After he was born with a cleft lip and palate and congenital heart disease, Danh (not his real name) spent his first month in an incubator struggling to breathe. He is now eight years old and thin as a rail. Danh has an endearing smile, but he can't speak, and his mother, Lien (also a pseudonym), says he is mentally disabled. Recently he sat playing with toy cars at home in Da Nang, Vietnam, while Lien talked wearily about her son's many needs.