Crossing continents to provide neurology care

When it comes to healthcare, every person deserves the proper treatment. It is that belief that drives Dr. Jose Suarez, professor of neurology at Baylor, to cross borders and share the latest techniques in neurocritical care with others. His latest endeavor took him to Ecuador where he helped establish the Clinic for Acute and Emergency Neurology and he doesn’t plan on stopping there.

Suarez began his outreach by founding the NINDS-funded Neurocritical Care Research Conference in Houston and hosting each symposium since 2009. The conference brings together researchers and healthcare providers from across the globe to focus on neurocritical care and research development.

However, three years ago he brought the opportunity for collaboration to South America in the form of the Annual International Symposium on Neurocritical Care. He organized this conference with the help of Dr. Nelson Maldonado, who works at the Hospital de Los Valles in Quito, affiliated with Universidad San Francisco de Quito (USFQ).

Their working relationship began when Maldonado was a neurocritical care fellow at Baylor. When he returned to Ecuador, he and Suarez began collaborating on patient cases when they realized the region needed specialty neurological care.

The third conference took place Nov. 23-25, 2016, in South America, and was organized under the auspice of the Neurocritical Care Society, USFQ and the International Office of Baylor St. Luke’s Medical Center. Not only did it bring together over 500 medical professionals and more than 30 international speakers, but it also laid the ground work for future research and education in the area.

“We are working to create a fellowship program in neurocritical care at USFQ so we can educate future doctors, and they in turn can begin to educate others, act as mentors and improve patient care,” Suarez said.

Currently the options for this specialty training and certification is limited to the U.S. and some European countries.

“I think that such an agreement will complement the work we are already doing here with Baylor St. Luke’s and Baylor,” he said.

Suarez and Maldonado also are currently in the beginning phases of studying the effects of high altitude on neurocritically ill patients. Quito, Ecuador, has an average altitude of 9,000 feet with about half the population living in the higher altitudes.

“Do high-altitude dwellers who suffer from stroke or brain injuries need a different or altered type of treatment than what is typically used?” asked Suarez. “The recommended treatment is based on research on people who live closer to sea level. This type of research will help to understand how the brain functions under different environments and could lead to better treatments and outcomes after a traumatic brain injury or illness regardless of geographical location.”

Suarez and his collaborators have received partial funding from Yachay in Ecuador and are currently seeking further support from the National Science Foundation (PIRE program) to begin this work.

Another outcome for the collaborative work between Suarez and Maldonado is the creation of the Clinic for Acute and Emergency Neurology in Quito. Suarez recently toured the offices, which include facilities and technology for telemedicine and will be opening in the coming weeks.

“It made sense to have the offices there. Patients were already being referred to the U.S. and this new facility will help to streamline the consultations. Since response time is also important when it comes to neurocritical care, having specialists in the area will help patients receive faster care,” Suarez said. “There is also a part of the population that cannot travel internationally for specialized consultations or care. We felt they still deserved to have quality healthcare when it comes to these very specific issues.”

The educational outreach doesn’t end there, Suarez also helped to organize the Galapagos Neurocritical Care Summit meeting to discuss ways to improve care to different geographical regions and determine what is needed to provide the proper care and create guidelines that can be used for other areas, not just South America.

“The hope is that these guidelines will be shared with government officials who can begin to make changes,” Suarez said. “If these models work, models we have created through our partnerships with USFQ, Baylor St. Luke’s and Baylor College of Medicine, as well as our proposed guidelines for neurocritical care, we can expand these programs to other areas of the world with similar needs.”