Innovative technology bridges training gap in global surgery
We caught up with trainee plastic surgeon Priyanka Naidu in Rwanda.
Q&A with Dr Priyanka Naidu
She’s from Cape Town, South Africa and completed her global surgical fellowship this year. Priyanka is now a medical advisor for Operation Smile and tells us what inspired her to become surgeon. We also asked her about her involvement in the Global Surgical Challenge and the development of an innovative virtual training app for surgical residents.
Q. Why did you choose plastic surgery as a specialty?
A. “I actually never wanted to be a doctor. I was training really hard to be a dancer but injured my knee quite badly when I was 17, and all those hopes and dreams were shattered, so I had started reimagining a different life for myself.
“My dad is an anesthesiologist and so medicine was second nature to me. It was my dance teacher who actually inspired me to think about a career in plastic surgery describing it as the perfect combination between art and science.
“And it just so happened that when I joined med school and started interacting with patients it was something I really loved. So I think my choice in career, my choice in plastic surgery really found me rather than the other way around.”
Q. Who inspired you to become a surgeon?
A. “I’ve had so many great mentors over the years, with the ability to not only be great in the operating room, but also be delicate with their tissue handling and have great respect for their patients and the operation they’re doing. I’ve been so lucky to have so many mentors throughout my career who have taught me lessons about life, about surgery, and about being a good doctor and a kind person. “
Q. Do you consider yourself a role model for girls interested in a career in medicine?
A. “Oh, of course! I think every woman should see themselves as a role model for the next generation of women. I hope that I’m able to set an example for women who want to pursue a career in medicine and for little girls who are dreaming about it and may not necessarily have the opportunities to pursue it because of resource limitations and societal expectations. Pursuing a career in surgery, in particular, is something that, in South Africa has not always been easy for women. And so, just standing here today in front of you doing this interview is testament to the fact that it can be done, and I hope that I can be a mentor and role model to others, like the many mentors I’ve had in my career.”
Q. What would you say to a girl who would like to become a surgeon?
A. “I would say keep going. I’d say don’t conform. Don’t ever try to fit yourself into a particular mould, because surgery has traditionally been very male-dominated. I can’t even tell you the number of times people looked at me and said, “Are you really the surgeon?” or “You don’t look like a surgeon!” Society needs to be challenged to change their perception of women in surgery and to embrace the rise of women in global health. This can only be done if we continue to push the limits of what has traditionally been possible. Our work is not done. The world is changing. We need more women in leadership positions to be able to understand the environment and how we can make it conducive to reducing challenges and barriers for women in medicine, and surgery, but it’s happening. Change is definitely coming. So, keep going, keep pushing. It really is an incredibly rewarding career, and you can do it! “
Q. What do you think are the barriers for women in medicine?
A. “I think it’s perception. Perception definitely is the greatest barrier. As I was mentioning, your patients not seeing you as the surgeon, other surgeons not recognizing or respecting you as a surgeon, your capacity to perform being judged on the basis of gender. Changing those perceptions not only amongst providers, but your patients is crucial.
“I think that’s why I’ve been so proud of the Operation Smile Women in Medicine Initiative, because it’s just been an incredibly powerful platform to be able to inspire individuals. Be able to really show patients that you could have an entire team of all women health care providers, that your providers are just as good as the male providers! And change those patient perceptions, but also encourage the mentorship and the leadership that I’ve received from so many women and men in my own career. “
Q. Tell us more about your time as a Global Surgery Fellow, what did the experience mean to you?
A. “Wow! I mean, you can bring me to tears with this question. The Global Surgery Fellowship came at a time in my life when I really needed to be inspired again and to be reminded why I chose this career. I had started general surgery in South Africa. It was a particularly grueling environment. There’s a high burden of trauma in South Africa and dealing with these injustices daily can wear you down and sometimes make you lose faith in humanity and struggle to see the kindness in the world.
“It just seemed a long, arduous path to where I wanted to be in plastic surgery and working with children. Fortuitously had met two previous female global surgery fellows in the programme, Caroline and Naikhoba who have been such inspirations in my life. Through them, I got to meet Dr. Billy Magee who has been an incredible mentor to me.
“And in those two years, I got to work with some of the most inspiring people from all over the world, people who weren’t only bringing challenges to the table, but had really innovative solutions to improve surgical care across the world.
“It’s been an incredibly inspiring journey and I know it will forever live in my heart. Being in Rwanda, just seeing it all come together and all the hard work of our local team, it makes me so confident in the future of Africa and our ability to achieve increased access to safe surgical care for our people.”
Q. Can you tell us about the Global Surgical Challenge? Why is virtual training for surgeons so important?
A.”Well, being a surgeon in Africa or a surgical resident in Africa, I know first-hand how difficult it can be to get the kind of education you see in the United States, England or Europe. It’s not only difficult, but it’s expensive and that kind of education is just not accessible to so many in Sub-Saharan, Africa.
“So, the global surgical training challenge is really about developing creative, innovative but affordable ways to break down those barriers to knowledge sharing, and really make education accessible to the people who should be empowered to provide it.
“We have an incredible team of surgeons, technical experts, policy advisors from all over the world, as well as Operation Smile, and advocates who’ve come together to really support this work. And as a result we’ve developed a virtual training app that is downloadable on all devices. The app functions in very low Wi-Fi and it teaches residents how to do local flap surgery. Right now, that’s a huge, huge burden in Sub-Saharan Africa, for big cancers and traumas.
“To give you an example, a little child who’s been really badly burnt on their arm who develops a contracture decreasing range of motion in that arm is incredibly debilitating for that child who may not be able to attend school, may struggle with their milestones and development, and as a result may not have the same opportunities to grow as other children. They might not be able to use that arm and might not be able to ever find employment because of a condition that could be so easily corrected. The surgery itself is simple, but there are principles to performing the surgery successfully that you must know. This app really is a way to teach step-by-step how to do what we call a Z-plasty – which is a form of local flap surgery – to release that contracture so that they have full function of their arm again. Something like that can be done in a matter of minutes, life-changing for a child.
“So, I’m proud of it. I know that the team is so incredibly proud of that work. We’ve developed a physical simulator to go along with it that can be built with materials easily sourced in-country. This is a huge win for Sub-Saharan Africa and hopefully for other low-resource settings, too. In some cases, a textbook costs as much as what a surgeon would earn in a month in Sub-Saharan Africa. Just putting that into context, this is a huge win, and we can’t thank the organisers of the Global Surgical Training Challenge enough for putting resources towards something so important and inspiring others to be creative.”
Q. What are your goals for the future – what’s next for you?
A. “So I finally just got into a plastic surgery training programme in the United States. It’s been incredibly difficult for me to get a training post in South Africa, as we just have such limited training posts, and I finally got a post in the United States. It is a dream I have been working towards for many years, and it took a village to get me here. I truly could not have done it without my family, friends, and mentors who have been firm advocates and cheerleaders for me in my career. After my plastic surgery residency, I hope to pursue a pediatric craniofacial fellowship. It’s the type of training and all skill sets that I hope to bring back to the region one day and to be able to share with others and help to build hubs of excellence in Sub-Saharan Africa for reconstructive care delivery and encourage global education partnerships so that others may have the opportunities I have been so fortunate to have. So that’s next. Watch this space!”
Lives touched in Rwanda
For over a decade Operation Smile Rwanda has provided cleft care for thousands of patients.