On-line version ISSN 2078-5135
SAMJ, S. Afr. med. j. vol.101 n.12 Cape Town Dec. 2011
Ubuntu values lived out by rural award winner
A happy disposition, an accepting attitude, and an innovative community-orientated work ethic that enrolled thousands into being tested for HIV and hundreds benefitting from early treatment have garnered Nigerian Dr Kolawole Adigun South Africa's Rural Doctor of the Year award.
Since arriving in South Africa in 2004 and being posted to Bethal Hospital in Mpumalanga Province, the specialist haematologist and blood transfusion expert has added family physician specialist training to his CV, but it's his blueprint for community-orientated primary healthcare that has impressed his peers. While the national Department of Health is finally punting this approach as a top solution to the current primary healthcare delivery woes (and a vital part of the future national health insurance system), Adigun began trailblazing in Mpumalanga two years ago. Working across the 10 'cluster zones' in the wider Govan Mbeki Municipality, he enrolled elders, pastors, imams, police services, sangomas, school principals, health circuit managers and school pupils into his vision, using commercial sponsors to provide food and clothing gifts to incentivise HIV testing and treatment. 'We went to businesses one by one, shop by shop,' he said. An international fast-food franchise owner in Secunda provided food packs to Adigun's field workers, a local printer donated 250 000 HIV-test questionnaire papers, another gave specially printed T-shirts and surgical face masks, while a major bread manufacturer provided loaves of bread for hungry test candidates.
'Honesty of purpose'
'When people saw our actions and realised we were genuine, everybody jumped on board. There was an honesty of purpose,' Adigun told Izindaba. The message was 'Get tested and get bread and a T shirt. Get 10 other people tested (i.e. thus becoming an HIV test 'Ambassador'), and get yourself a winter jacket.' Launched in May last year, the campaign now has residents, healthcare workers and community leaders coming in droves. 'We do it for farm labourers, township dwellers, school kids and hospital staff. Even the CEO of Evander Hospital here has been tested. People now thank us for saving their lives,' Adigun said. Asked if his being a foreigner had ever proved to be an obstacle, his response was immediate. 'I was born in Nigeria quite by accident. I consider myself a citizen of the world. That is my outlook. I approach people with respect - everyone in Africa understands that. I respect culture and see people as human beings, both white and black. That is how I was able to break down the cultural barriers and penetrate deep into the society. You can see the joy. I can't describe their faces. They are able to tell me the problems of their community. When I see people, I smile and that makes where I come from irrelevant.' Adigun, 46, says his wife, an accountant, with whom he has four children ranging from 7 to 11 years old, is his biggest motivator.
Sponsored by the HIV Clinicians Society and Africa Health Placements (the leading healthcare staff recruitment NGO that consistently outperforms its public sector counterpart), the prestigious award recognises doctors working at the coalface who have made a significant contribution during the previous year. It was named after Dr Pierre Jaques, a doyen of rural practice in South Africa, who spent most of his working life at Elim Hospital, Limpopo Province, where his father before him had worked, and who has been a tireless advocate for rural doctors. Ironically, the first-ever recipient (2002), Dr Thys von Mollendorf, was a victim of the then AIDS denialist Mpumalanga health department in February of that year. Its maverick health MEC, Sibongile Manana, fired him as superintendent of the Rob Ferreira Hospital in Nelspruit. His crime was to allow the Greater Nelspruit Rape Intervention Project to use a room in the hospital for HIV post-exposure prophylactic treatment and counselling - without first asking head office. The finding by an internal hearing of 'gross insubordination' was declared null and void by the Public Service Health Sectoral Bargaining Council and the Mpumalanga health department withdrew all charges, agreeing to pay compensation, pension benefits and legal costs. Von Mollendorf declined to accept reinstatement and now works in the private sector.
Thankfully Adigun's current trailblazing meets with more support than resistance, epitomising the watershed change in attitude to combating HIV/AIDS across the country. Now a permanent resident, Adigun was nominated by the Mpumalanga Department of Family Medicine.