run and not grow weary; they will walk and not be faint.”
“Oh, Dunia,” Mrs. Wolford said. “This is you. You will run and not grow weary. This is your life’s verse.”
The two hugged and cried together. Tears rolled down Dunia’s face. She knows what she wants to do when she gets home.
“Walk,” she said in Spanish. “I want to walk and visit a friend in a nearby village.”
Memphis in Honduras
The team of physicians and nurses who brought Dunia Peraza-Ramirez to Memphis has inspired Baptist Memorial Health Care officials to think about making more lasting connections to the girl’s home in Honduras.
“I want to see Dunia and follow up with her. Go see her home and be with her family,” said Rev. Anthony Burdick, pastoral care director for Baptist Memorial Hospital. “This could end up being a lifelong relationship.”
In coming months, Burdick and Dr. David Lewis of CrossLink International in Memphis, a non-profit, Christian ministry that equips medical mission teams, local free clinics and mission hospitals, plan to visit Honduras to see about adopting and supporting a hospital there.
One option is the hospital in Sula, where Dr. Ron Coleman of Cleveland, Tenn., conducts his monthly medical missions. Coleman is the surgeon who was monitoring Dunia’s heart condition and brought her to Memphis for surgery. The Sula hospital has dorms for doctors and nurses and cooking facilities that can feed and sleep 30 to 40 people.
Coleman had been trying for two years to equip the Sula hospital with laparoscopic equipment for gall bladder surgery. While he was in Memphis helping Dunia, Burdick took him to the local CrossLink office in the basement of First Baptist Church in Memphis.
“I walked into their office and there was an entire laparoscopic machine,” Coleman said. “I have taken it to Honduras piece by piece. When I am down there, I hope to do my first gall bladder surgery.”