Survivors of Guatemala Children's Home Fire in U.S. for Burn Treatment

Updated | Nine survivors of a fire that raged through a Guatemalan shelter for abused teenagers last week have been flown to the U.S. for treatment for their severe burns.

The death toll from the fire at the Virgen de Asunción children's home last Wednesday rose to 40 over the weekend. Nineteen girls died in the blaze on March 8, while another 21 people died in hospital. The shelter, located in San José Pinula, 15 miles south of the capital Guatemala City, is for children under 18.

The inferno began when a group of residents set fire to a mattress, Reuters reports. The girls were reportedly locked in a room as punishment for escaping the center and started the fire in order to call attention to someone outside. Three former child welfare officials responsible for running the center were arrested in Guatemala this week.

Dr. Jong Lee, medical director of the Burn Intensive Care Unit at Shriners Hospitals for Children in Galveston, spoke with Newsweek after five-and-a-half hours in surgery treating one of the center's victims. The four girls in Galveston, all of whom Lee describes as "adolescents," have third degree burns and three of them require skin grafts. None have family members with them in the U.S.; they are being visited by the Guatemalan consular officers, he says.

Lee says Tuesday's surgery "took a long time because this patient's burn was big."

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Shortly after the fire, the seven victims were airlifted out of Guatemala. The other three are receiving care in Boston. Two additional shelter residents were flown to the organization's hospital in Cincinnati this week.

"It's just a horrific situation," says John McCabe, executive vice president of Shriners Hospitals for Children, known for its care of children suffering from burns and spinal cord injuries. "There's nothing that's unusual except the sheer volume of patients we're getting. It would overwhelm any hospital."

Within 24 hours of the fire, McCabe says a team of physicians and workers from Shriners were on the ground in Guatemala to assess the situation and transport patients out. The most critical time for burn victims are the days immediately afterward, when they need intense and around-the-clock care, he says.

"Virtually all the children who came up here are in critical condition," says McCabe. "The injuries are pretty substantial."

In Galveston, the four girls are currently going through in-patient surgeries and will receive therapy and intense rehabilitation, says McCabe. Lee adds that they could develop mental health problems, including depression and post-traumatic stress disorder (PTSD). (All medical expenses are paid for by Shriners Hospitals For Children.) They will return to Guatemala once they've recovered, but will be able to also utilize medical care in the U.S. in the future. "Even after their discharge it's still a pretty long road to recovery," adds McCabe.

The challenges right now include the effects of smoke inhalation, and risk of infection, says Lee: "Not just with these children, but when the burn happens inside a closed space, you get smoke inhalation and it hurts the lungs. That's an issue." Lee foresees some of the skin graft patients needing reconstructive surgeries. Although skin grafts on adolescents should heal like those on adults, as the children grow "the scar tissue might be tighter," he says.

Even before the fire, the Virgen de Asunción shelter was known for allegations of overcrowding and abuse, which had been public since 2013. A mother of a 12-year-old boy who died in the fire told Reuters he was raped there, and there have been allegations of prostitution and sex trafficking through the center. Last year, there were calls from Guatemala's human rights ombudsman to shut down the center.

This story has been updated to include information about two children being treated for burns in Cincinnatti.