The immeasurable impact of long-term relationships

Organizations of all types are encouraged to quantify their achievements and impacts through hard data. So at Solidarity Bridge we are always asking ourselves, How do we measure our work?  We can count surgeries performed and medical supplies delivered, but what about our equally important work fostering relationships? How does one measure the impact of relationships on expanding access to surgical care?

I recently accompanied Dr. Richard Moser, Solidarity Bridge board member and Medical Director of the Neurosurgery and Neurology Institute, to the XXI Bolivian Congress of Neurosurgery, held in Santa Cruz de la Sierra on June 1-3. The event convened the majority of neurosurgeons in Bolivia as well as medical students, residents, and industry representatives. At the Congress—two years postponed by COVID-19—participants were eager to connect with old friends and colleagues and to exchange experiences and lessons learned. Dr. Moser was invited to give three presentations at the Congress based on his ongoing research of RNA-based gene therapy and his outlook on the future of brain tumor treatment. It was thrilling for everyone to discuss among peers the possibilities of, as one Bolivian doctor described it, “the miracle of being able to treat a glioma with a pill.” 

Dr. Moser is well known among the Bolivian neurosurgery community thanks to his mission trips and other activities through which he has built many long-term relationships. During the three-day Congress, many doctors approached Dr. Moser to express their joy at seeing him and to thank him for his leadership and commitment. Several recalled his impact on their personal and professional lives and on the medical institutions in which they work. Others remembered the Neurosurgery Skills Boot Camps he helped to lead, which have become a touchstone for neurosurgery training in Bolivia. Some who took the Boot Camp course as residents are now practicing neurosurgeons at important public and private institutions around the country. 

Dr. Freddy Terrazas, a founder of the neurosurgery service at San Juan de Dios Hospital, the largest public hospital in Santa Cruz, greeted Dr. Moser with the type of warm embrace one would give to a family member they haven’t seen in years. In his introductory remarks as chair of one of the panels, Dr. Terrazas estimated that “over 50 percent of what neurosurgery is in Santa Cruz today is thanks to the work and support of Dr. Moser… he needs no introduction for the audience of this conference.” 

Dr. Gueider Salas, the outgoing president of the Bolivian Society of Neurosurgery, while presenting on “Large Tumors of the Sellar Region,” recalled that his first surgeries of pituitary tumors, over 10 years ago, were performed with Dr. Moser. Dr. Salas recalled how Dr. Moser encouraged young doctors to perform the new surgical techniques “with care and determination.” At other moments during the Congress, doctors told Dr. Moser how they now routinely perform endoscopic surgery techniques they learned through his mentorship. Dr. Moser listened and provided gentle and often humorous advice while catching up with his surgical partners, who are now friends and colleagues.

We were joined at the Congress by U.S. pediatric neurosurgeons Dr. Art DiPatri and Dr. Carolina Sandoval, also longtime supporters of Solidarity Bridge’s Neurosurgery & Neurology Institute. Dr. DiPatri presented in Spanish on “Contemporary Strategies on the Treatment of Craniosynostosis.” He had been motivated to learn the language after he started traveling with Solidarity Bridge; he was eager to connect better with Bolivian doctors and patients. This dedication and commitment are recognized by his local colleagues, who look forward to future mission trips focused on pediatric neurosurgery, including epilepsy surgery.  

Dr. Sandoval gave a presentation on “Pediatric Hydrocephalus: Diagnosis and Treatment.” She was the only female speaker at the Congress. This did not go unnoticed or unappreciated. Before the start of her panel, she approached a group of eight young people—seven women and one man—sitting in the back. She asked if they were residents, but they explained, “no, we are medical students. We are here to support you because you are the only woman presenting at this conference.” Dr. Sandoval later described that encounter as the most beautiful moment of the Congress. We also took it as a reminder of the power of role models and representation; perhaps Dr. Sandoval planted a seed, and will reconnect with those students at a future Bolivian Neurosurgery Congress.  

Through 15 years of our neurosurgery program, and now the establishment of the Neurosurgery & Neurology Institute, we have supported the ongoing development of this surgical specialty throughout the country. One could feel the power and impact of that commitment through the relationships that were evident in the welcome and embrace of our US missioners by their Bolivian counterparts. The impact of these relationships may be hard to quantify. They are an experience of walking together, exchanging knowledge, sharing moments of difficult medical decisions, and joyful celebrations of healing. On this journey we join our strengths and weaknesses with a common goal of providing safe and timely medical care for all patients who need it. It is not only a professional endeavor but an experience of transforming lives and being transformed in the process. This is hard to reflect in data. But when one sees friends and colleagues meet and hug after too long apart, and watches them continue to share their work and future dreams, it is palpable.