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