Sometimes, the smallest things can change your life in profound ways. For Dr. Brian and Amy Gage of Clayton, it was a short email telling of a 5-year-old from the Dominican Republic who needed a place to stay in St. Louis.

The email was sent three years ago from Healing the Children (now called the World Pediatric Project), which helps children in developing countries suffering from birth defects, illness and injury. It explained that a host family was needed for Natalia Almonte, who would be in St. Louis for two weeks while undergoing medical evaluation at Shriners Hospitals for Children. The Gages, who have three daughters including one Natalia’s age, decided in short order to open their home to the little girl.

“Our family was learning Spanish at the time and she spoke Spanish,” explained Amy Gage. “We thought this would be a wonderful experience for our whole family so we jumped on it.”

As Amy and her husband, an associate professor of medicine at Washington University School of Medicine, drove to the airport to pick up Natalia in April 2008, they discussed what she should call them.

“We aren’t her parents so we decided on Senor and Senora Gage,” said Amy, explaining that they brought their youngest daughter Belle, who is Natalia’s age, with them to the airport. Sensing some trepidation from Natalia in meeting these strangers, Belle took the little girl’s hand to welcome her. And with that gesture, a best friendship and sisterhood were born.

“(Natalia) gabbed all the way home,” said Amy, who teaches creative writing part-time. “We asked her what she wanted for breakfast and she said cookies and juice. By 7 a.m. the next morning, she was calling us Mama and Papa Brian. And it’s been that way ever since.”

The initial two weeks Natalia was to stay turned into six months. Doctors at Shriners said she needed hip surgery as a first step in correcting a birth defect. One of Natalia’s legs is significantly shorter than the other. A pin was placed in her hip, which required her to be in a spica cast for eight weeks, keeping her legs spread wide apart.

“She crawled around on her belly,” Amy said. “She’s so resilient, it hardly fazed her.”

The Gages enrolled Natalia in kindergarten with Belle at Meramec Elementary School in Clayton. They took her to services at Central Reform Congregation, where they are members. Within three months, Natalia, who spoke only Spanish when she arrived here, was fluent in English.

The following year, Natalia came back for a month for a follow-up visit and stayed with the Gages. Then, in May of this year, she returned to St. Louis with her grandmother, who is her primary caretaker in the Dominican Republic. The grandmother stayed for 10 days at Shriners while Natalia underwent another surgery to lengthen her leg, followed by a two-month stay at the Ronald McDonald House while the little girl recovered.

“We were able to establish a relationship with Natalia’s grandmother who is warm, wonderful and hilarious,” said Amy. “We brought her and Natalia to our house and we all got to be very comfortable with each other.”

Since mid-July, Natalia, who is now 9, has been living with the Gages, attending school in the same third grade class as Belle, going to physical therapy at Shriners several times a week and most recently, celebrating Hanukkah with her American Jewish family. Despite still wearing an external fixator on her leg to keep the healing bones stabilized, she’s physically very able. “P.E. is her favorite class,” reported Amy. “She can do everything except roller skating and jump roping.”

When the fixator is removed, most likely in February, Natalia will go home to the Dominican Republic.

“Initially, we thought she would be able to go home for Christmas but her leg is healing a little more slowly,” said Amy. “When she was told this I thought she would be disappointed but instead she said, ‘You mean I’m going to see snow? I get to have Hanukkah?’ She’s so excited, it’s unbelievable.”

Of course what had initially been a two-week commitment has turned into a mitzvah of multiple years. The Gages receive no financial compensation for housing Natalia. They’ve even paid for school for Natalia in the Dominican Republic. “We look at this as our big charitable donation of the year,” joked Amy, adding that in truth, Natalia is a big, joyous part of their family.

Still, the old adage “it takes a village” has taken on new meaning as friends, family members, neighbors and CRC congregants pitch in to take Natalia shopping, to dinner, to doctor and therapist appointments, even to see Santa.

Perhaps the one person who has been the most generous with her time and energy is Belle Gage. “It’s been wonderful but it also provides many challenges for her,” said Amy. “We are so amazed and proud of Belle. She shares everything with Natalia from her clothes and socks, to her parents’ time and time with her sisters, to her home and her friends.

“Natalia doesn’t like to be by herself and she doesn’t yet have the tools to read or sit by herself. Belle loves to be by herself and read and have quiet time. We are really aware of this so we try on weekends to have friends take Natalia on outings so that Belle can have some personal space and alone time.”

Currently, Amy says her family’s big goal is to get Natalia reading. “That’s been going slowly,” Amy explained. “She very bright, with an amazing sense of direction. She’s worldly, has a witty sense of humor and she learned English so quickly. But she learned to read in Spanish and English at the same time and I think that slowed her down. We are hoping that by the time she goes home she can read a book to her family.”

This Hanukkah, Amy said she and her family have much to celebrate, not the least of which are the many lessons learned from Natalia. “Having Natalia has given us a keen sense of gratitude for all the blessings, the comforts, the opportunities we have in our lives-especially the opportunity for a wonderful education and for advanced medical care,” said Amy. “We have also learned some amazing lessons from her about tackling adversity with courage and resilience.”