Whether she establishes an army of community health workers or helps get a medical complex built -- both if she can do it -- Bongeka Zuma, MD, is determined to provide better care for people in her tiny rural hometown of Nkwezela, South Africa.
"There is no world in which I don't help my people," said the recent graduate of the Stanford School of Medicine. "So many have helped me, I have a responsibility to use my skills to benefit them."
While medical care that measures up to U.S. standards is available in South Africa's largest cities, care in the country's rural areas is deficient, Zuma said. The nearest hospital to Nkwezela, population about 2,500, is an hour's drive, and although there are small medical clinics in town, they are understaffed and lack supplies. In a region where one-third of the residents live off less than $70 per month and life expectancy is 60, few people make annual visits to primary care doctors, she said.
As a result, many die from complications of chronic conditions such as hypertension and diabetes -- "diseases people shouldn't be dying of," Zuma said. "A lot of people don't realize they have a condition until it's too late. They go to the hospital only for extreme cases."
Zuma recently began her internal medicine residency at the Hospital of the University of Pennsylvania. The program offers rotations in Africa, so Zuma is planning to learn more about health care on her home continent.
"I'm humbled by how much you need to know to provide care when you don't have all the resources at your disposal," she said.
An educational opportunity
Zuma and her five siblings grew up in a home without running water -- typical for most residents of Nkwezela, which lies a two-hour drive south of Durban, on the country's eastern edge.
As South Africans who were Black and growing up under apartheid, her parents received an inferior education, Zuma said. So the couple encouraged their children to perform well in school, forcing them to attend class even when it rained and the dirt roads turned to mud. Many kids would stay home on those days, Zuma said. But her father bought them all rain boots -- "They weren't pretty," she lamented -- so they would have no excuse.
From farmworker to doctor: A bold dream is reuniting her with her Indigenous community
"To miss school, we'd have to be sick enough to be in a hospital," she said.
When the Oprah Winfrey Leadership Academy for Girls, a boarding school for disadvantaged South African students, was slated to open near Johannesburg, the principal of her school in Nkwezela suggested Zuma apply; she did and was accepted to the program's very first class.
"It was amazing," she said of her five years at the academy. "Where I came from, we didn't have a flush toilet or electricity. And now I had my own room. I had my own chair and desk and books; things like pens and highlighters. I had a laptop!"
After Zuma and other students toured colleges in the United States, she chose to attend Spelman College in Atlanta and focus on a career in medicine. A lifelong interest in science combined with the experience of caring for a sister with cerebral palsy pointed her down that path.
After Spelman, she earned a master's in medical anthropology at Oxford University. Then she was accepted into the Stanford School of Medicine, where she flourished. "I really loved how flexible the curriculum was," she said. "The way the system is set up emphasizes inclusivity, and people come from diverse environments."
Stanford Medicine appealed to her because of her aspirations beyond caring for patients: "At Stanford you can aspire to be more than a doctor, do more with your medical education," she said.
Help for the homeland
Now, as Zuma begins her residency, she thinks about how to help her homeland. Though well-trained in modern medicine techniques, she's not sure how effective she can be caring for patients in resource-limited rural South Africa as a solo doctor. So, she's thinking about creating collaborations.
"There are a number of ways to contribute that don't involve being in the clinic," she said. "I have a dream of building a comprehensive medical complex in my community, of finding organizations and foundations that could build a good medical complex."
I have a dream of building a comprehensive medical complex in my community, of finding organizations and foundations that could build a good medical complex.
Bongeka Zuma
She also envisions using traditional healers to bridge the gap between Zulu-speaking patients with little medical knowledge and English-speaking white and Indian doctors.
"The traditional healers have a lot of trust, and they understand the people in the community," Zuma said. "They could be that link between Western medicine and the local residents." Acting as community health workers, they could educate patients on managing chronic conditions and guide them in navigating diagnostic care such as blood tests or imaging.
"Right now, these two groups aren't working together," she said. "There's a need for people to understand both systems."
However she manages it, her goal is for the people of Nkwezela to have access to the kind of medical care she learned to provide at the Stanford School of Medicine.
"I hope and dream that my people will be able to experience that kind of medicine eventually," she said.
Photo: Steve Fisch
Like stories like this?
Read the We Are Stanford Med stories here; and watch the video series here. (Sample below)
