Specialized Skills at the Service of the Most Vulnerable Patients
Written by: Jodi Grahl, Director of General Surgery, Gynecology & Pacemaker Programs
This is the second of our latest blog series, dedicated to introducing some of Solidarity Bridge’s key Bolivian medical partners.
Many of our local partners are identified through Solidarity Bridge medical mission trips, often when they are just beginning their surgical practice. Our missioners then work with these promising young surgeons to further their training over years of repeat mission visits.
In other cases, Solidarity Bridge is blessed to partner with doctors already recognized as Bolivia’s best and brightest. Such is the case of many of our Heart Program partners, including Dr. Carlos Brockmann, who has helped shape and grow the Solidarity Bridge Heart Program from the start.
The origins of the Solidarity Bridge Heart Surgery Program
The Heart Program continues to expand the boundaries of cardiac implants in Bolivia. In 2014, U.S. electrophysiologist Marian Holland trained cardiac surgeons at Belga Hospital in Cochabamba and Incor Hospital in Santa Cruz (pictured here) in the implant and management of more complex defibrillator and cardiac resynchronization therapy devices.
This partner story is intimately entwined with the story of the origin of our Heart Surgery Program. We’ll therefore begin with a little background.
In the early 2000s when Solidarity Bridge was still in its infancy, its founder Juan Lorenzo Hinojosa was especially struck by the impact he observed of Chagas disease on impoverished Bolivians. Too many were dying of heart failure. When Chagas disease attacks the heart, it often strikes victims in their 30s, 40s or 50s, leaving young families destitute. Juan Lorenzo had been offered used pacemakers that could be sterilized and re-implanted to save lives. But he needed to find a partner hospital and surgeon in Bolivia to perform the implants.
A partnership is born: Meet Carlos!
Dr. Carlos Brockmann was a young but already highly-specialized heart surgeon who worked at the Belga Hospital in Cochabamba, then recognized as the best private cardiac hospital in Bolivia. Juan Lorenzo knew Dr. Brockmann better as Carlitos, because he was also his nephew. He told Carlitos about his pacemaker efforts, and Carlos in turn introduced him to the hospital’s director. That moment marked the beginning of what is now our cornerstone Heart Surgery Program.
I sat down with Dr. Brockmann in May 2014 to retrace that early history and to remark on the many fruits borne since.
From the beginning, everyone involved --Solidarity Bridge, Belga Hospital, patients, the local surgeons, and other medical staff-- all had to contribute their part to gather the materials and skills needed, first for pacemaker implants, and soon after for other heart surgeries such as valve replacements. In 2002, Medtronic recognized and joined the effort as an in-kind donor, allowing Solidarity Bridge to offer the same, new, top-of-the-line pacemakers, leads, and other implantable devices for its patients as those implanted in U.S. hospitals. The program has now expanded to three more cities, and by late 2015 we expect to implant our 2000th pacemaker!
Program expands to children’s open heart surgeries
Dr. Brockmann supported the creation of Bolivia's first pediatric heart surgery facilities in a public children's hospital in Santa Cruz by generously sharing his unique expertise. Earlier this year, Carlos personally met a delegation from the Santa Cruz children's hospital that traveled to Cochabamba to tour the renowned Belga Hospital facilities.
Within a few years the pacemaker program had taken off, and additional physician and hospital partners specialized in implants had joined the program. Having entrusted most of the implant work to them, Dr. Brockmann was then called upon to address another pressing need. Carlos had spent six years in Belgium specializing in pediatric heart surgery, and there were innumerable babies and children in Bolivia who needed those skills. No public hospitals in Bolivia offered pediatric heart surgery, leaving no option for families who could not afford private care. Through expanded partnership with Carlos and the Belga, and thanks to the financial backing of program donors Isaac and Renee Goff, in 2004 the Solidarity Bridge Heart Program began to offer children’s open heart surgery.
Dr. Brockmann and his team operate an average of one Solidarity Bridge patient per month, which implies weeks or months of care before and after surgery, and permanent long-term follow up for each patient. It is our most resource-intense program; babies often arrive in grave condition and may require extensive hospitalization even before surgery to stabilize them. After surgery, they remain in intensive care for several days to allow their tiny hearts to heal. As Carlos says, ”Perhaps we exaggerate the number of days a child might need in intensive care, but we don’t discharge them until they are 100% well.”
Although Dr. Brockmann’s story follows a slightly different trajectory than that of our partner profiled in the previous blog post, general surgeon Dr. Jaime Vallejos, they do share several key traits. Both are at the top of their fields, and both are eager to put their most specialized skills at the service of the most vulnerable patients. The other key characteristic is that both continuously strive to expand the limits of surgery in Bolivia. Carlos is humble but nonetheless proud of the fact that he and his team are known for taking on cases rejected by every other hospital in the country. Recent examples have included the separation of four-month-old Siamese twins connected at the heart and liver, and surgery to correct a rare and complex congenital defect known as transposition of the great arteries.
We are humbled and honored to claim Dr. Carlos Brockmann not only as a most esteemed partner but also as a dear friend of Solidarity Bridge!
Learn more about the work of Solidarity Bridge in the struggle against Chagas Disease and about our continually expanding heart program!
The impact of Chagas in Bolivia and what Solidarity Bridge is doing to combat it was explored in a 2013 blog post, Breaking the Silence on Chagas.
Dr. Brockmann also provides surgery for adult patients, such as the young mother, Yola, profiled on our website.
Heart Surgery Video - Aurora and Mario, Bolivian subsistence farmers, struggle to make ends meet as Aurora's heart worsens. Hear their story from 2010 in HEART TO HEART: SOLIDARITY BRIDGE PACEMAKER PROGRAM
The Solidarity Bridge partnership with Doctors Without Borders in the battle against Chagas Disease is presented in the moving documentary: SOLIDARITY BEYOND BORDERS - THE FRONTLINES AGAINST CHAGAS