Trust and Communion in Paraguay

Written by Lindsay Doucette

“This is your thermos, your guampa, and your tereré,” Paraguayan neurosurgeon, Dr. José Kuzli said as fellow surgeons and residents looked on. Tereré is the Guaraní name for an infused herbal tea prepared with cold water and ice. The Guaraní culture remains strong in this country where over 80% of the population are bilingual in both of the official languages, Guaraní and Spanish. Not only is tereré a refreshing drink in a hot climate, the act of sharing it is a uniquely Paraguayan ritual, signifying trust and communion. Since my 2018 visit to Paraguay, this simple gift grew in significance as a fitting symbol of our time there and makes me excited to return again.


On Saturday our Neurosurgery mission team will arrive in Asunción. Drs. Art DiPatri, Carolina Sandoval-Garcia, and Mark Piedra will lead a symposium on epilepsy surgery as part of the National Paraguayan Neurosurgical Congress. Just prior to that, staff leaders and board members of Solidarity Bridge will participate in meetings with the Ministry of Health, the Archdiocese of Asunción, and the leadership of the Itaguá Public Hospital to finalize agreements for a three year neurosurgery partnership.

We look forward to building upon the positive relationships we’ve established with the Paraguayan neurosurgical community and to advance the ideas that came from our 2018 trip to this same location. Below is that back story. Meanwhile, stay tuned for our unfolding adventure next week!


Missioners on the March 2018 trip to Paraguay included Bolivian ENT, Dr. Patricia Arteaga (left), and US missioners, Drs. Art DiPatri, Richard Moser, and Barbar Lazio (left to right).

Missioners on the March 2018 trip to Paraguay included Bolivian ENT, Dr. Patricia Arteaga (left), and US missioners, Drs. Art DiPatri, Richard Moser, and Barbar Lazio (left to right).

In March 2018, the Paraguayan Society of Neurosurgery welcomed us with great fanfare to the Itaguá Public Hospital in Asunción. As the country’s central reference hospital for low-income patients, and with over 1,000 neurosurgical cases per year, it was the perfect place to consider extending our efforts to advance Neurosurgery in the Southern Cone. Paraguayan neurosurgeons, Drs. Pablo Maidana, José Kuzli, Ramon Migliorisi and Diego Servián joined us to help facilitate a training course and connected with us throughout the week to explain the needs of their patients and the challenges they face.

The health care system in Paraguay is severely understaffed with roughly 11 doctors for every 10,000 people. It goes without saying that neurosurgeons in Paraguay are in constant demand, with less than 30 licensed neurosurgeons serving a country of nearly 7 million people.

The neurosurgeons and ENTs we met on that first trip were relatively young, dynamic, and clearly driven by a passion for their profession and a duty to serve. Among them, was Dr. Carlos Feltes, former president of the Paraguayan Society of Neurosurgery. Dr. Feltes is a second-generation neurosurgeon who trained in the United States and has done much to connect the Paraguayan neurosurgery community with the larger, global community. Meeting with our counterparts last year, and seeing the heroic efforts being made to serve patients with the scant resources available to them, we felt we had found a promising new partnership.

Following our March 2018 trip, we met again with our Paraguayan neurosurgical peers in November at an international neurosurgical congress hosted in Santa Cruz, Bolivia. We listened to the priorities of our Paraguayan neurosurgical partners. Namely, they expressed a need for development in the area of epilepsy surgery. Solidarity Bridge founder, Juan Lorenzo Hinojosa, Neurosurgery Medical Director, Dr. Richard Moser, and Senior Director of Programs, Lindsay Doucette presented the idea of developing a long term partnership to support the strengthening of neurosurgical systems at the Itaguá Public Hospital. This week, we are pleased to return to Paraguay.