In Bogota, Colombia, hope lives in a hospital crib

BOGOTA, Colombia – Little Juan David, like so many poor children in this city, might well have been forgotten.

He was born prematurely in March, weighing just two pounds and suffering from serious pulmonary ailments. With his mother abandoning him after an emergency Caesarean section, it was the nurses at the big public hospital where he was delivered who gave him his name.

But the timing of his arrival at the Mothers and Children’s Institute on Bogota’s south side ensured that he became the center of attention in this city and beyond.

Officials want to close the hospital, which is deeply in debt. Hospital workers, dozens of whom have taken over the facility in pressing their demand for unpaid wages, are fighting back. And their leverage is little Juan David. He is now the only patient in a vast, rambling institution that treated 155,000 children in its 60-plus years but is now mostly silent – save for the whimpers of a baby and the fussing of nurses in Intensive Care Unit 2 on the fifth floor.

If Juan David is moved to another hospital, as some federal and state officials would like, the hospital would lose its reason for being and close.

For months, the infant simply could not be moved. His lungs were so weak that he required a ventilator. Pneumonia threatened his life. He suffered from various infections, requiring large doses of antibiotics.

With no one else to care for him, doctors, nurses, therapists and pharmacists have hovered over Juan David since he was born. Little by little, he has improved. Now 6 months old, he weighs nearly 11 pounds and breathes without help.

But medical personnel still fawn over him – 16 of them a day across four six-hour rounds.

“We love him a lot; he’s like our son,” said Maritza Molina, a therapist who has worked at the institute for 10 years and spends her days with Juan David. “He’s given us hope that this hospital will remain open. That’s why we’re fearful that they’ll take him away.”

All over Latin America, public hospitals have been in trouble for years. Often, they hang on, even if poorly funded and badly run. Some are shuttered as governments privatize, consolidate and cut costs. Though the closings usually are accompanied by loud protests from unions, they happen nonetheless.

Here, the Children’s Institute may yet be mothballed. But the arrival of the little boy with blue eyes and a tuft of soft hair has touched a nation inured by the violence and injustice that has marked life here.

El Tiempo, Colombia’s largest paper, has devoted story upon story to the hospital’s agony and Juan David’s role in the tussle to keep it open, as have television stations and radio talk shows. Even Colombia’s right-leaning president, Alvaro Uribe, who is no softie, has made calls to city and provincial authorities to try to find a way to keep the institute open.

“The baby has become an important symbol, and to take him away would mean the end of the hospital,” said Hector Zambrano, the provincial health secretary. “It certainly won’t be easy to take the baby. The workers may try to impede the move.”

On a recent Friday morning, physician Wilfredo Leyton took Juan David’s pulse while a nurse, Marta Herrera, weighed him. Jasbleydi Otalora, another nurse, checked his vital signs. When the baby began to cry, Molina, the therapist, picked him up from his little metal crib and carried him around the intensive care unit.

“He has all these aunts to take care of him,” said Herrera, who has worked at the hospital for 10 years. “We all pick him up, spoil him, do his therapy.”

In many ways, the hospital’s woes were not unlike Juan David’s in his first few weeks.

Once a bustling institution with 700 workers and enough beds for 200 children, the hospital has in recent months gone dark. New patients are not admitted, and with each discharge, hospital rooms have been closed and the lights turned off.

The federal government earmarked $25 million in its budget to pay off some of the hospital’s debt, money the workers expected to pay their wages. But the institution has perhaps an additional $140 million outstanding, largely because it assumed the debts of a sister hospital, San Juan de Dios, which closed a few years ago.

No one – not the provincial government, the city or the federal Health Ministry – wants the burden of paying those costs. So Uribe’s government has held back funding as officials from various agencies squabble over which entity should run the hospital.

Now that Juan David’s health has improved, he can be moved, said physician Luis Gerardo Cano, director of La Victoria, another public hospital where the baby would go.

“This cannot go on,” Cano said, explaining that the Children’s Institute is not capable of providing the boy the complete medical care he needs. “He does not need urgent exams. But he needs more exams.”

Still, nurses and other workers who show up at the hospital each day vow to keep Juan David.

“This baby is very important to us,” said Melida Salazar, a nurse. “For me, this is everything. It’s very important. My children were born here.”