Maria Magdalena and 37 other children died in a fire at the ABC day care center in the northern Mexican city of Hermosillo on Friday, despite desperate attempts to evacuate babies and toddlers through the building's only working exit.
One father crashed his pickup truck through the wall in an effort to rescue his child.
Delfina Ruelas, 60, said her grandchild German Leon died of his burns Saturday morning, three days after his fourth birthday. She and her husband saw television news reports that the ABC day care was on fire Friday and rushed over that evening.
"I thought he wasn't that burned and that we would find him OK, but he was very burned," said Ruelas, dissolving into tears outside the morgue in the northern city of Hermosillo, where she waited along with 30 other relatives. "They operated on him yesterday, and he held on, but today he couldn't hold on."
Firefighters carried injured children through the front door - the building's only working exit - and through large holes that a civilian knocked into the walls before rescue crews arrived, according to a fire department official who spoke on condition of anonymity because he was not authorized to speak publicly about the fire.
Noe Velasquez, an employee at a nearby auto parts store who helped pull out five toddlers, said the father of one of the children rammed his pickup truck through a wall. Velasquez did not know if the man's child survived.
"I didn't sleep last night. I've never gone through anything like that in all my life," he said.
The tragedy in Hermosillo, capital of the northwestern state of Sonora with a population of about 560,000, once again raised questions about building safety in Mexico. Officials cracked down on code violations following a deadly stampede at a nightclub last year and a fire at a disco nine years ago.
A May 26 inspection found that the day care building - a converted warehouse with a few windows mounted high up - complied with safety standards, said Daniel Karam, the director of Mexico's Social Security Institute, which outsourced services to the privately run day care.
Asked if the single functioning exit constituted a safety code violation, Karam only repeated that the building had passed the inspection, although he conceded that the security requirements might have to be re-evaluated.
"We always have to be open to improvements, especially when we have a tragedy that has so moved us," Karam said.
Guadalupe Arvizu, who was visiting her injured 2-year-old grandson at a hospital, said the building has an emergency exit but it could not be opened on the day of the fire. She did not know why.
"The place is in bad condition. It's a warehouse. There are no windows in the classrooms," said Arvizu, whose daughter - the boy's mother - is a caretaker at the day care but was not injured in the fire.
The death toll rose to 38 after three more children died Saturday, Sonora state health secretary Raymundo Lopez Vucovich told a news conference. He did not say how they died, but said that in general, most of the victims had died of organ collapse caused by smoke inhalation.
Some of the children had third-degree burns, the Hermosillo fire department official said.
"As a doctor I have confronted death on many occasions," Lopez said, his voice cracking. "But I'm seeing so much misfortune and suffering now, it breaks my heart."
Thirty-three children remain hospitalized, 23 of them in Hermosillo, including 15 who are in critical condition, Lopez said, adding that one of them is brain dead.
Nine children have been transferred to other Mexican hospitals, eight of them to the western Mexican city of Guadalajara, and one to Ciudad Obregon in Sonora, he said.
A 3-year-old girl with burns over 80 percent of her body was sent by military transport to be treated at Shriners Hospital for Children Northern California, said Carlos Gonzalez Gutierrez, Consul General for Mexico based in Sacramento, California.
There were an estimated 142 children in the day care at the time, with ages ranging from 6 months to 5 years, and six staffers to look after them, Sonora state Gov. Eduardo Bours said at a news conference Saturday.
The ratio is in keeping with legal standards, Karam said. A 3-year-old girl with burns over 80 percent of her body was sent by military transport to be treated at Shriners Hospital for Children Northern California, said Carlos Gonzalez Gutierrez, Consul General for Mexico based in Sacramento.
The girl's injuries could require months of treatment, which will be free of charge, Gonzalez Gutierrez said. One parent is traveling with the girl, and will be housed nearby.
"It's going to be challenging. The survivability is about 50 percent. A lot of it is how deep the burn is and where it's located and how bad is the smoke inhalation," said Dr. Tina Palmieri, assistant chief of burns for Shriners'.
Velasquez said he and several other people rushed to the day care when they saw smoke. Teachers already had lined up some of the children outside but the very smallest were trapped inside, some of them in their cribs. Velasquez said he pulled out limp toddlers without knowing if they were dead or alive.
The fire started at an adjoining tire and car warehouse leased by the state government, Bours said. The blaze eventually spread to the roof of the day care, sending flames raining down on the children, according to the fire department official.
Firefighters took two hours to control the blaze, the cause of which was still unconfirmed. Most the victims died from smoke inhalation.
Five of the six women who cared for children at the center and a security guard also were hospitalized. Two of the adults were released Saturday and the remaining four are in stable condition, Lopez said.
Police trucks cordoned off the block surrounding the cavernous salmon-and-blue day care Saturday, while forensic investigators gathered material, searching for clues to what started the blaze.
Photographs showed the sidewalk outside the day care strewn with upturned, slightly blackened baby seats and cribs in the immediate aftermath of the blaze. Cribs also could been seen through huge holes punched through the walls.
The Mexican government sent a team of 15 burn specialists, three air ambulances, and other medical equipment, President Felipe Calderon said. He ordered an investigation by Mexico's attorney general.
"I want to say to the mothers and fathers of the little ones who died that we share their profound sadness over this terrible loss, and we will do everything possible to mitigate it," Calderon said during a visit to a town in the Yucatan Peninsula.
Building safety violations have been blamed for previous disasters in Mexico.
In 2000, a fire killed 21 people at a glitzy Mexico City disco that only had one available exit, lacked smoke detectors and did not have enough fire extinguishers. Many of the dead were found near the club's emergency exit, which was locked with a chain. More than 140 nightclubs were closed for code violations after that fire.
Last year, 12 people died in a botched police raid at another Mexico City nightclub. Officers blocked the overcrowded club's lone working exit, creating a deadly stampede in which nine patrons and three police died in the rush to get out. The emergency exits had been blocked.
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Associated Press Writers Alexandra Olson in Mexico City and Don Thompson in Sacramento contributed to this report.
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