NOMINATION OF FOREIGN VIP FOR MEDICAL CARE

UNCLAS LA PAZ 002424 SIPDIS PM/ISO FOR RODNEY BETHEA AND VAN MORFIT E.O. 12958: N/A TAGS: PREL BL SUBJECT: NOMINATION OF FOREIGN VIP FOR MEDICAL CARE REF: 03 STATE 161386 ¶1. Summary: Embassy La Paz proposes to send Mrs. Maria Elizabeth Espindola Mackay, wife of Bolivian Army commander General Freddy Mackay Peralta, to the United States for medical treatment under the guidelines of the VIP Medical Program (reftel). As per program guidelines, Charge d'Affaires nominates Mrs. Mackay for this program. Mrs. Mackay has been diagnosed with a brain tumor, an otherwise terminal condition that cannot be treated successfully in Bolivia. Doctors have told Mrs. Mackay she should seek surgery by the end of November. Post believes that during a time of otherwise deteriorating relations, facilitating this trip would help improve relations at the highest levels of the Bolivian military. The Mackays understand the VIP Medical Program will not pay for transportation or medical treatment. End summary. - - - - - - - - - - - - Request for Medical Care - - - - - - - - - - - - ¶2. Following is the information requested as per instructions (reftel): Name: Elizabeth Mackay, wife of General Freddy Mackay Peralta, Commander-in-Chief of the Bolivian army. Explanation: Mrs. Mackay is the wife of General Freddy Mackay Peralta, Commander-in-Chief of the Bolivian army. At a time when relations have deteriorated significantly between the U.S. and Bolivian governments, use of the U.S. VIP Medical Program to facilitate an operation not available in Bolivia could give a critical boost to our Pol-Mil and Mil-Mil relationships. General Mackay has at least one more year left in command, and an increase in our ability to communicate with him as leader of the Bolivian army during a period of intense civil unrest could prove invaluable. As per program guidelines, Charge d'Affaires nominates Mrs. Mackay for this program. Certification of Inavailability of Medical Care: According to neurosurgeon Carlos Sillerico of the Central Military Hospital in La Paz, Boliva, the medical equipment necessary to operate successfully on Mrs. Mackay's brain tumor is simply not available in Bolivia. When treatment was sought in Chile, she was informed the tumor could be removed, but she would almost certainly lose her vision in one or both eyes. Treatment in a civilian hospital in the U.S. would also be appropriate, but timing is critical, as the surgery needs to be performed by the end of November. It would therefore benefit both Mrs. Mackay and our relationship with the Bolivian military command if medical treatment could be facilitated via this program. Description of Medical Problem: Mrs. Mackay has been diagnosed with a brain tumor (hypophysis adenoma or pituitary adenoma),which if left untreated would first blind her and then kill her. According to a translation of the diagnosis, magnetic resonance imaging shows "an expansive tumor process of the hipophysis region compatible with the existence of a macro adenoma affecting chiasm in the patient without affecting the brain parenchyma." Also: "The skull base presents an expansion of the sella turcica (or "turkish seat"),visualizing in its interior a voluminous, ovoid image that extends from the interior of the turkish seat towards the chiasmic cistern in contact with optic chiasm without expansion toward the sphenoid plane or the retroclival region." Previous Treatment at a DOD Facility: Mrs. Mackay has not had any previous treatment at a DOD facility. Medical Records: Medical records will accompany Mrs. Mackay, in both Spanish and English translation. More information about Mrs. Mackay's condition, including the diagnosis, can also be sent via e-mail for review. Requested Timeframe: The neurosurgeon who examined Mrs. Mackay recommended surgery by the end of November. Treatment is expected to take one to two days, according to medical literature. Payment Confirmation: General and Mrs. Mackay have confirmed their understanding that the U.S. government will not assume responsibility for payment of medical, transportation, or any other costs incurred. Mission Point of Contact: Charles Sellers, Political Officer, is the POC at Post, and can be reached via e-mail at: sellerscr@state.gov or via phone at (591-2) 216-8057. URS