Dedication and Motivation Advance Surgical Care
Written by Lindsay Doucette, NNI Program Director
This week, our Neurosurgery and Neurology Institute (NNI) continues its support around the expansion of treatment options for cerebrovascular disorders in Paraguay. Our eleven-member mission team began its week at the Hospital Nacional de Itauguá with the call to be attentive: attentive to the people, environment, and culture of our host city, to the patients and doctors we will encounter, and to one another. The immensity of the experience of intercultural encounter always beckons our attention. The complexity of performing neurosurgery in an unfamiliar clinical context adds another level of sobriety.
Five patients, each under the age of 40, will undergo surgery this week for cerebral arteriovenous malformations (AVMs). An AVM is an irregular tangle of blood vessels that can disrupt the flow of blood and oxygen. Cerebral AVMs are rare—affecting roughly 10 out of every 100,000 people—but they can put a patient at risk of serious complications including stroke or brain damage. Despite being a rare disease, the prevalence of cerebral AVMs in Paraguay is enough to bring a steady flow of cases to this large public hospital.
Dr. José Kuzli, director of the Neurosurgery Service at the Itauguá hospital, first requested training in this speciality in 2021. In 2022, Dr. Nirav Patel from Brigham and Women’s Hospital of Massachusetts made his first trip to Paraguay along with Brigham neuro-anesthesiologist Dr. Grace Kim and surgical technician Carlos Vazquez. This week all three return to continue their mentorship and training.
Over these three years, Dr. Kuzli and his team have seized every opportunity to build their skills and their hospital’s integral capacity to perform these surgeries, which they now do on their own with positive results. The credit in this achievement goes to both our NNI missioners as expert mentors and to Dr. Kuzli and his team for their desire and aptitude to learn and apply their growing expertise for the benefit of the Paraguayan people.
When asked to comment on this remarkable progress, Dr. Patel observed, “Successful surgical training is not dependent on the equipment, the finances, or even the planning as much as on the dedication of the people and their motivations for being here.” Dr. Kuzli and his team have clearly demonstrated such dedication and motivation through their efforts to advance their practice and make this surgery accessible to Paraguayan patients. We look forward to sharing the stories of some of this week’s patients in the coming days.
But that’s not all we’re doing in Itauguá this week! This week’s NNI team also includes Dr. Lucia Rivera Lara, a Stanford neurologist and neuro-critical care physician. Dr. Rivera will provide training in neuro-monitoring for the hospital’s intensive care and internal medicine teams. Dr. Deepak Sharma from the University of Washington has also returned to continue training in neuro-anesthesia and the use of transcranial doppler to measure cerebrovascular functions. Finally, our team is complimented by two biomedical engineers, Elial McGurk and Kevin Collazo from the TriMedx Foundation; they will perform maintenance and repair of specialized surgical equipment and collaborate with local staff on future maintenance plans.
These various disciplines are critical to providing safe, effective, and timely neurosurgical care. Under the guidance of team leader Lindsay Doucette and team chaplain Mary McCann Sanchez, our missioners will continue to pay attention to the interweaving of these threads throughout the week, along with the strands of science and spirit, pain and hope, difference and unity, and of the experiences of both healing and being healed.
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.