Venezuelan girl gives thanks to her family, her doctor, her God

• Parents, sister moved to U.S. for girl's colorectal surgery
• She sings to thank God for her parents, sister
• Family prays to stay

CARTHAGE, Ohio -- Maria Valentina Almeida Vazquez is a gift to her family. She is a gift to her church community. She is a gift to her doctors.

Yet this 10-year-old Venezuelan girl doesn't see it that way. All she sees is a debt she wants to pay to the people who've sacrificed and cared for her.

Her gift is her song. "Sometimes I feel like I need to do something," Maria said. So she sings.¶

Her rendition of the traditional Catholic hymn "Ave Maria" moves to tears many of her fellow parishioners at San Carolos Borromeo Church in Carthage. These people, originally from Mexico, Guatemala, Honduras and Peru – all once-anxious yet resilient immigrants – have embraced Maria's family just as they found a welcoming and familiar place of shared language and religious traditions.¶

Maria sings to St. Mary – in her homeland the national patroness Our Lady of Coromoto – believed to be the earthly mother of Jesus.

Y hoy aquí Madre del alma / Rogamos por toda la humanidad

And here today, Mother of my heart / We pray for all humanity.

Traigamos por toda la humanidad

For you to lead us, all of humanity

Since initially singing "Ave Maria" during her First Communion Mass in May, Maria has come to be known at the Carthage church as the little girl with the big voice.

"It is the best thing I can do," said Maria, who gave her gift to the church again Monday during Christmas Eve Mass.

Yet it is mostly for her parents and twin sister, Maria Victoria, for whom she sings, seeking with her clear brown eyes their approval each time the last note passes her lips.

She sings, too, for her doctor, Alberto Pena, whose procedure first saved and then preserved the quality of Maria's life.

Born with a series of life-threatening colorectal malformations that can affect 1 in 4,000 infants, Maria first went to New York for Pena's care in 2004 – a year before he created the world's first pediatric colorectal center at Cincinnati Children's Hospital.

Her parents, Javier Ignacio Almeida Alvarez and Lorena Margarita Vazquez de Almeida, now 43 and 40, sold their apartment, car and furniture to pay for that first trip to the United States. Then they returned to Venezuela, knowing Maria would likely need another operation in the United States. Javier went back to work as a civil engineer and saved money, every bolivar possible.

"That moment came last year," Lorena said through a Spanish-speaking interpreter.

The family again sold a car and furniture and put their apartment on the market.

"The doctors in Venezuela are not experienced in this type of surgery," Lorena said. "We didn't want our daughter to die."

The family came on a tourist visa that has been renewed once. A second extension is pending. Neither Javier nor Lorena is allowed to work under terms of the visa.

Maria needed 11 hours of surgery in May 2011 and another two hours two months later.

Thinner and shorter than her sister, Maria should now begin to grow, Pena said. Still, Maria has other health problems and will require long-term treatment to protect her kidney and bowel functions.

"It is a privilege and honor to operate on this girl and to work with this family," said Pena, whose procedure was performed for the 3,000th time in 2012 since its creation in 1980. "These types of congenital malformations can destroy families. Not this one."

Most often, these patients "are born without an opening for the stool to exit the body, a life-threatening condition," said Dr. Marc Levitt, center director and Pena's medical partner. "The surgeon intervenes to allow for a route for waste to get out."

Previous surgical techniques saved lives, but frequently rendered children incontinent for life. Pena's procedure, Levitt said, "is anatomically elegant and allows children to ... live normally."

Since the colorectal center opened at Children's, 5,000 patients from all 50 states and 88 countries have been treated there.

"They look to the United States as the promised land," Pena said.

Many of his patients, Maria included, Pena said, have strong personalities and deal with their condition with positive attitudes.

Still, Maria feels sad at times. She has said she is responsible for uprooting her parents and sister, taking them away from a dozen aunts and uncles, 14 cousins and loving grandmothers in Venezuela.

She will pray and sing, even if no one else is around. Often, she sings to Mary.

Solo tu podras mis pesares calmar

Only you will be able to calm my sorrows

"Ave Maria" – the common Catholic prayer "Hail Mary" – has been set to music many times in many languages, most notably by Franz Schubert in about 1825.

The hymn is Maria's favorite.

"I sing it from my heart," she said. "I sing to say thank you to God and to Mary for my parents and my sister."

Maria Victoria often takes on a role of a second mother. If she gets mad at her sister, she says, "I feel sad. I tell myself not to be mad because she has to go through so much. … I love her so much."

The family's faith is strong. They attend Mass together on Sunday at San Carlos.

Maria sings in the adult and children's choirs, taking the lead during Christmas season services on "Silent Night," "Noche de Paz."

"Maria and her family are wonderful additions to our community," said Sergio Lopez-Diaz, choir director at San Carlos Borromeo, who provides accompaniment to Maria's solos on classical guitar. "Maria has an amazing voice, a beautiful gift, for such a young child."

Her parents say they trust that God will provide for them, particularly after the sale in November of their apartment in Caracas that yielded a profit to add to a dwindling savings account.

Their prayer is to stay together and for both their daughters to live full lives, become educated, marry and have children of their own. But that vision is a distant one.

Of more immediate concern is the urgency of Maria's ongoing medical care, securing an extension to the family's tourist visa and applying for permanent residency in the United States.

Javier has difficulty speaking about his daughters and wife without choking up. He and his wife struggled with infertility for 10 years before getting pregnant.

"We want to be able to work and provide for our daughters and be near Maria's doctors," Javier said.

"We want simple things all people want."

Lorena speaks more forcefully.

"We want to live a normal life," she said, "even though our normal is to do all we can to help our daughter survive. I am afraid to go back to Venezuela and repeat this process again."

Through the uncertainty, Maria sings for her family to her namesake, Mary, whom Catholics believe intercedes on their behalf to her son.

Amarte oh madre es mi consuelo

Loving you, oh Mother, is my comfort

Ave Maria