Dr Thandeka Mazibuko, Specialist in Radiation Oncology, Founder, Sinomusanothando Community Development
Words of Wisdom: “You are gold. You are precious, intelligent. You’re beautiful don’t let anyone convince you otherwise. We are the rock of our nation.” – Dr Thandeka Mazibuko
Interview with Dr Thandeka Mazibuko, Specialist in Radiation Oncology, Founder, Sinomusanothando Community Development
Dr Thandeka Mazibuko, Specialist in Radiation Oncology, Founder, Sinomusanothando Community Development
Dr Thandeka Mazibuko, specialising in Radiation Oncology in Kwa-Zulu Natal, South Africa and is the founder of Sinomusanothando Community Development that advocates for cancer awareness in the rural areas and townships, she is using her government salary to keep this NGO active. As a medical doctor born in the rural areas of Kwa-Zulu Natal, she could not sit back and watch rural communities presenting with very late stage and incurable cancer related advanced disease in KZN hospitals. Sinomusanothando Community Development is a non-profit non-governmental organization whose vision is to facilitate the realization of the potential of individuals and communities and enhance their ability to improve their health and quality of life in a democratic society. She focuses on breast, cervical and prostate cancer, and HIV and Aids, through her organization. It was founded in 2004, registered in 2007 aiming at preventing the escalating morbidity and mortality caused by cancer related diseases.
The NGO provides education in the form of school visits and cancer awareness walks, free screening for cervical cancer, breast cancer, prostate cancer and AIDS-related cancers. It also provides follow up for those already diagnosed and on treatment. These are preventable cancers if patients screen and present to the health facilities, they have good outcome and long survival rates. We cannot sit back and watch our communities die in numbers, while they presents with foul smelling ulcerative diseases, presenting with wounds infested by worms, coming out of their bodies. Nobody deserves that.
Dr Mazibuko the first Black student accepted to specialize in radiation oncology in KwaZulu-Natal. She has been nominated by Oprah to be her Heroine of the Month in 2010. She has also been nominated by Checkers as one of the candidates for Woman of the Year, as she continues to do charity work with her NGO to raise funds for orphaned children.
Dr Thandeka Mazibuko, Specialist in Radiation Oncology, Founder, Sinomusanothando Community Development
Note: The key messages in the interview have been transcribed and slightly altered for legibility and succinctness. More information is provided in the audio and video version above. Please comment on the site, we want to hear your wisdom!
What was the catalyst for working in the rural communities and donating time to women with cancer?
They say you don’t choose where you are born, but your birth chooses you. This is where I find myself as a woman who says, I will make it. Poverty, I will beat it. Literacy, I will prove it wrong. I am a rural child and I can succeed.
Lets talk about you being a rural child. I think a lot of people think that we are a product of your circumstances, which can be very limiting if that is the case, what are your thoughts?
It is all in the mind. It begins in the mind and ends in the mind. You have the power over your mind. Allow your vision that you set in your own private space to be released and you will beat the odds. You see it; you believe it; you do it now. Don’t wait. You do it with maximum effort.
You have no guidance, no money and no opportunities. Even if you have capabilities no one believes in you. It takes double the effort, double the time, and double the amount of energy. Not to mention, more sacrifice. These are the characteristics that have pushed me. I don’t set limits for myself or I am controlled by the vision not the lack of ability.
Is there someone along the way who helped you see the bigger opportunity?
It has been all by coincidence. Being a Christian, I believed in Gods plan. When he says: “I knew before you were in your mother womb, your future was planned.” I believe I am walking in a path like I’m blindfolded, but I am going somewhere. I only see the achievements when they happen. I never anticipate.
Even when I was young doing homework, not knowing homework would help me become a Doctor. It was a vision to become a Doctor but it was not possible. For me it is about having a strong and sound mind. But mostly it was mother prayers. I believe our mothers should be behind children and her prayers have gone a long way.
Starting an NGO can be challenging? What are some of the biggest challenges you have had establishing a NGO and how did you overcome them?
The challenges came in stages verses the inception of starting something. How did I even start an NGO as a Doctor? I always had the philosophy if I meet a challenge I must try and find a solution. I find myself in Medical school. My family doesn’t understand why it is taking me so long to finish.
