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Cablegate: Nomination of Foreign Vip for Medical Care

VZCZCXYZ0019
PP RUEHWEB

DE RUEHLP #2424/01 3171415
ZNR UUUUU ZZH
P 121415Z NOV 08
FM AMEMBASSY LA PAZ
TO RUEHC/SECSTATE WASHDC PRIORITY 9204
INFO RUEKJCS/SECDEF WASHINGTON DC//ISA/OASD (HA)//

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

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