How did Kokila Lakhoo, a woman of color who grew up under apartheid, become one of the first female pediatric surgeons in Africa?

Born in South Africa, Lakhoo is now a consultant pediatric surgeon at the Children’s Hospital in Oxford and the University of Oxford in the U.K. In addition to neonatal surgery, her interests include global health, prenatal counseling, and pediatric tumor surgery. She is the editor of several textbooks, has contributed to more than 70 chapters in pediatric surgical texts, and has written more than 300 peer-reviewed publications. Hers is a powerful story from the diaspora: her journey to becoming a pediatric surgeon, achieving international recognition, and giving back to the continent’s next generation of physicians.

Kokila Lakhoo performs an abdominal cyst biopsy in Dar es Salaam, Tanzania, where she is leading the development of pediatric surgery services. (Photo: Kokila Lakhoo)

“I grew up in a tiny hamlet in South Africa,” says Lakhoo. “I lived with my extended family, and my grandmother was a self-taught health worker. She dealt with childbirth, sprains, and minor wounds.” In apartheid, there was no facility for people of color in remote areas to receive medical care, she says. “I saw her work, and I got interested in the joy and appreciation of the people that she looked after."

Under apartheid, there were also no schools in small towns like hers for nonwhite children past the age of nine. So Lakhoo was forced to leave her family and move to Pretoria alone to continue her schooling. “My family had no money,” she explains, “but they cared about education.” Though difficult, the experience of leaving home by herself at such an early age made her “very independent,” she says.

Later, when Lakhoo decided to pursue a medical degree, she found that her choices were limited to black medical schools. After that, she found that “black hospitals were run by black doctors, who all had gone abroad to get training,” she explains. “They had studied in countries where there was sympathy toward working against apartheid.” Even after completing her medical education, Lakhoo was given low status and little guidance. She was sent to Baragwanath Hospital in Soweto for further training, but also made the effort to attend monthly state-of-the-art lectures at the University of the Witwatersrand — a 70-kilometer trip. She was forced to sit in the back of the lecture hall. “Surgery was for white males,” she says. “We were invisible.”

To ensure that she received world-class training, Lakhoo left for a yearlong fellowship in London, at the Great Ormond Street Hospital for Children. When she returned to Johannesburg, however, “It was a really rough time in South Africa,” she says. “Some of my colleagues were murdered or hijacked … some in the hospital.” By that time, Lakhoo was pregnant, and she learned that Oxford was looking for someone with her experience. So, for the sake of her family’s safety, she immigrated to England — and thus became part of the African academic diaspora.

With support from such organizations as Carnegie Corporation of New York, Kokila Lakhoo and other alumni from African institutions are bridging gaps in important ways.

The term “brain drain” is often used to describe the loss of highly trained individuals from less-developed regions such as Africa, who relocate to economically advanced countries. Although these successful graduates have left their universities behind, many maintain strong connections with them and feel strongly motivated to give back. And with support from such organizations as Carnegie Corporation of New York, Kokila Lakhoo and other alumni from African institutions are bridging gaps in important ways.

“It’s ‘brain circulation’ as opposed to ‘brain drain,’” says Claudia Frittelli, Carnegie Corporation of New York program officer for Higher Education and Research in Africa. “Lakhoo is able to do so much because of her international experience. But today, instead of leaving their home countries, highly skilled graduates can have contacts all over the world. They can stay in Africa because of their networks with leaders in their field.”

Higher-education enrollment in sub-Saharan Africa has grown nearly fivefold in the past several decades, and today South African universities function as training hubs for academics throughout the continent. At the same time, graduate school enrollment in South Africa has more than doubled, and the country’s universities no longer have enough staff with doctorates to train this new generation. But diaspora programs supported by the Corporation are helping in key areas: graduate supervision and training, use of laboratories and equipment, and access to research funding and collaboration, to name a few.

Support for Kokila Lakhoo’s work came via the University of the Witwatersrand (“Wits”) Health Sciences Research Office (HSRO). Established in 2010, and funded in part by Carnegie Corporation of New York since 2014, the Carnegie-Wits Alumni Diaspora Programme stimulates research collaboration among leading health sciences alumni working in academic institutions abroad and their counterparts at Wits. So far, the program has developed exchange partnerships with universities in England, Australia, New Zealand, and the United States.

“In most cases, visiting alums do much more than come back for one trip,“ notes Frittelli. Long-term linkages formed at Wits have led to the coauthoring of articles and manuscripts, the acceptance of joint abstracts at conferences, joint grant proposals, guest lecturer visits and seminars, access to laboratories for testing purposes, and more. One growing partnership with U.S.-based Wits alumnus Roy Zent, vice chair for clinical affairs at Vanderbilt University Department of Medicine, has supported visits to Wits by Vanderbilt students, researchers, and faculty, as well as reciprocal visits to Vanderbilt by Wits personnel, collaborations in various medical fields, and even support for a medical bioinformatics system at Wits.

The Wits diaspora story started in South Africa, but it doesn’t end there. When a baby girl living near Oxford, England, developed a disfiguring facial birthmark that grew into her eye socket and threatened her sight, Lakhoo, by this time practicing in Oxford, saved the child’s eyesight and restored her perfect appearance. But a baby in Kigoma, Tanzania, far from the capital, born with a life-threatening tumor can be saved too, thanks to Lakhoo’s efforts in leading the development of pediatric surgery services throughout the country, which previously did not have a single pediatric surgeon.

“Once my children were out of the house, I could do global work,” Lakhoo says. For the past 16 years she has spent her vacations training surgeons from all regions of Tanzania, where the profession had not previously existed. The above scenarios illustrate more than the accomplishments of one woman; they demonstrate the immense global potential of African diaspora networks.

“Kokila Lakhoo serves as one example of a scholar giving back to another whole country and saving multiple lives every day,” Frittelli says. In South Africa in 2018, in an especially gratifying example of giving back, Lakhoo delivered a state-of-the-art lecture at Wits titled “Pediatric Surgery, Then and Now” — in the same auditorium in which she had previously been made to sit in the back.

Read more stories like this in the Carnegie Reporter