Dr. Dakalo Muavha, a Fellow who is being trained in urogynaecology through the University of Cape Town at Groote Schuur Hospital and Chris Barnard Memorial Hospital, hails from Limpopo where there are no such specialists. In fact, only three urogynaecologists have been trained in this country, all at UCT.

Dr. Muavha Dakalo, whose training has been funded by the office of the MEC for Health in Limpopo, will become the first African urogynaecologist in South Africa.

When Dr. Dakalo was invited to attend the 2018 budget speech of the MEC, Dr. Phophi Ramatuba, he used the opportunity to meet with health stakeholders. This resulted in the MEC offering to co-host a three-day workshop on urogynaecology from 5-7th September 2018 in Polokwane in partnership with Storz, the GSH Facilities Board and 10 other pharmaceutical companies.

We spoke to Dr. Dakalo to find out more about his chosen career path and why there is a need for urogynaecology, especially in Limpopo.  

Q:  What made you want to become a doctor?

Dr.: I had and still to date have a burning desire to maximise my contribution to create positive change to my surroundings. As a child growing up in a small village called Nwaxinyamani in Limpopo Province in the 1980s, the professions I was more exposed to that were making those positive changes in my community were the teachers, policemen, preachers and doctors. Somehow being a doctor was more appealing to me with a perceived potential of unshackling the chains of poverty for me and the greatest opportunity to be an instrument of change for my immediate community and beyond.
 
Q: Why did you choose this area of specialisation? What does a urogynaecologist focus on, and why is it important?

Dr.: A urogynaecologist is an obstetrics and gynaecology specialist with additional training and experience in treating problems associated with the dysfunction of the pelvic floor and bladder such as urinary incontinence and prolapse. These conditions are not life-threatening, but it has a social debilitating effect on the sufferers. Some patients isolate themselves or are purged by their own community into no man’s land due to the consequences of untreated urinary incontinence as an example.

These conditions mostly affect older people and there is an African Proverb that says Mutswari I Xikwembu xa wena (loosely translated from Tsonga to mean that your parent is your God). A parent in African tradition is any person who is old enough to be your mother or father, hence it is a privilege for me to devote my whole remaining life to serve this population and bring their dignity back, especially poor rural elderly women who are the most vulnerable group in our society.

Q: What is the need with regards to this area of women’s health in your province?

Dr.: Limpopo Province has a population of 5.4 million people serviced by one tertiary hospital, the Polokwane Mankweng Complex for complex medical conditions (which is supposed to include urogynaecology conditions) with an option of referring outside the province to George Mukharhi Hospital in Pretoria. However, urogynaecology service is non-existent in both levels of referral hospitals, therefore many women, especially poor rural women who solely depend on government health services, have no choice but to accept these social dwarfing urogynaecology conditions as a normal part of growing up which is absurd in the 21st century.
 
Q: As there are no urogynaecologists in Limpopo, what impact are you hoping to have in this province?  How does this statistic compare with other provinces nationally?

Dr.: South Africa has previously never trained urogynaecologists and upon my completion next year I will be the third urogynaecologist trained in South Africa and the first African urogynaecologist in the whole of South Africa. This achievement alone will be a great motivation for rural young boys and girls from previously disadvantaged backgrounds. Since we now have a medical school in Limpopo, it means our medical students will now graduate with some basic knowledge and exposure in urogynaecology conditions where previously they would have not had the opportunity. Our clients (patients) will be the biggest winners because marriage vows are now not going to be broken due to effects of urinary incontinence and /or prolapse. Productive employees are no longer going to spend a third of their time at work running to the bathroom which means our economy will also improve. The big losers will be adult nappy companies because their clients will no longer need their services.
 
Q: How important is it for your studies to be funded? And how will this aid the impact you will have in your career?

Dr.: The Limpopo government has to realise the need of our poor rural women and make a great commitment to support my journey to come to the University of Cape Town to learn this scarce skill from one of the best pioneers of urogynaecology in the world (Dr Stephen Jeffery and his whole team under the great Leadership of University of Cape Town Obstetrics and Gynaecology Head of Department Professor Linnette Denny). I am blessed to have the opportunity of a life time to be mentored by excellent teachers, including our former urogynaecology fellowship coordinator at the University of Cape Town and a great friend, Dr Pieter Kruger who is currently practising in Canada.
 
Q: Share the experience of your trip to the MEC’s budget speech, what did it mean to you?

Dr.: The trip to the MEC budget speech on the 10 April 2018 in Limpopo Legislature was very refreshing. The appreciation and commitment I got from the Honourable MEC of Health in Limpopo Dr Phophi Ramathuba was inspiring. My burning desire to uplift our community was well received by the whole house of Parliament including all political parties. The trip gave me a unique opportunity to get all stakeholders of health care in Limpopo in one room and most of them have pledged to support a dream of establishing a sustainable world-class urogynaecology service for the entire province which will, without a doubt, formally and informally also assist the neighbouring provinces such as Mpumalanga and even our fellow Africans in neighbouring countries like Zimbabwe and Mozambique.

Q: Tell us about the workshop that is planned, and how it will make an impact.

Dr.: The Inaugaural Urogynaecology Workshop endorsed by the University of Cape Town Obstetrics and Gynaecology (O&G) department, Groote Schuur Hospital Facility board and also supported by multiple Private companies in association with top urogynaecologists and minimum invasive surgeons from South Africa, Kenya, Canada, United Kingdom, United States of America and Netherlands will all be answering a Thuma Mina call made by our honourable President Matamela Ramaphosa. In order to lend a hand to the victims of urinary incontinence and prolapse in Limpopo, on 5,6, and 7 September 2018, there will be a live surgery and seminars dealing with these elusive silent social dwarfing urogynaecology conditions as well as a road show to surrounding communities for awareness and putting a spotlight on this “enigma” especially in African communities. The long-term goal of the workshop is an ongoing collaboration and skill exchange between Limpopo and big urogynaecology centres in South Africa and the world.