Not a Minute Lost:
International Spinal Surgery Course Underway in Cochabamba
Written by: Mary McCann Sanchez
It is hard to believe that five days of Solidarity Bridge’s Neurosurgery Mission to Cochabamba have already spun by. On Sunday morning, March 26, our team arrived at daybreak to La Paz, Bolivia. Dr. Richard Moser, medical director of the mission, and Dr. John Weaver, lead faculty in the international spinal surgery course on the agenda for the week lead the group as veteran missioners. They were joined by first-time missioners Dr. Barbara Lazio, a neurosurgeon from Washington state, and Dr. Fanor Saavedra, a Bolivian neurosurgeon who practices and teaches at the University of Puerto Rico Medical School. Zachary Kaufman, representative of Atlas Medical, joined us on his fifth mission as a provider of Globus surgical instrumentation, an essential element of the course we were about to initiate.
What would have been a long wait in the La Paz airport, due to fewer Sunday flights to our final destination of Cochabamba, triggered opportunity. Anxious to see a bit of the city of La Paz, we found two taxis that whisked us to the teleférico, an airway cable car system that crosses the cities of El Alto and La Paz, providing public transportation for thousands of working people each day. As visitors to Bolivia, the teleférico literally provided us with a bird’s eye view of the dramatic mountainous terrain, steep hillside stairways leading to neighborhoods of red brick houses, historic church steeples, markets, soccer fields, highrises and a multitude of structures within a colonial city in a rapidly changing world.
We were later welcomed to Cochabamba by our colleagues from Puente de Solidaridad, the partner organization of Solidarity Bridge. Also there to greet us were two recently graduated doctors and two medical students who had generously offered to join our team as interpreters and translators. The work of the latter had already begun with the translation of course lectures. Marcela Canedo and Fr. Dae Kim, chaplains for this mission, led an opening welcome ceremony on the terrace of our hotel. Candles and spices served as symbols to remind each of us of our roles as light and salt. Music enlivened us as we shared our motivations for the journey.
After a warm Monday morning welcome by the director of the Viedma Hospital and host of this mission, Dr. Daysi Rocabado, and the president of the Cochabamba chapter of the Bolivian Society of Neurosurgeons, Dr. Sandra Campero, we proceeded to patient consultations. Given our dual purpose of healing and teaching, Bolivian neurosurgeons together with our mission team determined which of 13 previously pre-screened patients would receive treatment via course and post-course surgeries. Criteria included the probability of positive results for the patient, availability of instrumentation for each unique case, assessment of the mitigation of possible risks, and the potential for the transmission of technical information via each case. Our afternoon was a busy one – the audiovisual set-up in the operating theater was tested, surgical schedules were confirmed and hands-on work stations for the course were set up. At the same time, Puente de Solidaridad director Patricia Vargas and social worker Maria Ines Uriona managed a series of logistical tasks and responded to patient and family needs.
This careful preparation – and months of prior planning – transformed into a very dynamic course. Now in Day 3, I appreciate this opportunity to consult and interact with more than 40 individuals who are a vital part of this course as faculty, participants and support persons as well as the many staff of the Viedma Hospital who join us to listen to lectures each morning or discuss case studies. The four-pronged teaching approach, consisting of lectures, hands-on work stations, analysis of case studies, and observation of simulcast surgeries, has fueled ongoing discussion and exchange of professional experience. I am hearing common concerns expressed by both our missioners and their Bolivian colleagues, specifically the importance of pre- and post-surgical care to ensure the success of a surgery, as well as the urgent need for equipment, instrumentation and supplies in under-resourced hospitals.
And, of course, the heart of the matter is the patients and the solutions they need for diverse pain and mobility problems. Our first patient, a woman with rheumatoid arthritis, had suffered the dislocation of two vertebrae and spinal cord compression, resulting in chronic pain and numbness in her limbs. She is now recovering after successful spinal fusion. The next case involved a 13-year-old boy with spinal tumors that had caused the dislocation of his third vertebrae. In his complex surgery, the surgeons removed hardware installed in a previous surgery as well as an additional tumor. He will require continued treatment by our team and his attending surgeon following the conclusion of the course.
As I listen to the lectures, observe the simulcast surgeries and facilitate conversations among medical professionals from the United States, Bolivia and as far away as Nicaragua, I cannot help but to be impressed by the high level of technical exchange that Solidarity Bridge and Puente de Solidaridad has been able to facilitate. At the same time, I am cognizant of the transmission of other messages that transcend the highly-specialized realm of neurosurgery. These messages have a certain harmony – the awareness of pain, the importance of listening with care, and the fundamental role of solidarity as all human beings seek to live with dignity, wherever they may be. Not a minute is lost as we work and live when these messages are our guide.
Mary McCann Sanchez is the Senior Director of Programs for Solidarity Bridge.
The Program for the Development of Neurosurgery is a program of Solidarity Bridge and Puente de Solidaridad. Under the leadership of Dr. Richard Moser and other top US neurosurgeons, we are raising the level of neurosurgery in Bolivia. Our mission teams have been the first to introduce several neurosurgical advancements in the country, while restoring quality of life to patients who had nowhere else to turn for treatment. Plans are also moving forward to form the first Epilepsy Center in Bolivia. Learn more about our Neurosurgery program.