They have expectations in the rural area that I am going to come back and be a GP. I am going to come back see patients and make money so we can build a bigger house. But when I was in medical school I realized that I am an intellectual, I like to read, study, my interest is in research. But that doesn’t bring money to table. Which means I am going to sacrifice a lot. So how do I cater to the needs of my community and cater to the needs of my academic side? I have these sides of me, one side is community oriented, and this other side that is built up that wants to know more and more.
I need something to bridge the two, which is why I created the NGO. This was to ensure I could study while giving back to the community. I have a responsibility to them. They made me who I am. They taught me to be the person I am. I owe something to them. But it didn’t begin as an NGO, but a charity from my heart.
I use to babysit a lot of kids, which was the way I would make small amounts of cash. I was collect 5R – 300 R and we use to throw a huge Christmas party in rural area. Then I started realizing many of these kids where living with their Grannies, as their mothers died of HIV or cancer. There are so many chronic diseases that are preventable and are killing the community.
As my career in medicine grew, my love for the community grew. The more I learnt, the more I wanted to share. People started to say: “You are doing the work, but you are not collecting the money, you need to be registered.” I didn’t want to register because we wanted to do more than Christmas parties and we started introducing story telling in the medical format. This is how it evolved.
Now that you have a registered NGO, what are some of the challenges of getting people onboard, and how did you overcome them?
As a women working in the rural communities you are not given a platform. If I am going to host an event on cancer awareness, I need to meet the Chiefs who are all men to negotiate to get the school grounds. To get that meeting is difficult. To talk to the Chief you need talk in a certain manner; you need to be submissive. Even though you are uncomfortable with certain things, or you have to say things in a certain way.
There is a mentality that an African woman will not be given the platform. As the leader and founder of the NGO it is strange that I need to educate them. I find that sometimes when educated women go back to the community, we are not wanted. It is difficult for us to get in. They think you know it all. They don’t realize what you are bringing to them. They think you are getting the benefit. These are the challenges we are faced with.
There are a lot of glory problems, where some people take the glory. If they see if it is starting to be successful they will prevent it no matter how much it is needed.
The challenge is also that we are not funded. We have no money. The community wants to know what are you giving us while you are screening us, food, water? They want to be feed, they want freebies, T-shirts. We can’t afford that. You find some organizations that are well funded that may be doing less work but are more affective in the communities because they have buy-in. I am working and living through the passion in my heart. I am responding to the need: I am not leaving my country. I won’t run away. I am going to do the best I can one step at a time, one patient at a time and one difference at a time.
That is the challenge of having no financial support. You can’t pay the staff. It is difficult to get volunteers to last long. You will get volunteers to work for three months and then they will be gone.
To do screening, you need professionals – Doctors and nurses. I am a junior Doctor, who is going to believe in me really when I have to drag them all the way to the rural areas? Our Government has told us you can only work in the rural areas one year as a Doctor and that is good enough. So Doctors think one year is good enough, so why should I go back again? I have always been someone who has been considered that I go beyond; many think I am crazy? They don’t understand why I would go back. Our system has trained us, but it hasn’t instilled in us that I am going to go out there because I am a proud South African and I just want to make a difference with or without payment.
The challenge is I am the only one who gets it.
There are a lot of challenges, one of which is that you have to influence the chiefs to allow you to help with the community.
You need permission.
It also sounds like you are saying, that when you go back to the rural community to help with their health, it is not enough. They want material things to encourage them to live longer, am I understanding correctly?
They think: “She is our Doctor, what is she bringing us?”
There is the materialist mentality. You have to give incentives.
Where do you think that comes from?
From severe poverty. I always say, illiteracy is very painful and poverty leaves scars that are very deep. Those scars get filled with greed.
Also some of those patients are really hungry, they have no food. They hear the title ‘Doctor,’ and in their mind we have everything they desire. Sometimes they are genuinely asking for help.
We opened our new clinic and 50 people came to our door asking for jobs. We are not offering jobs, we are offering screening, but they came asking for jobs. Sometimes it is need, sometimes it is greed, and sometimes it is trying their luck.
Do you think they may also start to expect ‘gifts’ because foreigners have created the expectation? They are not realizing you are giving the best gift of all – their health.
Cancer is a disease that so many of us are susceptible to, what can we do to reduce the chances of getting it?
