A South African Doctor Finds Her Footing in a Turbulent Public Healthcare System

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Dr. Fanele Mdeltshe is now training as an ear, nose, and throat specialist in Johannesburg. (Photo: Megan Lindow)

Raised in a rural community, Fanele Mdletshe has fulfilled her childhood dream of becoming a doctor and helping those in need. 

This article is part of a series exploring the transformation of African women's lives through education.

Fanele Mdletshe has always dreamed of becoming a doctor. Her early childhood was spent in a deeply rural community nestled in the rolling green hills of KwaZulu-Natal, South Africa. She grew up swimming in the rivers, attending the same primary school her mother had attended, studying by candlelight, and helping her grandmother plough the family plots of maize and vegetables.

“She was a hard-working woman,” Fanele recalls, speaking of her grandmother. “She didn't go to school, she was a subsistence farmer. She had this huge plot where she would farm different things to sell each year. She would give me a little stipend so I would have money to spend at school.”

At age 12, Fanele went to live with her maternal aunt, a teacher, just outside of Durban, so that she could attend better schools and serve as a role model to her younger cousin. In that household, Fanele matured on a steady diet of serious study and rich political discussion. Her uncle introduced her to Chinua Achebe, Chris Hani and other eminent African thinkers and writers. Fanele took well to her studies. She became a model student, and in her penultimate year of high school her principal told her about the scholarship program funded by Carnegie Corporation of New York.

“It requires a lot of you, emotionally and physically. You become wiser, you become more compassionate, you understand people’s pain.”
— Fanele Mdletshe

Pre-selected for the scholarship, and subsequently admitted into medical school at the University of KwaZulu-NatalFanele had been handed the keys to a new life. She, her family, and her community were overjoyed. “My school principal was like, 'Go for it, you are definitely going to be great at it.' My biology teacher was like, 'This is our future doctor.' Everyone was on the program,” she recalls. “It was the happiest time of my life.”

For Fanele, university became a time of finding her feet and growing as a person. While she continued to maintain focus on her academic achievements, she also came into her own.  Other aspects of her personality found expression and flourished. “I think university allowed me to know myself, and what I'm capable of as a person,” she says. “I was head girl in high school, but I really didn't feel like my leadership potential was realized earlier. I was very meek and quiet, I think partly because I came from a household where we were taught to wait your turn, speak when spoken to. I mean, I used to have those little bursts of wanting to speak out against things I thought were unfair. I was very political about washing dishes, so they called me Nkosazana Zuma." (A joke, referring to a South African politician).

Fired up by the earlier discussions she’d had with her uncle, Fanele thrived on student politics. She served as the deputy president of the Student Representatives Council, and volunteered at a student-run health clinic in a nearby underprivileged community. Working in the volunteer clinic appealed to her sense of justice, and reminded her of her roots. In student life, she relished every new opportunity to learn, challenge herself, and grow.

From the University of KwaZulu-Natal, she went on to complete the mandatory two year stint for all newly qualified South African doctors in the public healthcare system. Throughout these two years she found herself working in some tremendously challenging rural hospital environments, after which she moved to a tiny rural hospital not far from the Mozambican border.

“There were like 10 doctors in the whole hospital," she recalls. "It was a very interesting time, working under pressure, working without supervision, working without supplies. I remember I cried one day, I had this 19-year-old patient who had eclampsiaEclampsia is a treatable disease, nobody has eclampsia anymore. This woman died at the (hospital) gate, because they had taken a day and a half to bring her."

As the only doctor on duty, she would often find herself having to deal with situations beyond her level of experience. Obstructed labor, breached deliveries, no matter what the situation, she rolled up her sleeves and got on with it as best she could. "These things used to get to me so much. I realized, it's very difficult to change the system. It's a political issue," she says.

Today, Fanele is based in Johannesburg, working toward the completion of a master’s degree in medicine. She’s training as an ear, nose, and throat specialist, and eventually, hopes to make her career in this field as a pediatric ear, nose and throat specialist.

She summarizes her experience: “Working in the health system is a challenge that not only grows you professionally but matures you as a person as well. It requires a lot of you, emotionally and physically. You become wiser, you become more compassionate, you understand people’s pain. You understand that a person is a lot more complex than just a physical self, and you understand that life is more complex than just offering medication.”

The experience has inspired her to keep learning and growing. “It’s made me want to do more and more, and it’s made me want to grow more and more,” she says. “So I’m in the process of doing things that will make me grow.”

Megan Lindow is an award-winning writer based in Cape Town, South Africa. She is a former Africa Correspondent for the Chronicle of Higher Education and the author of Weaving Success: Voices of Change in African Higher Education, the story of a major 10-year initiative investing in African universities.