A Long Wait for Lifesaving Care
Written by Dr. Joe Sherman
“…por falta de los insumos” (due to lack of supplies)…
This was the phrase we kept hearing from patient after patient as we interviewed the 11 people selected for surgery and interventional radiology procedures on our Neurosurgery & Neurology Institute (NNI) trip to the Hospital Nacional de Itauguá (HNI) in Paraguay. They all had various vascular lesions in their brains and had been told they would need to purchase all of the materials needed for their procedure. The cost for each surgery was in the thousands of dollars, far more than they could ever imagine raising. Some were even told their particular lesion was too complicated to treat at all. And so, they had been waiting, hoping that their symptoms wouldn't further disable them or become fatal before they could find a solution.
Finally, as Luz, a 62 year old mother of 10 children said, “the call came from God” that she could receive the treatment she needed for her aneurysm. She had been waiting for 11 years.
Luz was one of three women we encountered sharing a room in the Neurosurgical ward of Hospital Nacional de Itauguá (HNI). Each of them had been called by the HNI neurological staff with news that the NNI team from Solidarity Bridge was returning to Paraguay, bringing the materials and expertise needed to treat them, and offering to do so at no cost. Now they were lying in beds next to each other, surrounded by members of their families, and anxiously preparing for their procedures.
They were hesitant at first, but slowly their faces began to light up as the surgeons and anesthesiologists from both teams greeted them and explained the plan for treating their rare neurovascular lesions. Each woman had a unique diagnosis, and a unique experience living precariously for years without treatment.
Luz had a giant brain aneurysm. She had traveled to Argentina twice in attempts to treat it, only to return disappointed because there was no doctor available to perform the surgery. After her second attempt, she returned home saying, “I decided I wanted to just die in my own country, in my own house.”
Graciela, a 52 year old mother of six who worked on her small farm caring for cows, pigs, and chickens, was told five years ago that her symptoms of dizziness and vision loss were caused by stress and hypertension. She was only recently diagnosed at HNI with an aneurysm.
Twenty-year-old Fatima, was diagnosed with a large AVM four years ago after repeated headaches and fainting spells. She was told that her lesion was too deep to reach surgically.
(l-r) Dr. Joe Sherman, Luz, her daughter, Maria Eugenia Brockmann
Graciela Melgarejo meets with with Dr. Telischak before her procedure.
(l-r) Fatima’s brother, Maria Eugenia Brockmann, Fatima, Dr. Joe Sherman
In the days before our trip, Luz, Graciela, and Fatima all lived together in the hospital awaiting their procedures and surgeries. During this time they became like family. Their children and siblings slept on the floor each night making sure that they knew they were loved and cared for. They asked questions for each other if one was too shy to speak up to the doctors. They shared food, clothing, and bedding to make each other comfortable. They supported each other as one by one, they were escorted to the operating room or interventional radiology suite to receive their long-awaited treatments.
In the role of accompanyer for NNI team, I had the privilege to visit their room each day, hear their concerns and make sure they were up to date with each other’s progress. They shared their life stories, laughed, and cried together as they prayed for the best outcome for themselves and their roommates. With God’s grace and the expertise of our joint team, each of them made it through very complex operations without any complications.
Now, none of these three brave women, or the other eight patients who were treated this week, will have to worry about “falta de los insumos” or a catastrophic stroke as they return to their homes, their families, and the rest of their lives. We are overjoyed at their progress and hopeful for their healthy futures ahead. More than that, we are inspired by the commitment of the HNI Neurosurgical Service to partner with us and expand their skills to ensure that future patients won’t have to wait so long for lifesaving care.
Thank you to our NNI surgical team:
Dr. Nick Telischak (interventional radiologist, Stanford Medicine)
Dr. Nirav Patel (cerebrovascular neurosurgeon, Brigham & Women’s Hospital)
Dr. Claudia Clavijo (neuroanesthesiologist, University of Colorado Medicine)
Dr. Jake Gamboa (anesthesia resident, University of Colorado Medicine)
Dr. Silvia Vaca (neurosurgery resident, Stanford Medicine)
Jared Bouis and Liliana Acosta (Stryker medical device specialists)
Dr. Richard Moser (team medical director, UMass)
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.