In my country we do exceptionally well with treatment, but we can improve on education. We have no literature in the indigenous language that talks about cancer. We need to depend on the community health work that are on the ground, three levels before they can see me. We are good at educating the doctors, although still gaps.
In the university we have not produced any indigenous black South African doctors. I still have not qualified as a doctor. Many challenges. There are lots of gaps on education for the patient, education on the ground level in the community health care work, education at the primary health care sector, on education for the person that has cancer. They don’t understand the medication they are taking.
If you are to educate me to avoid cancer, what would you tell me?
It is all in lifestyles. As African we have a lot of lifestyle diseases that are preventable.
- Blood pressure
The way we eat:
- stop smoking
- should not be drinking
- avoid sunlight
- high fat diets
We are not cooking as parents as much. We have eat take-out more. We are no longer eating from the garden. As a result more diseases are coming into play. These are the diseases that taking our lives.
How about in the rural communities, what are some things they can do to avoid cancer?
- Sexual intercourse – children are having sex too early.
- Long exposure to contraceptive predisposes you to breast cancer
- Sexual transmitted disease
- Bad diet
- Lack of exercise
We even have poor screening. There are no resources. You find you have cancer, you cannot access screening immediately; you have to wait to be seen by the clinic. You have to wait another three months to get booked into a primary hospital. They will transfer you to a surgeon then you will wait another six months. You wait for tissue diagnose for another three months, by the time the patient sees the oncologist in a tertiary hospital, the patient has been walking through this path for more than a year sometimes two years. What is happening to that cancer? It is growing.
How are we going to detect it early if we have so many challenges?
What can people do to detect cancer early?
As an NGO we look at all cancer patients and try to figure out how we can help to educate and screen as many as possible. We need the department of health and community leaders’ support. We need an integrated system. Our systems are too disintegrated, and our resources are too centralized. We need a decentralized method of screening resources.
There should be private and public partnerships: someone who has the money to fund, someone who has knowledge to do the job. We provide screening at the community level. Why should I inconvenience the patient to come to me to wait to get the disease and come to me later? We need a paradigm shift in the management of patients. It is important in rural areas because they don’t have cars to get to the doctors.
If I am a woman what do you recommend I should do to detect cancer?
We should be going to the schools, infiltrate the community meetings.
We should show women how to do the breast examination. Know your breast. Get your husbands, boyfriends to also pay attention when they are touch our breast. Tell husbands, boyfriends to help us.
Know how your breast feels.
Know what your vagina looks like. Take a mirror and look at it. There is a vagina cancer, people see a pimple and it is growing, but because they did not know what their vagina looks like they didn’t know there was a change. In Africa there is a mentality of ‘don’t look there, don’t talk about that, don’t mention that.’
We need to change our language and presentation of things. It begins at home, in the village and the community setting. You need to know what to. How are you going to learn unless people come from the higher institutions of learning and go down to the ground for a conversation in the community?
Our patients would rather go into a traditional healer rather than go to a doctor. They would rather believe the mechanism of disease is a spell because the healer is visible in the community. They eat their food; the walk their walk they talk their talk. Their books they understand. I tend to see patients and even though I speak good Zulu they will still go to a traditional healer saying health issues are a spell; its my neighbours spell, or it my husbands girlfriend putting a spell on me that is why I have vaginal discharge, it’s not cancer.
It is because the person that tells them the genesis of disease speaks their language. So we Doctors need to go to the communities and speak the local language. We need to learn the patient’s culture; learn their language. We cannot transform them to us or we create resistance. Even the good news we want to bring, we impose that knowledge. I always ask a patient to tell me what they think? Listen to what they have to say. Then I tell them what I think and we match it together and they understand.
I was reading an article featuring you, where it said that women that believe in witchcraft have been told that if they get their breast removed they would die. By the time they go to see you the cancer has manifesting itself and now there is worms and pus. It is so important to educate. Who is actually doing the education?
We start with education. You can’t do it alone. To register the message you need people who share the vision. I believe a visionary should go out there and be hands-on to make an impact. If want to ‘decentralize resources to rural areas,’ why would I not be there to do the work? Education has to be done by me first before I even teach the next person. When I teach the person I want to monitor and observe.
