Emergency care doctor Rudo Mathivha, head of intensive care at Chris Hani Baragwanath, has worked tirelessly, for 25 years, to transform the trauma unit at the largest hospital in Africa – and the third largest in the world.
Her name means ‘love”, and it’s what will keep driving her passion for patients, even after retirement, writes Sean Christie for Bhekisisa.
Her years at Bara have not been smooth sailing, however, the rocky journey having been fraught with various issues, including the trauma and tragedy of the pandemic; sabotage of the facility’s oxygen supply – just before Christmas 2022, when two dozen patients were on mechanical ventilation – personal tragedies, and death threats on her phone.
On what provoked the latter, Mathivha is unclear. “There are various possible explanations,” she said: she had joined a case against the state regarding load shedding and its effects on patients relying on medications or medical devices requiring electricity at home.
She was also part of a tribunal that reviewed the health ombudsman’s report into the circumstances surrounding the death of Shonisani Letholie, a patient at Tembisa Tertiary Hospital; and she had been very vocal when there was no food for patients in Baragwanath and several other Gauteng hospitals.
Also last year, her nephew died of diabetes while she was at the World Intensive and Critical Care Congress in Istanbul. “He was a son to me; I brought him up from infancy until the age of 29,” she says.
“I can’t describe how I felt when I came home. It wasn’t just the devastation of losing someone; it was also the devastation of returning to the same fights I have been waging since 1998, when I became head of the ICU here, for equipment, for medication, for staff – everything you need if you want to save lives.”
Relentless drive
Looking back Mathivha believes “we’ve done enough to transform the ICU environment at Bara so that it won’t collapse in my absence”, and of that there can be little doubt.
Long-time colleague Shahed Omar praised her “relentlessness in growing the ICU to serve the hospital while maintaining the best international standards, and expecting the best from her staff”.
Yet, ultimately for Mathivha (and doubtless many others), working at Bara has become too much to endure.
She was recently diagnosed with Covid-19 and pneumonia, and spent some time recovering.
“I’m feeling more myself now,” she says, adding that she will be back at Bara this month, for another two years: “Not as head of department, and not on the treadmill, but on a sessional basis, to teach fellows and to provide handover support. I still want to contribute to critical care medicine.”
The collapse of her health was perhaps inevitable. Mathivha admits she’s made her professional life harder than it needed to be.
“I find it difficult to keep quiet when things are going wrong, and I tell my colleagues to speak up, too. But it’s a little self-defeating, because when you speak up, others feel they don’t have to.”
A fighting spirit
Her roots lie in a dusty little place called Sibasa, outside Thohoyandou in Limpopo, “the last stop of the railway buses that came from Johannesburg”.
The middle child of seven, preceded by three boys, and followed by three girls, Mathiva was born preterm, and was nameless for the first three months of her life because her parents did not think she would survive.
“I guess in time they saw the fighting spirit in me, because my father sent a telegram to his sister in Masvingo, Zimbabwe, saying, ‘we have a child, would you please give her a name’. Then they asked my maternal grandmother to do the same, and my father’s family also gave me a name.”
The name suggested from Zimbabwe was Rudo. Her maternal grandmother gave the Venda name Lufuno, and her father’s family the Hebrew name, Ahava. All mean “love”.
Mathivha is a member of the Lemba community – descendants of the Yemenite Hebrews.
Her father was a teacher and school principal, and when she was five, he was hired to lecture at the University of the North, now the University of Limpopo. The family moved to Turfloop, the university village.
Her drive to help people with their healthcare goes back to when she was eight.
“My father was sick and I went with him to our doctor, who diagnosed flu and the beginning of pneumonia, and gave him an injection.”
Mathivha watched this from a chair on the other side of the surgery, her father partly obscured by a dividing curtain. Minutes after the injection, she heard him coughing violently, and then the doctor pulled back the curtain and called for help.
“My immediate thought was, ‘He’s dead’, but the doctor said he was just having a reaction to the jab.’
“Another doctor ran in, and they both worked on my dad and he recovered,” says Mathivha, who later figured that an injection of penicillin had triggered life-threatening anaphylaxis, which was halted by adrenaline and steroids.
“As we drove home, I knew I did not want to ever feel such helplessness again, and vowed to learn about medicines… It was the start of something.”
Intensive care
Mathivha excelled at school and without telling her, her father enrolled her for a Bachelor of Science degree at the University of the North.
But Mathivha had already applied for – and been offered a place – in the medicine programme at the University of Natal.
She studied with zeal, graduated and did her internship at Durban’s McCord Hospital.
Then she applied for and was appointed as a medical officer in the paediatrics department, and later, was awarded the department’s registrar post, where she worked for six months before transferring to the University of the Witwatersrand (Wits) to finish her specialisation at Baragwanath.
She says her registrarship “messed” with her mind, “because of the prejudice of seniors in the paediatrics department, directed mainly at black registrars”.
She repeatedly called her father to say she couldn’t go on.
“He said: ‘You will, and you will make it,’ and so I struggled through.” She ultimately qualified as a paediatrician, but not before leaving to take a post at Bara’s ICU.
The catalyst for her departure was her mother’s death from breast cancer, and on her return from the funeral, she approached Professor Jeff Lipman in the ICU, asking for a medical officer post.
“He instantly typed an offer letter, and that’s how I …became an intensivist,” she says.
In time, Lipman offered Mathivha a specialist post and found her a fellowship at Duke University Medical Centre in the United States.
In the final months of her fellowship, Lipman called from Brisbane, Australia, to say he had been headhunted, and that his post (at Baragwanath) had been advertised. He convinced her to apply. She did, successfully, and was appointed as head of intensive care.
Mathivha started work in July 1998, and was happy to find that Jacqui Brown, who had been a medical officer alongside her, was now a specialist in the department.
“We set our minds to modernising the ICU, both from an equipment and a teaching programme point of view,” she recalls.
She has since had a hand in training 48 intensive care specialists, one of whom is Kuban Naidoo, who said Mathivha “always had time for discussion, and was always willing to hear new ideas”.
“She’d reverse a decision based on good input, and I think that’s the hallmark of a good leader.”
Naidoo said Mathivha has helped to both transform and develop critical care services at Bara, and beyond.
“In her time, the ICU has been female-led, and there are slightly more women than men working in the department, so that’s transformative.
“But this is not to be confused with the development in critical care services …and by this I mean the increase in staffing she’s managed to achieve, and the educational outreach initiatives she’s set up, which have helped to expand critical care services beyond the metros.”
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