Neurosurgery Mission from a New Missioner's Perspective

Written by: Dr. Barbara Lazio, first-time missioner

When I left Washington last Saturday for my first mission trip, I had first-day jitters. This surprised me, as I am not generally a nervous person. However, the idea of going to a country where I do not speak the language, teaching a course with people I have never met, and operating in hospitals with unknown staff and equipment was somewhat daunting. I wondered about the Bolivian doctors with whom I would be working and how I would handle the challenges faced by our patients during such a short trip. I left at “o dark thirty” with my two max weight bags of donated medical equipment and a carryon containing everything I needed for two weeks.

So far I have been so pleasantly surprised. This team of people I had never met: Mary McCann Sanchez, Zack Kaufman, and Drs. Moser, Weaver, Saavedra and Vaezi, have become fast friends. Day and night, we have shared the common goal of helping the neurosurgery communities here as well as many funny stories from prior missions, life, neurosurgery, and travels. We’ve pooled our collective talents and resources to solve complex challenges together.

The patients we are seeing face many obstacles to their care: they have very complex medical issues, little or no resources to travel for care, or are without the equipment needed for their  ideal surgery. Even with the equipment we brought, I did not have at my fingertips many of the things I take for granted in my OR like duplicate sets of sterile instruments, head holders, retracting instruments, bone grafts. Not knowing whether there would be a microscope, I packed my loupes and headlight, only to have them get lost by the airline in one of my checked bags of equipment that never made it to Bolivia.  No loupes, no headlight, no retractors, no problem! Somehow, working without your comfortable tools enhances your creativity. Drs. Garcia and Wilcarani from Viedma Hospital, Dr. Saavedra and I managed to troubleshoot a highly complex spinal tumor with instability using the tools available to us. After three surgeries for young Diego, he gave us the thumbs up when it was all done.

As for our Bolivian colleagues, I have been very impressed. Many sought training outside of Bolivia but by returning home, they are advancing neurosurgical care here one patient at a time. These doctors must adapt every day to the financial limitations of their medical system.  I was surprised to find that typically in Bolivia, patients have to raise money to pay for any instrumentation to be implanted, any postoperative antibiotics, and any imaging studies -all essential elements of surgical care. Solidarity Bridge works, with the support of the medical industry, mission doctors, and donors in the U.S. to overcome these financial barriers and provide significant support to our year-round surgical programs. Moreover, I learned that even in the private hospitals much of the instrumentation we use daily in the U.S. is too expensive. Despite this, Bolivian neurosurgeons continue to train and inspire new generations of neurosurgeons.

The language barrier? Two months of Rosetta Stone Spanish and I was good to go! Well, not so much. But, we have been blessed with some fabulous young doctors who have volunteered day and night translating slides, interpreting lectures for the attendees of the course,and  making sure I have café, scrubs, anything I need. They did not make fun of me when I said “pincers sin muelas” to the surgical tech when I wanted some smooth forceps (I later found I was asking for a pickup without molars). They kept me laughing the whole first week and then treated our team to a hike in Paseo a Pairumani and a Bolivian barbecue - muy bien.

Our patients and their families have provided me the greatest pleasure and deepest regret. These people traveled far and some waited days in the hospital, all for a chance with no guarantee of surgery. Several had to be turned away because of the complexity of the most urgent patients and the scarcity of both equipment and staff resources. The patients have been beyond grateful, showering me with what I feel is undeserved gratitude. I now have so many new ideas about how we can solve other problems I did not even appreciate until this week.

We are settling in to Sucre tonight to start our second week. I FaceTimed my daughter to wish her a happy birthday. One of our surgical patients tomorrow reminds me much of her. I am looking forward to another good week of working with these most gracious people.

Dr. Barbara Lazio is a neurosurgeon from Providence Health & Services in Olympia, Washington. This is her first mission trip with 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.