As the NGO grows, I think the number of people will increase. We need to teach the rural vision by being present and by doing.
How much of your time is spent on the NGO?
Almost all of it. The NGO is my job. I see patients for a living. I am in the oncology department. I am training to be an oncologist. I read about cancer. I talk about cancer in the rural areas on the weekend and I treat patients through the week.
The NGO is involved in my daily work, which works very well because it matches with my passion and intellect.
It takes a lot of my sleeping time, because without being funded you can’t afford a lot of administrators. You can’t hire people to write articles about the disease. Luckily I am a person that likes to be hands on. Sometimes you wish you could get more hands, more feet to walk. You need someone to do the education, to write articles, you need an IT specialist. Because of the lack of funding you end up doing a lot of the work.
You mention ‘listen to the patient,’ how does listening help you as a doctor and how does that affect what you prescribe to a patient as a solution to their problems?
It is so important to listen. I could listen and not agree. We find there is a lot of listening without the interpretation of what the patient is telling you. I always say that medicine is a story; it is about someone telling a story, someone listening and interpreting that story in a way that is comprehended by both sides. That is why you are dedicated and called to become a doctor. That is why an ‘A’ student may not qualify to be a doctor, but there are certain qualities required. The patient has a story to tell you and the story doesn’t begin and end in 15 minutes. The story has begun years back, like you were explaining that the warms were developed over a long time.
This woman had a lump and had it for a long time. She was offered surgery; she declined. “If they cut my left breast, it is close to my heart and it will stop pumping.” This is years of story. Can this story be finished in 15 minutes? You need to high level of listening skills. You need to be patient. When she tells me the story, she hasn’t gone to medical school. She is not going to be able to tell me the history:
- how it started
- when it started
- how it presented itself.
She is going to talk about the pain in her leg.
I have been asked to write an article in the breast cancer magazine as a doctor, I told them I can’t write as a doctor but I can write as someone who listens to stories. What I do every day is list to stories and try to find solutions. The solutions can be in form of chemotherapy, radiotherapy or palliative medication, it may be in the form of listening. Every day I get taught through the various stories.
So when I write an article it is called: ‘Let’s Listen.’ We are writing about stories of patients in which we see.
I think if a lot more doctors did listen we would be more comfortable sharing those stories.
Someone watching this interview may be looking at you and saying you are a beautiful women, you are smart, you seem to have it all together. What they wouldn’t have seen is that you did come from the rural community and that you do and did have challenges. You were also forced into marriage, and you eventually left that husband because you were abused in some way. Tell us less about what happened to you, but more importantly what advise do you have for women that are in a situation where they are constrained by their environment and how do they get out of that situation?
Look deep to the vision you have for yourself. Some women have lost the vision. I was once there. I use to drink pills to sleep. I use to cry most of the time because I was in a situation that was discomforting. I went through a lot of pain. I was very young. Very tender 17 year old, a virgin girl told now you are going to be married. I had dreams – my own visions. A lot of people will come persuade you. They will violate you. They will influence you, convince you.
It is difficult to take control of your own destiny especially when you are going through a difficult situation that you never intended to be in: Teenage pregnancy, forced marriages, sexual abuse. These women’s comfort zones are amongst their parents. They find themselves in this situation where they are starving; they need to make a living. She is a domestic worker and she can’t survive. What do they do? A child has to marry someone who can afford to support her. Parents think they are doing the best for you; honestly they are caring for you the best way they know how. You feel violated. You are confused; do they hate me? No they don’t, but why… those questions will never be answered. How do you find yourself in those situations, it is difficult but you can’t give up. It takes long. You cry the cry. You go through the pain as long as it takes, but it will not last forever. When the sun rises, there will be light. Grab the first light and maximize it. It takes a long time. You educate yourself, but don’t settle for less and don’t be comfortable with the minimal. Reach for more. Talk to someone. Ask for advise.
Most importantly is education. What ever you do don’t stop going to school. Always learn. Education became my safe place. The day I went to university was the day I got freedom. It was the day I stopped asking people to put food on my plate. I have money for food. The university will take care of you.
It starts at primary level. All I know is that education will set you free.
What has been the most significant impact you feel that you have made so far in your career?
