Dr Porai Moshesh: From rural Transkei to the peak of paediatric profession

‘The day you stop being sorrowful and hurting after a child’s death, you should leave because you don’t belong in paediatrics.”

These words by Dr Porai Moshesh, head of the paediatrics intensive care unit (ICU) at Nelson Mandela Children’s Hospital, are indicative of the passion that she brings into the medical facility – and it’s a passion that began in her formative years.

Born and raised in rural Transkei, in a place called Esithangameni, she says her grandmother, Thandi, thought her calling was to be a doctor even before she realised it because Moshesh loved taking care of others, especially children, in their neighbourhood.

“It was only when I saw the first black female doctor that I realised that my grandmother was right.”

She recalls how, later on at medical school, she was inspired by Dr Karaire, a female paediatric specialist who, like herself, was tall, gentle and shared her passion for taking care of children.

“I realised I, too, was meant to help children.” And so began Moshesh’s long academic journey involving years of dedication to achieve her dream of becoming a paediatrician.

“The journey from rural Transkei to becoming a doctor took me 18 years. To become a paediatrician, it took me a further four years. Thereafter, becoming a super specialist took me another two years. In total, from my first day at school until graduation as a super specialist took 24 years.”

Asked if she would do it all again, she replies without hesitation: “Absolutely!” She tells us that her desire to escape rural Transkei was her first goal and what encouraged her to go on as she studied by candlelight and walked scantily clothed in bitterly cold weather on long dusty roads to school each day.

“My second challenge was adapting to city life in Umtata and to university life at 18 years of age with very few resources. My third was the most difficult, yet most rewarding: becoming a specialist through Wits [university] at the busiest hospital in Africa [Baragwanath], while being a young mother and wife and looking after ageing parents.”

Dr Porai Nthabeleng Head of Paediatrics at the Nelson Mandela Children’s hospital in Parktown poses for a picture at the hospital, 6 August 2020. Picture: Tracy Lee Stark

Her last stretch towards achieving her dream involved being trained on donor funds and getting a small salary at a private hospital for two years, while still paying black tax.

“No one, absolutely no one, understood why I was hurting myself so much with unending studies. Hard as it was, five years later I’m now head of paediatrics ICU at Nelson Mandela Children’s Hospital. Doing what I love most … looking after sick kids.”

Children’s hospitals are needed, Moshesh says, as the current healthcare system caters for children as small adults. But children are very different physiologically, psychologically and emotionally to adults and need to be catered for as children. Nelson Mandela Children’s Hospital provides family oriented childcare with children allowed to play and get love while getting help.

“Children’s needs are best catered for in an environment such as ours. Children often have to take a back seat and take leftovers from adults. This [hospital] gives children the opportunity to be front and centre.”

Nelson Mandela Children’s Hospital is a quaternary hospital, which means fourth level medical care.

“We do not have a casualty or walking consultations. We take over patients from other hospitals in the country who need super specialist care.”

The hospital has done a kidney transplant, brain surgery, heart surgery and provides a level of skill and care not available in a normal hospital. Moshesh says they have put all paediatric super specialists under one roof to make sure no child needing specialist care goes without help.

“Our patients come from other hospitals after already receiving care that needs further super specialised care. Inside those pretty walls, the wards are busy and the doctors are at work for long hours with operations sometimes taking longer than eight hours, using equipment never before seen in this country.”

Regarding how Covid-19 has affected the services provided by the hospital’s team, Moshesh says the pandemic is a thief.

“It stole time, resources and personnel. We joined hands with the rest of the country to develop protocols, get more beds and staff. Instead of working as a super specialised centre, we had to open our doors to general care and ICU for critical patients. We joined the rest of the world in understanding this disease that we all knew very little of. It’s made us think differently. As a result, more now goes into preparation and admission of a child than previously.”

With Women’s Month kicking off on Monday, Moshesh had some pearls of wisdom to impart to women and young girls everywhere.

“I am appealing to all women to stand up and be counted. Our girl children sometimes need a small push and a mentor to help them dream. No dream is unreachable. It will take lots of guts and strength on your part. It won’t be easy. In fact, easy paths lead to very little joy in the long term.”

– haydenh@citizen.co.za

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