Vital

News & commentary about the global health workforce
Vital Home

A Physician’s Dispatch from KwaZulu-Natal

In honor of World Health Worker Week 2018, health workers from around the world are telling us what it's really like on the front lines.


What’s it really like providing health services on the front lines?

This week, frontline health workers from around the world are answering that question on VITAL, in honor of World Health Worker Week 2018.

It’s grueling, they say. Sometimes exciting. Gratifying. Heartbreaking.

Here they’ll tell us more about the clients who’ve moved them, and the unseen triumphs and tragedies that keep them coming to work each day.

Our first story is from Sanele Madela, a physician from South Africa and founder of Expectra 868 Health Solutions. Today he’s using his story to advocate for policy changes that could expand access to health care in his community and in others like it. 

A physician’s dispatch from KwaZulu-Natal

I grew up in the dusty streets of KwaZulu-Natal in South Africa. We had a population that was previously disadvantaged in South Africa and, up until today, part of that population is still disadvantaged.

We played on the streets with the other kids in the community. And there was one young girl—a neighbor who was a little older than me—she had health problems that we could not understand as young kids.

One day I came back from school and there was a group of ladies, including my mother, sitting around the girl’s house gate, and people were coming in and out of the house.

I was shocked to find out that the little girl had died. We were just playing the other day. And she was sick, but I never saw her go to the hospital.

Later, I got a scholarship from the government of South Africa to go and study medicine in Cuba. I got the shock of my life to see that the population in Cuba was almost the same as the population where I grew up—they were just as disadvantaged, but they had access to health care, and that was a huge difference.

I wanted to contribute to my country's access to health, and to the quality of health care available there. So, in my third or fourth year at medical school in Cuba, I started an NGO called Expectra 868 Health Solutions. Back in South Africa, by the second year of its functioning, it employed about 97 people. I became accredited to train community caregivers, to work in the community, and profile the community the way I was taught in Cuba.

For many, it is the first time they’ve seen a doctor, been touched by a doctor.

Later, I got a grant from Medtronic Foundation and their HealthRise program, and was able to amplify what I had started by focusing on noncommunicable diseases, or NCDs, and offering screening, diagnosis, management, and care for NCDs.

HealthRise has been a game-changer in these communities. For many of these patients, it is the first time they’ve seen a doctor, been touched by a doctor—you can see in their eyes what the HealthRise project has done.

For me as a doctor, seeing people—no matter how poor—gain access to health care was the most important thing that has happened in my life. No one should die just because she doesn't have access to health care.

Read more posts in this series. Watch Sanele's video and others like it. And join the conversation online: #HealthWorkersCount #WHWWeek

This post is based on Sanele’s talk at SwitchPoint 2017, which was the first time he shared this story with a wider audience.  

This storytelling initiative is a collaboration of IntraHealth International and Medtronic Foundation.