The history of neurosurgery in Bolivia and pediatric neurosurgery in Santa Cruz de la Sierra.

We have an enormous technical gap with other developing countries because of the following: (1) there is not a good universal health system; (2) the prehospital system or paramedic system does not work properly because there is no good organization or not enough human resources or well-appointed ambulances; (3) there is an evident trend to centralize health care services to the larger cities; (4) there are not enough neurosurgical beds in hospitals and intensive care units; (5) there are neither proper surgical instruments nor modern diagnostic or therapeutic equipment, such as laser surgery, neuronavigation, ultrasonic aspirators, or gamma knife; and (6) in many cases, we still depend on national or international cooperation.

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