Surgery in South Sudan: Support Services Make All the Difference

CYNTHIA GREGG, MD
FACE & BODY SPECIALISTS

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CYNTHIA GREGG, MD, FACS
FACE & BODY SPECIALISTS
Cynthia Gregg, MD, FACS
Cindy Wu, MD
3550 NW Cary Parkway
Suite 100
Cary, NC 27513

“Nothing more clearly illustrates the importance of supportive technologies and protocols to the success of the surgery I do,” observes Dr. Cynthia Gregg of Cynthia Gregg Face & Body Specialists, “than my experiences in South Sudan. In my Cary office, we are wonderfully equipped with the most advanced tools and facilities for our work. Contrast that with the situation in Juba, where three surgeons share a makeshift operating room, supported by a generator, to provide cleft-lip surgery. On this last trip, we served 84 patients in a week, ranging from a three-month old to a man in his 60s.

“What the South Sudan trip reminds me, is that successful surgery demands much more than equipment, facilities, and a surgeon’s skill. There are so many other things that support the process. Pre-op planning and preparation, and post-operative care—including everything from medication and nutrition to pain management—are essential. And technological advances not only in tools, but in anesthesia and pain management are equally important.

Operating conditions are challenging: three surgeons work simultaneously in one room. “And, from time to time,” notes Dr. Gregg, “we cope with power outages!”
Dr. Gregg with one of her patients and his mother.

“And this network of support makes all the difference. We don’t benefit from all the tools available to me in Cary when in South Sudan,” she acknowledges. “But even there, it’s the support system that is key. A perfect example is the amazing advancement in anesthesia technology. For our work in Juba, we have to bring everything in—everything: medications, gloves, sutures, equipment. And now there are anesthesia machines that are completely portable—so small you can put them in a suitcase.

Dr. Gregg has for many years joined a surgical team sponsored and supported by Samaritan’s Purse that provides cleft palate and cleft lip surgery to patients in many parts of the world. She has worked in Kenya, and Bolivia as well as South Sudan. “It is a privilege and joy for me to do this work,” she says. “I am enriched with every experience.”

“And there are other non-technological forms of support. The infrastructure in South Sudan is terrible, so getting patients to the temporary hospital is a huge logistical challenge. To meet it, a team of missionary pilots arrange to fly patients in and back home from all over the country. “The situation in South Sudan is difficult,” she says, “and there are limits of what we can do (for example, we can only do cleft lip and not cleft palate surgeries). The actual procedures haven’t changed—what I do with my hands during surgery I have done for many years. But new technology and extraordinary support and planning are what allows me to be there and to do this gratifying work.”