On the academic side, breaking through the oncology bounders as the first African to pursue and to persistently wait for post to get this knowledge of cancer. There have been a lot of challenges. I think that has been the peak of my career to manage to stay despite the exclusions, despite the criticisms, despite multiple interviews – 10 interviews over five years. In 2007 I started applying and I only accepted got in 2011. That is patience. I think that has been the most tormenting, daunting, frustrating experience. You feel like human rights have been ripped off. But you have a vision that you want to achieve and you want to get there. It is not an achievement you want to do just for yourself. If it was just for me, I could have taken another job, but I had the responsibility of a community that is pushing me. Even in the middle of my sleep I knew I couldn’t give up for that lady that died because she was too far from the health center, she bled. She called me and said: ‘ help me’ but I knew I couldn’t because I didn’t have the power. Those are the patients that kept me going and make me patient.
I seek and beg for knowledge on cancer.
Edgeness Insight (An enhanced version of yourself discovered when you push the edge of your comfort zone). What is something that you are uncomfortable doing, but you need to continue to do, in order to make you as successful as you are?
This persistence and patience is to get into oncology was my edgeness. It seem like in life before you get there you have to go through some thrones. I don’t know why, but look at President Mandela? Look at current President now, he had to go through courts. Gandhi, and the life he went through. There are so many.
Female presidents have gone through exiled.
It seems like if you are not going through hardships you must not give up. You get pushed to limits. You are told to stop fighting. But if you stop fighting how are you going to get this knowledge? I have to push the door in to get in. You loose friends. Leaders don’t like you because you are touching the areas that should not be touched. You loose friends. If you talk about it you are wrong; if you don’t talk about it you are wrong. If you become silent you’re wrong. At every turn you are wrong.
There is a time when things get very dark and you don’t know which way to turn, but you persist because there is a goal you need to obtain. There is no room for giving up. It pushes to limits because your friends stop liking you because when you walked in they thought you would just step on their toes and fall, you don’t fall. You prove them wrong. The more you prove them wrong, the more they up their strategy. The more they up their strategy, the more you become low.
Now that I realize I am the first African here, I am staying. Now that I realize that the knowledge is not available, I am staying. I have been suspended for things that I don’t know what I have done. I have almost lost my career many times, but I have stayed.
At the end of the day the community doesn’t understand what you are going through for them. We go to raise funds for the patients; you have sleepless nights for them and they may not even appreciate it.
I went to med school not to suffer, but liberate myself. But because of your kindness and passion you find yourself in the circle of challenges, which seems like you have created yourself.
People wonder, what is your problem? People are being screened and they are dying. So What? While everyone else is driving in their fancy cars, living in nice houses, why should you spend your money and go make sure the screening is progressing while you are waiting for sponsorship? Why don’t you just leave it to the government? The government will do it. But when? How many? How much will they be able to do? Why can’t we help them?
But is it your problem? Those are the questions that keep coming.
If there was one thing you could attribute your success to, a personality trait, or something that happened to you, what would it be?
If you are thrown in the deep end, certain qualities rise up. You are being carved while you are going through challenges. It is like a glass that has been bent into different shapes and is sitting on the self in the gallery for people to appreciate, but they don’t know you it went through fire.
Patience. I learned patience, persistence and make something out of nothing and hard work.
You are a leader in the community, what advice would you provide to others?
- Be hands on
- Be passionate
- Don’t let anyone stop you.
What is next for?
More education, so I can be an oncologist. But go more to the ground and get more funding so the NGO can be international. We pray for funding. We want to go around Africa. I want to distribute pamphlets for cancer awareness.
Is there anything that you would do differently?
I would give my time a little bit more to my child and myself.
Q. What advice would you give to your 10yr. old daughter?
Delay sex in your life. Don’t smoke, don’t drink and work hard. Nothing is free in life. Screen and educate yourself. Give selflessly and don’t expect the rewards now, it will come. Let money follow you: don’t chase money. Go to school.
Q. What do you wish you were told at 10 years old?
I wish I was taught business skills. That is is ok to fundraise. Taught to start business when I was young. I wish I were taught community management. I wish there was better education for me. I wish I had mentors to guide me.
Words of Wisdom for African women
You are gold. You are precious, intelligent. You’re beautiful don’t let anyone convince you otherwise. We are the rock of our nation. African women are the vessel of the home and glory of their families.