‘Had I not been who I was, I could have died’

A doctor who started in a managerial position just as the Covid-19 pandemic began talks about surviving the virus and what needs to be done to improve South Africa’s unequal health system.

Starting a new job is generally challenging and stressful. But doing so in the medical field at the onset of a global pandemic that has changed the world adds a few extra layers of stress and anxiety.

However, Lehlohonolo Majake-Mogoba, 39, a public health specialist and the operations manager at a private hospital in Pretoria, has taken it all in her stride, running the hospital, looking after nearly 200 staff members and taking care of her family. 

It’s been a little over a year since Covid-19 first arrived in South Africa with the first case identified on 5 March 2020. Since then, more than 52 000 people have lost their lives to the coronavirus and more than 1.5 million people have been infected by it. But the impact of the virus has been much bigger, with the economy rocked and thousands of people losing their livelihoods.

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During all the uncertainty and fear of the virus, it has been frontline workers like Majake-Mogoba who have had to make huge sacrifices to continue going to work every day and ensuring people receive the treatment they need and the hospital runs as it should. 

A year ago, few people would have anticipated the effects that the pandemic would have on the world. “I think it was quite horrific, to put it quite mildly. It initially felt like something that was happening from afar,” said Majake-Mogoba, sitting in the living room of her home in Pretoria. 

“The next thing you know it starts spreading, so now you start getting scared. Before you know it, you have a national address declaring it a national state of disaster and everyone is told to rather stay at home – and you are expected to go to work.”

While many people were able to stay home and practise social distancing, people like Majake-Mogoba had to continue going to work and facing the virus head-on. “You associate Covid-19 with death, and I remember one of the first things I did was send someone a WhatsApp saying I don’t even have B3 [funeral cover],” she said. 

“You’re already in that state of mind where you’re going to die, so you have to prepare for death. There is nothing worse in life than facing death or the potential of death, and there is not much you can do about it,” she said. “What if I get it, what if my parents get it, what if my husband gets it?”

Unfair advantage 

Majake-Mogoba did eventually get the virus. She said her experience of battling Covid-19 herself once again drove home the inequalities in South Africa and its healthcare system. “It was horrific. It was very scary. I don’t once take for granted that I had access to all the resources I needed when I needed it,” she said. 

“Healthcare shouldn’t be that way. It shouldn’t be that you have access to things so your life is better. Had I not been who I was, I could have died. That is incredibly sad.”

Majake-Mogoba’s husband and two young children were able to move out of their home and stay with family while she battled Covid-19 alone. “You are terrified, but you also have that need to protect your family. So do the risks outweigh the benefits? Do the risks of them getting it and dying because you just don’t know outweigh the benefits of you feeling comfortable? Absolutely not. Let’s try and contain this and not make this a familial crisis.”

While Majake-Mogoba has managed to avoid her family getting Covid-19, she said one of the biggest challenges over the past year was taking care of them. As the primary caregiver of her children, she had to come up with new ways to keep them entertained, celebrate their birthdays and learn along with them as they did their schooling from home through videos. 

For Majake-Mogoba, the pandemic has exposed the problems with the healthcare system in South Africa. “The reality is that if there’s anything South Africa can take from this and the world can take from this, it is that we really need to bolster our health systems. We need to bolster our primary healthcare.”

19 March 2021: Lehlohonolo Majake-Mogoba chats with a newly admitted patient at the Pretoria hospital where she is operations manager.

No excuses

In impoverished areas in South Africa, quality healthcare is either unavailable or too far away, needing money that patients don’t have to go to hospitals in urban areas. “I don’t think we should be there, not in this day and age. There is no excuse for where we are,” she said. 

“I just think for the longest time health has always been seen as a social duty that can be done if the resources are there. Without health, and Covid has shown us, it can destroy an economy. People have died, people have become sick, people couldn’t work, and the systems couldn’t catch Covid fast enough and it spread and it shot the economy. That absolutely needs to change.”

While some people might shy away from being on the front line when they work in a managerial role, Majake-Mogoba said it was impossible for her not to get involved. “As a medic, it is very difficult to be a manager that’s not hands-on because you have that medical background,” she said. 

“You are always going to be involved. I think that’s the double whammy of being a manager who is a doctor. I think the difference is one wouldn’t have to focus so much on the mental wellbeing of the staff because that is quite big.”

19 March 2021: Lehlohonolo Majake-Mogoba chats with some of the staff of a designated Covid-19 ward.

Despite having counselling and debriefing programmes in place for staff at the hospital, Majake-Mogoba said the effects of working strenuous, long hours day in and day out during the pandemic had left their mark. “The debriefing sessions we have are nowhere near enough to scratch the true depth of the frustrations people have felt. The scars are going to be there lifelong, because you deal with patients and losing patients is hard enough, but you lose colleagues, you lose loved ones.”

While the daily numbers of new cases are currently low compared with those during the second wave that hit South Africa over December and January, Majake-Mogoba said healthcare workers were bracing for the inevitable third wave of the virus, especially as many people had let their guard down since the easing of lockdown restrictions. 

19 March 2021: Lehlohonolo Majake-Mogoba relaxes at home after a long day at work.
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