By Mary McCann Sanchez

We came to La Paz from different starting points: Boston, Chicago, Sao Paulo, and several cities in Bolivia. Our purpose? To share knowledge and skills on endoscopic surgery. Join neurosurgeons, ENT specialists, planners and patients in this important Solidarity Bridge mission.

As Senior Director of Programs at Solidarity Bridge, I was happy to deplane once again in La Paz, Bolivia, at five o’clock yesterday morning. The thin crisp air of one of the world’s highest cities quickly shook off the residual grogginess of the overnight journey. The lights of La Paz, scattered over rugged mountain terrain, twinkled in shades of yellow, blue and white. The high-tram cable cars in La Paz’s skyway carried early commuters into the city, reminding me that dawn was about to break. What a welcome!

My traveling companions are long-time missioner Dr. Richard Moser, who heads the department of neurosurgery at the University of Massachusetts Medical School, and Juan Lorenzo Hinojosa, founder of Solidarity Bridge. We were soon to be joined at the Caja Nacional Hospital by Patricia Vargas, the executive director of Puente de Solidaridad in Bolivia, and a distinguished group of Latin American medical professionals -- Bolivian neurosurgeon Dr. Martin Aliaga and his Brazilian colleague Dr. Pedro Mariani, and Bolivian ENT Dr. Sergio Rojas.

The purpose of the mission is to provide training to Bolivian neurosurgeons and ENT surgeons in endoscopic skull base surgery. The course has attracted surgeons from Tarija, Cochabamba, Santa Cruz, and La Paz, Bolivia, and will include lectures and the commented operative simulcast of five surgeries. It is part of an ambitious agenda of the recently created Institute for the Development of Neurosurgery to improve quality of care. The transnasal procedure used to eliminate pituitary tumors is less invasive than cranial interventions. It has not been widely used in Bolivia due to limitations in training and equipment, two needs that Solidarity Bridge has sought to mitigate over the past sixteen years. 

As I accompanied the doctors while they met with patients of limited financial means and I watched them review the images of each case, I was repeatedly struck by the importance of vision. Of the five patients whose surgeries will be central to the course, four are working women in the prime of their lives who are losing their vision -- and their livelihoods -- to pituitary tumors. “I was a teacher until the darkness closed in from both sides,” one woman explained to me, holding up her hands to demonstrate the loss of her peripheral vision. Thankfully, improving her eyesight is one of the expected outcomes of her upcoming surgery.

The impact of a single surgery can be tremendous on the life of an individual, family, and community. At the same time, it is clear that the vision of sharing skill sets, resources, and opportunities is equally important. As we exited the hospital, anxious to return tomorrow, a mantra ran steadily through my mind:

It is all about vision, all about care.

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