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Uruguay's Maximiliano Pereira, left, fights with Ghana's Sulley Muntari for the ball. ((Stephane de Sakutin/AFP/Getty Images))

Victories — and defeats — don't come any tougher than this.

Uruguay survived when Ghana missed a penalty kick at the very end of extra time, then won the shootout 4-2 after a 1-1 draw Friday in Johannesburg. The wild win sent the South Americans into the FIFA World Cup semifinals for the first time in 40 years. It sent the final African team home in tears.

Sebastian Abreu chipped in his penalty kick to give Uruguay a spot opposite the Netherlands in the final four.

Ghana missed twice in the shootout, but wouldn't have been there at all had Asamoah Gyan, who made two penalty kicks earlier in the tournament, not hit the crossbar on the final play of extra time.

So Uruguay, once a soccer power, most recently an afterthought, travels to Cape Town for Tuesday's semifinal. The last nation to make the tournament, it needed a playoff against Costa Rica just to get in. Now it is one step from the title match.

"To be among the four best [teams] in the world, there are no words for that," star striker Diego Forlan said. "We felt we were going to faint with each penalty."

A continent's hopes on Ghana

Ghana carried the weight of an entire continent's soccer hopes — the other five African nations did not advance — and became the third African team to exit in the quarter-finals of a World Cup. The Black Stars couldn't replicate the opportunism they used to beat the United States in extra time six days ago.

Uruguay won the first World Cup in 1930, then again in 1950, beating Brazil in Rio de Janeiro.

That scene couldn't have been any more difficult for the Celeste than the atmosphere at Soccer City. The vuvuzela-blowing, flag-waving capacity crowd cheered the Black Stars as if they were South Africa's Bafana Bafana.

Nelson Mandela himself praised the Black Stars earlier Friday, and Sulley Muntari, known more for his bad attitude than his good play, gave Ghana the lead in the final seconds of the first half.

Even with Brazil's loss to the Dutch earlier Friday, however, this has been South America's tournament. Star striker Diego Forlan tied it with a free kick early in the second half, and penalty kicks won it for Uruguay.

And lost it for Ghana.

As extra time ticked down, a scramble in front of the Uruguay net caught goalkeeper Fernando Muslera out of position. Dominic Adiyiah's header was cleared off the goal-line by Luis Suarez — using his arm. That drew an immediate red card for the striker, who will miss the semifinal, and sent Gyan to the penalty spot. 

'The hand of Suarez'

Gyan calmly eyed Muslera, then struck the ball off the crossbar. 

"I think I made the best save of the World Cup," Suarez said, labelling it "the hand of Suarez." 

Gyan stumbled away holding his head as the whistle sounded, sending the match to penalty kicks and the crowd into stunned silence. 

"It has been a very difficult moment," Ghana Football Association president Kwesi Nyantakyi said in a television interview. "Our boys played very well, beautiful football.

"If it was meant for us, less than a second to go, we would have won the match. It has been a terrible moment for the entire continent, not just for our nation."

Gyan put it down to "hard luck," but was convinced the ball crossed the line before Suarez touched it, and should have counted as a goal.

"We had [an] opportunity to win this game but unfortunately, that is football for you," Gyan said. "The ball went in, it did cross the line, and the referee disallowed it."

The fans, except for the small pockets of blue-clad Uruguay supporters in the crowd of 84,017, booed Forlan before he calmly sent the first kick past Richard Kingson. 

Gyan scores on 2nd attempt

And who would step up first for Ghana but Gyan — and he also struck the ball perfectly. Had he done so minutes earlier, Ghana and all of Africa would be celebrating an historic achievement. 

Instead, the shootout moved to 3-2 for Uruguay when Muslera guessed correctly, diving left for an easy save on John Mensah. After Maximiliano Pereira's kick skied over the net, the vuvuzelas were at their loudest.

But Muslera also stopped Adiyiah, and Abreu won it with a soft but accurate placement as Kingson dived right.

"It's a way of kicking [penalties]. I believe in it, and the team has given me confidence to believe it's the right way," Abreu said.

As his teammates sprinted to smother him in an ecstatic scrum, several Ghanaians slumped to the field.

Then, Uruguayans who couldn't be heard over the din during the match were singing everything from "Ole, Ole, Ole, Ole" to their national anthem after their greatest victory in four decades.

Muntari, often a disciplinary problem who nearly was sent home earlier for arguing with a coach — and was kicked off the 2004 Olympic and 2010 African Cup of Nations teams — was a catalyst as Ghana took control of the first half. Muntari and Michael Essien were supposed to anchor the Black Stars' midfield, but Essien missed the tournament with a knee injury and Muntari had been nearly invisible.

His goal was a masterful twister from 35 yards. 

Forlan's free kick turned the game in Uruguay's favour, and he gave Suarez an open net to shoot at a few minutes later, only to see his usually deadeye teammate put it wide from close range. 

Neither team backed down until exhaustion hit in extra time. Still, the Black Stars had enough for those late challenges that turned into bitter disappointments, and — eventually — defeat.