IZINDABA

 

Improving lives on borrowed time - Andrew Wilkins

 

 

Madwaleni Hospital family physician, Andrew Wilkins, 35, made it his business to 'find the gaps and qualify himself to fill them,' achieving in his 9 years at the deep rural hospital what few clinicians do in decades.

That he won Rural Doctor of the Year at last year's rural health conference in Pietermaritzburg, while his speech therapist wife Sarah won Rural Therapist of the Year, speaks volumes about their partnership in rural life and healthcare. It's the first time a husband-and-wife couple have won these awards in a single year. Their enthusiastically applauding conference colleagues were painfully aware that Andrew's humble and buoyant acceptance speech followed recent emergency surgery for a brain tumour. By the time he accepted the award (3 months after his diagnosis, and judged on merit alone by independent outsiders) - the malignant melanoma had metastasised throughout his body.

For the couple, their 6-year-old twin girls, Maddie and Josie, and year-old son Eli, the journey to Andrew's passing last November was marked by 'emotional intelligence, resilience and humour', say colleagues. The close-knit rural healthcare community across the country, his school mates, university colleagues and family and friends exceeded a ZAR1.5 million social media fund-raising treatment target (with ZAR1.98 million) within just 3 days of its 1 August launch. The target was based on anticipated medical expenses, including immunotherapy, a hugely expensive modality of last resort. The administrators took down the crowdfunding initiative when it reached ZAR2.048 million, the immune therapy having proved futile in the face of what his colleagues described as the most aggressive melanoma they'd seen.

The couple arrived as newly-weds at Madwaleni District Hospital, on the Wild Coast, some 100 km from Mthatha, in 2016, and lived in a spare room of the hospital's then Chief Clinical Officer Andrew Miller for 4 months until accommodation became available.

'They quickly sought to make deeper impacts on local communities, setting up NGOs, with Andy specialising and qualifying cum laude in family medicine, despite being the lone registrar at Madwaleni,' said Miller at the gala banquet award ceremony.

Wilkins did such a great job at teaching others how to do tendon repairs, skin grafts and anaesthesia that Madwaleni became a referral centre for other local healthcare facilities battling scarce human and equipment resource shortages.

Adds Andrew Miller, 'He worked with IT specialists in schools and did screening for bilharzia, which we know can cause anaemia, with those children ending up with learning difficulties.'

Andrew and Sarah worked with a local NGO, launching a First One Thousand Days maternal care programme, with Andrew pursuing his passion for versatile point-of-care ultrasound, a diagnostic boon for young doctors taught how to use it properly.

Says Miller, 'We've had a lot of good people at Madwaleni, and Andy was one of the best, an all-rounder who really got things going, bringing higher standards in emergency medicine, obstetrics and surgery.'

Miller says his namesake, who everybody expected to take over when he moved to KuGompo City (formerly East London) in the interests of his teenage children's schooling, identified family medicine as the best way to meet the hospital's needs.

Wilkins began the hospital's family medicine teaching programme through Walter Sisulu University's four campuses at Mthatha, Butterworth, East London (Buffalo City) and Komani (formerly Queenstown), under the trailblazing Prof. P Yogeswaren, with Dr James Porter, his mentor, and working alongside close friend Dr Stuart Poole.

When the first higher-paid family medicine post at Madwaleni opened, Andrew stood back to allow a much-needed extra hand at the hospital. Family medicine registrars, however, continued to flow through the hospital under his guidance.

 

 

'Wherever there was a need, it became his passion. He loved working with his wife. Anything that was her passion became his project, like the neonatal feeding they began - it was very special,' says Miller.

He adds, 'It was Sarah's dream to work in a rural hospital. Andy was unsure, but being so humble he followed her lead, and very quickly realised that it was his dream too.'

Miller cites the early childhood development centre that Sarah began with the Layita (Light Up) Foundation, which has since gone national. Sarah also set up a breastfeeding support project, with two full-time counsellors helping mothers at the hospital with contraception and feeding choices.

Her award citation reads, 'Sarah exemplifies rural health excellence. She is visionary yet grounded, compassionate yet strategic, and always dedicated to lifting others up. Her leadership has brought hope, systems change and meaningful development to the Madwaleni catchment area.'

She led the rehabilitation department and pioneered sustainable community-rooted programmes, strengthening interdisciplinary collaboration.

Another colleague said that Sarah strengthened rehabilitation services while fostering a high standard of multidisciplinary and patient-centred care, 'mentoring and valuing each team member's scope of practice and encouraging ongoing skills development and creative thinking, embedding medical officers into a variety of rehabilitation groups to ensure co-ordinated and collaborative patient outcomes. This helped broaden the medical staff's understanding of the rehab role, and improved referral systems and team dynamics.'

The Layita Foundation does innovative early literacy work in 120 local early childhood development centres. Sarah has also established a children's library at Madwaleni to promote a culture of reading. Andrew, a passionate, erudite speaker, led the Christian church at Madwaleni for the past 6 years, Sarah adding that the 4 years he spent studying family medicine 'without doubt made him a better father, husband and person'.

A Madwaleni nurse summed up Andrew's 'essence' thus: 'I think one thing that marks Andy is his kind face and greetings. When you meet him, it's almost as if he presents life with the essence of Ubuntu. He makes such an effort to try and understand people and each of their relevant cultures and beings, to really hear them and come with a solution which is relevant to them.'

One award joint nomination read, 'Together they exemplify the creativity, compassion, grit and excellence vital to rural healthcare, qualities we honour in this nomination.'

Concludes Miller, 'Andrew was someone who maybe made the rest of us all feel a bit jealous. It's incredible how he was able to maximise his short career, despite being a junior doctor - and in just 9 or 10 clinical years. There were only 3 months at the end when he was too sick and couldn't work. He managed to mix being a doctor and a social activist, and always found where he could make the most impact. His life/work balance was phenomenal, being a one hundred percent husband, dad and family physician. There was no compromise in his life. I'm just grateful that like many rural doctors, the first dozen or so years were the most significant of his life. It was a short, amazing career.'

C Bateman

Former news editor, Izindaba, South African Medical Journal (2000 -2016); freelance healthcare writer, www.thrive2write.co.za ciffbat@thrive2write.co.za