Faster Healing: Laparoscopy’s Role in Low-Income Healthcare

Doña Faustina invites the team into her home before surgery to share her story.

At 68, Doña Faustina has experienced five cesarean sections. Three of her children survived into adulthood and now have children of their own. As her adult children and their spouses work during the day, she is responsible for taking care of her five grandchildren. When we visited her before her recent surgery, she was caring for her grandchildren despite suffering extreme pain from an incisional hernia adjacent to her multiple cesarean scars. The hernia was not only painful –  sometimes leaving her crying out in pain - but also dangerous when it occasionally became incarcerated (when intestinal tissue gets trapped in the hernia sac), resulting in life-threatening intestinal obstruction. 

Dr. Gay partners with Dr. Jaime Vallejos while teaching medical residents during hernia surgery.

Doña Faustina’s family relies on her for childcare, as their precarious financial situation makes it impossible for anyone else to stay home from work. Fortunately, this month Doña Faustina was able to receive surgery to repair her hernia as part of Solidarity Bridge’s General Surgery Mission Trip hosted by Hospital del Norte in Cochabamba, Bolivia.

Jimmy in his home talking with the social work team.

Over the course of just four days, U.S. surgeon Dr. Gay Garrett operated alongside multiple Bolivian doctors including Dr. Luis Herrera, Dr. Jaime Vallejos, Dr. Johnny Camacho, Dr. Oscar Román, Dr. Karen García, Dr. Ignacio Bustamante, Dr. Cristian Rojas and others to perform 18 laparoscopic hernia surgeries. Several patients also benefited from other procedures including gall bladder and colon surgeries in conjunction with their hernia repairs. The mission week was designed to provide training for around a dozen residents and young surgeons at Hospital del Norte, while meeting the care needs of a large number of patients in need.  

Jimmy recovering after a successful hernia surgery!

Like Doña Faustina, many Bolivian patients develop hernias as a result of previous surgeries. For 46-year-old Jimmy, it was likely related to an earlier appendectomy. Solidarity Bridge patients from low-income or working-class backgrounds cannot afford the extended recovery time that traditional open surgery techniques require. But if they return to their regular, often physically strenuous activities before their bodies have healed, they are at high risk of suffering an incisional hernia.

Recovering from open appendicitis surgery typically takes 6 to 8 weeks, while laparoscopic surgery usually requires only about 2 weeks. This difference often determines whether a patient can take the necessary time to rest and fully recover or must return to work prematurely due to financial pressures—leading to a higher risk of  a hernia in the future.

Patients and families waiting at the hospital

In Doña Faustina’s case, she likely did not have the option to fully recover after her cesarean deliveries as she had children to care for at home. Similarly, Jimmy works as a taxi driver from 3 a.m. to 6 p.m. daily to support his two children and his parents. For families like these, economic challenges make proper post-operative recovery extremely difficult.

Checking in with a patient before surgery

Too often, we overlook the fact that there is not only an economic barrier preventing patients from receiving care but also a time barrier. In many cases, the ability to take time off to heal is a luxury. As Jodi Grahl, General Surgery Program Director, explains, “Many patients put off life-saving surgery because they can’t afford to take time off work to get treated.”

Teaching a medical resident laparoscopic techniques

This is why our general surgery program has placed a strong emphasis on training local doctors and residents in laparoscopic surgery, as well as donating laparoscopic equipment and supplies. This surgical technique provides a significant benefit to patients and their families.

Over the past 15 years, Dr. Gay Garrett, Solidarity Bridge’s Medical Director and volunteer missioner, has worked closely with many of the same Bolivian surgeons, training them in laparoscopic surgery and consulting on challenging cases and advanced techniques. The Bolivian surgeons who worked alongside Dr. Gay during the week extended the mission beyond our time there, performing over 40 hernia surgeries over the following weeks to treat all the patients who sought care in conjunction with our visit. The same core group of Bolivian partner surgeons also continuously pass along their skills to the surgical residents at Hospital del Norte, and volunteer their services for medical campaigns in smaller towns across the country.

“When I graduated medical school 20 years ago, there was no opportunity to learn laparoscopy. You had to travel abroad or figure out how to learn on your own. But what helped me the most was when Solidarity Bridge arrived and offered laparoscopic surgery,” shares Dr. Luis Herrera.

Dr. Johnny Camacho, Dr. Gay Garrett, and Dr. Luis Herrera

Dr. Johnny Camacho elaborates on his collaboration with Dr. Gay and Solidarity Bridge over the years: “First of all, it’s very difficult not to get along with Dr. Gay! We’ve learned a lot from her. We started with gall bladder surgeries, then moved on to hernias, abscesses, incisional hernias, colon surgeries... In surgery, you never stop learning; there’s always a new trick, always something new.”

Over time, this group of surgeons has not only become colleagues but also friends. It is evident that they enjoy collaborating in the operating room, teaching, and explaining techniques to medical residents during each surgery. As Dr. Gay often likes to say, “My guys [the Bolivian surgeons] are really the ones leading these surgeries now. I’m just here to watch.”