Our Neurosurgery & Neurology Institute (NNI) team is half-way through a week of collaboration with the neurosurgical community in Asunción, Paraguay. Our first three days were packed with activities including a Stroke Symposium, endovascular procedures, a cerebral bypass surgery, a presentation on revascularization, dinner with the Paraguayan Neurosurgical Society, and a two-day training workshop on microsurgical bypass skills. Now the NNI team is at the Hospital Nacional de Itauguá, assisting with endovascular and AVM surgeries.

Dr. Silvia Vaca (Stanford Medicine) uses a Stryker simulator to demonstrate how to insert a coil for the endovascular treatment of brain aneurysms.

Within this short time, our team has been immersed in opportunities to learn about the realities of neurosurgical care in Paraguay. In particular, team members report being “blown away” by the energy, enthusiasm, dedication, professionalism, technical skill, and wisdom of our Paraguayan counterparts.

During a brief moment between activities, a fourth year Paraguayan medical student, Mauricio Guerrero, commented to our staff: “We are doing so much here, with limited resources, but no one knows about it. We are an oral culture. Very little is written down, but we need to share our story with the global neurosurgery community.” Through our partnership, we hope to shine a spotlight on the outstanding work being done in Paraguay. With that in mind, missioner Dr. Nirav Patel (Brigham & Women’s Hospital) invited Dr. Kuzli to participate in an upcoming Global Neurosurgery conference at Harvard Medical School to present to world-renowned neurosurgeons, business leaders, and donors about what is happening in Paraguay and what we can learn from their unique experience.

The neurosurgery department of the Hospital Nacional de Itauguá has grown leaps and bounds since we began our partnership in 2018. At the time, they had five neurosurgeons. Now, only five years later, the program has nine neurosurgeons, two neuro interventionists, and five residents. Our partnership has also expanded, with the inclusion of focused training in neuro anesthesia and microsurgical skills training.

This impressive growth comes from the outstanding leadership of the neurosurgery department’s director, Dr. José Kuzli, as well as the incredible dedication and energy of his team of attendings and residents. Dr. Kuzli shared that, while he learned from great teachers in his early formation, his knowledge of surgical advancements comes from watching presentations by surgeons on YouTube and through our NNI partnership, specifically the mentorship of surgeons like Dr. Nirav Patel.

Dr. Patel protested at hearing himself referred to as a mentor, saying, “No, we are colleagues.”

But Dr. Kuzli countered, “Everyone needs a mentor. I am alone here in this practice. What I learn … I pass on to the new neurosurgeons, and they will pass it on to the residents.” Dr. Patel nodded, saying he can relate to Dr. Kuzli’s experience. The ultimate blessing will be that, strengthened by this time working side-by-side, Drs. Kuzli, Patel, and the rest of the team will be able to turn to each other well into the future as sounding boards, colleagues, co-mentors, and friends.

Drs. Nick Telischak, Richard Moser, Silvia Vaca, José Kuzli, Claudia Clavijo, and Nirav Patel with a young AVM patient and his mother.

An important part of the work of the NNI is to make the world smaller. By creating new networks and opportunities for the exchange of contacts, knowledge, and experience, we can break down the silos that keep scientific advancement from reaching all who need it. It is exciting to see the fruits of this exchange after just five years of collaboration, and to contemplate all the possibilities ahead.

Through partnerships and collaborative actions that are measurable and sustainable, the Neurosurgery and Neurology Institute works to build capacity and expertise in Bolivia and Paraguay in order to increase access to safe, affordable and timely health care.

We are committed to alleviating the suffering, death and disability from neurological disorders and injuries that disproportionately impact patients in the countries where we serve.

Shining a spotlight on Paraguayan neurosurgery