MANOA — With an orchid lei around her neck, Ruthie Mersburgh scampered barefoot around the Ronald McDonald House in Manoa yesterday, proudly showing off her newly painted fingernails.

The 5-year-old from Kona had done them herself.

Her parents, Dan and Charlene Mersburgh, marveled at her energy.

It was just last month that the family was able to return home after Ruthie's battle with neuroblastoma, a form of cancer that occurs in infants and young children. She wasn't so full of energy or smiles during her yearlong treatment, which included intense chemotherapy, a stem cell transplant and a five-hour surgery to remove a tumor from her little chest.

But staying at the Ronald McDonald House for $20 a night with other families going through similar challenges eased their suffering and stress.

"This house saved us a lot of heartache," said Charlene Mersburgh, 36, a mother of three. "It was bittersweet when we left. There were a lot of tears. Tears of joy and tears of sadness."

The Mersburghs were among several families who came back to the two-story residential facility yesterday to participate in the 20th anniversary celebration of the Ronald McDonald House Charities of Hawaii.

Former volunteers, staffers and board members also returned to the Manoa home, which was bustling with kids, some in remission, some still going through treatment.

It was 20 years ago yesterday that the 10-bedroom house on Judd Hillside Road was opened. Since then it has housed more than 10,000 families of seriously ill children from all over the world who come to Honolulu for medical treatment.

The need has been so great for this service that last year the nonprofit organization opened a second home on O'ahu Avenue, which can accommodate seven adult family members of in-patient children.

It also runs a respite center at Kapi'olani Medical Center for Women & Children that, over the past four years, has been used by more than 30,000 people, including some from O'ahu.

"The need for this house has never been greater," said Jerri Chong, executive director of the Ronald McDonald House Charities of Hawaii.

Prior to the Ronald McDonald House opening, families struggled to find places to stay while their children underwent treatment, Chong said. They would spend thousands of dollars paying for hotel rooms, desperately seek out relatives to stay with, even sleeping in hospital lobbies.

"Twenty years ago we had enough people to fill this house for 23 1/2 years," said Suzie Entz, the first president of the charity's founding board and driving force behind opening the first home in 1987. "I was shocked at the need. Nobody knew."

The two residential facilities in Manoa provide all the comforts of home, from outdoor play areas to living rooms to well-stocked kitchens. The organization also helps coordinate transportation to and from hospitals and grocery stores.

Merced Matagolai, a 47-year-old mother of nine from Guam, said she feels more relaxed here than in the St. Louis, Mo., hospital where her son, Joshua Quinata, underwent spinal cord surgery this month.

The mother and son moved into the Ronald McDonald House on Friday.

"It's just like home," said Matagolai, whose other children are in Guam. "This is a very relaxing place. It takes the stress away."

She said she gets only two hours of sleep a night, worrying about her 16-year-old son, who suffers from scoliosis.

"I like to be here, it's so peaceful," said Joshua, who can't wait to play basketball again. "The people are nice and it's less stressful."

While they appreciate the comfortable beds and hot meals at such a reasonable cost, many parents say the connection they make with other families facing similar struggles and fears has been the most healing part of their stay.

"That was one of the most invaluable experiences we had here at the Ronald McDonald House," said Charlene Mersburgh, who, at the Manoa home, met Meredith Palafox — now 17 and in remission — who underwent the same stem cell transplant procedure as Ruthie. "There's no way I could thank (the Palafox family) enough."

Ruthie rarely left Meredith's side yesterday, feeling a bond that only two children battling cancer can have.

Ruthie said she feels better now, happier to be at home in Kona where she can eat chicken nuggets and paint her nails in front of the TV.

"You can provide a house with bricks and mortar, but what really makes a difference is who lives within these walls," Chong said. "The love, the support, the families who live here — that's really what the Ronald McDonald House is all about."

Reach Catherine E. Toth at ctoth@honoluluadvertiser.com.