Lessons in Accompaniment from a Paraguayan Daughter

Written by Maria Eugenia Brockmann, Senior Director of Programs

One of Solidarity Bridge’s Guiding Principles states: 

We seek to embody a spirit of humility and cultural sensitivity. We hold ourselves to standards of mutual partnership and bidirectional learning.

Reflecting on bidirectional learning, I often find that our greatest teachers are patients and their family members. It is only through their eyes and experiences that we can begin to understand the challenges patients face in accessing a safe and timely surgery. On a recent trip with our Neurosurgery & Neurology Institute (NNI), I was humbled to learn more about Paraguay’s health system and culture from one such person. 

I met Lisandra in the hallways of the Hospital Nacional de Itaguá on the outskirts of the capital city of Asunción during our April 2022 mission trip to Paraguay. She is one of the daughters of Lorena, a 59-year-old woman who underwent an aneurysm clip surgery during our trip. When we met, Lisandra was on her way to see the head ICU nurse to deliver medical supplies for her mother’s post-op care. She explained to me that “the hospital sometimes runs out of things, like diapers and pads.” She brings these daily for her mother. “When I can, I also bring one or two extras because I know other patients need them too.”

Lorena was transferred to the Hospital Nacional in mid-February after suffering a posterior communicating artery aneurysm (PCA). She and her two youngest children live in a town located 80 kilometers from Itaguá. Lisandra and her siblings knew that their mother needed specialized neurosurgical treatment. With fierce determination, they insisted that their mother be transferred from the rural clinic to the larger hospital in Itaguá because it has “the best doctors in Paraguay.” They saw Hospital Nacional as their mom’s only chance of survival.

It has been a rough road to healing for Lorena. Before we met her in April, she had already undergone two surgeries. In the first procedure, doctors installed a drainage catheter to relieve pressure around her swollen brain. In the second surgery, doctors were able to clip the aneurism, but afterward they told the family she would likely need yet another intervention. We are hopeful that this third procedure, performed during the NNI trip, will be Lorena's last surgery to bring definitive healing.

Lisandra has accompanied her mother at every step of this difficult journey, staying in the hospital and at the bedside whenever she is allowed amidst COVID restrictions. Lisandra told me that in Paraguay “you always accompany your sick … you never leave them alone or by themselves.” 

Lisandra’s temporary home on the Hospital Nacional grounds.

Lisandra asked me if I had noticed the big orange tents at the entrance of the hospital. Along with seven other people, Lisandra lives in one of the orange tents so she can be close to her mother during her hospital stay. At 20 years old, Lisandra is the youngest person living in the tent, but she is referred to as the “oldest” given that she’s been there the longest. And because her long weeks navigating the hospital have taught her how the system works, she is also the one to offer “orientation” to newcomers.

I was grateful to Lisandra for orienting me. Through our conversation, I learned that the tents were a donation of the Paraguayan government’s National Emergency Secretariat. The donation includes two 40-foot blue containers that have been equipped to serve as toilets and showers. People living in the tents take turns cleaning the bathrooms. The three orange tents have wooden plank floors and are built over bricks. I wondered how they fared with the intense rain of the previous day. With relief, Lisandra said that “it was good luck that this rain did not set mattresses afloat,” which has happened during previous storms. The strong rains, the limited drainage, and the low elevation of the base of the tent conspire to leave things wet and ruined.    

Bathrooms installed for family members of hospitalized patients.

There is a small space at the head of the mattresses where people can store a few belongings. Lisandra keeps her books there. She is a dedicated lab technician student, and hopes to work at this hospital in a few years after completing her studies. I asked her how she manages to study, write papers, and attend classes and exams while living at the hospital. Lisandra explained that most of her classes can be accessed through Zoom. Her phone had become her best tool. She writes papers and does all her research with her phone. The day we spoke, she was preparing for an “in person” exam the next day. Her oldest sister was going to come and take over for her at the hospital while she prepared for and took the test. I admired her resolve and commitment. Lisandra was not going to abandon her studies because of this setback—and she certainly was not going to abandon her mother.

Lisandra told me how grateful she is to the hospital’s medical staff who have given her mom a chance to continue living. She is also grateful to her migrant aunt in Spain who sent money to rent the craniotome for Lorena’s surgery, and to her neighbors who organized raffles to raise funds for Lorena’s medicine. Finally, she told me how grateful she feels for us at Solidarity Bridge, for the hope we brought with this third, and hopefully last, surgery.

And yet I was the one who felt immensely grateful to Lisandra for sharing with me a little bit of her life. As we walked away from the tent she now calls home, Lisandra reminded me, with the maturity of an elder, that Paraguay is a small country, located at the heart of South America, with only 7.3 million inhabitants. She said, “we are young, we still have to learn.” I countered that she in fact had much to teach us on how to be a kind human being, caring for others with such lightness and joy.

Since my return to the U.S., our Paraguayan medical partners have informed us that Lorena is doing well. The brain takes time to heal, but we remain hopeful that the most difficult parts of her journey to health are behind her. We look forward to seeing Lisandra again soon in the hallways of the Hospital Nacional de Itaguá, but next time as a member of the hospital’s dedicated healthcare team.