Women in the public sector
CEO of the Nelson Mandela Children’s Hospital Dr Mandisa Maholwana explains how Mandela’s passion for children guides the hospital
Walking into the building with its colourful walls and art murals that are meant to cheer up sick babies and children every morning also brightens the days of Dr Mandisa Maholwana, who is the CEO of the Nelson Mandela Children’s Hospital.
With the world celebrating Madiba this month, Dr Maholwana said that ensuring his legacy stays alive at the hospital is part of her daily job.
It is exactly a year since she became CEO of the hospital built predominantly to ensure that underprivileged children get the kind of healthcare services they deserve.
According to Maholwana, Madiba was inspired to establish the hospital after witnessing a child being admitted to an intensive care unit (ICU) that also catered for adults. He felt it was not appropriate for children.
“He felt that a special facility should be built for children to access healthcare services without having to compete with adult patients. He felt that children needed to be with other children when admitted to hospital, in an environment that is friendly and promotes proper healing,” she explained.
This sentiment led to the Nelson Mandela Children’s Fund establishing the Nelson Mandela Children’s Hospital Trust in 2009. Almost R1 billion was fundraised to build and equip the hospital, as well as train medical professionals.
The construction of the hospital building was completed in June 2016 and the doors were opened
to welcome the first referred patients in June last year.
Clearing backlogs
So far, the hospital has managed to clear many backlogs in hospitals across the country. It has helped about 600 patients receive radiology services alone.The focus is on magnetic resonance imaging and computed tomography scans for children who have been on waiting lists for as long as two years in certain areas.
Treatment and services started in phases to ensure safety and manageability, as well as the procurement of highly specialised doctors and nurses.
“That is challenging because South Africa does not have enough doctors. Getting highly specialised nurses is also a challenge because they have to be paediatric trained and also ICU or theatre trained,” she said, adding that the hospital was established to improve healthcare and not undermine it by poaching other hospitals’ professionals.
Currently, over 150 staff members have been employed in line with the hospital’s phasing-in plan. These include 30 specialists, many nurses and administrative staff. Also on hand are about 40 allied health services workers, including social workers, physiotherapists, dietitians, radiology staff and pharmacy staff.
It is envisaged that the hospital will eventually employ around 150 doctors and 451 paediatric nursing professionals.
All Madiba wanted was a children’s hospital that meets the tertiary paediatric healthcare needs in southern Africa, said Maholwana.
“Madiba was a man of excellence. He loved children and wanted to ensure that they are taken care of,” she added.
On the road to progress
The 200-bed hospital operates as a specialist, referral-only tertiary facility. Once fully operational, it will provide services in cardiology and cardiothoracic surgery, haematology and oncology, nephrology, neurosciences and general paediatric surgery. It is integrated into the referral networks of hospitals across South Africa. Patients who are not South African will be treated if they are referred by a South African hospital.
The hospital started with radiology services when it opened, followed by ICU, dialysis and cardiology earlier this year, and more recently surgical services.
The wards that are open provide renal and cardiology services. Also in operation are the neo-natal and paediatric ICUs.
Maholwana said the next step is to open theatres specifically for neurosurgery and general paediatric, orthopaedic and cardiothoracic surgery.
“We have already started with neurosurgery and this was before our anticipated start date.We have also already done general paediatric surgery,” she said.
“With the hospital being a specialist-to-specialist referral facility, children are first taken to a primary healthcare facility. If it cannot deal with the condition, they are referred to the secondary facility which would ordinarily be a district hospital.
If the district hospital cannot provide the service that is required, the child will be referred to a tertiary hospital like ours,”
Maholwana explained.
There are already a number of tertiary hospitals across the country, but only two are specifically for children. Africa now has four children’s hospitals. This is a small number when compared to the 23 in Canada, 19 in Australia, 20 in Germany and 157 in the United States.
Tertiary hospitals deal with more complicated disease profiles, while a specialised children’s tertiary hospital caters for children needing surgery and focuses on the specific types of surgeries and conditions that are more prevalent in children.
“In a normal hospital, there are around 10 theatres but none are dedicated to children. Patients are split by speciality and the theatres serve both adults and children.At our facility, there is for instance an orthopaedic theatre that is strictly for children,” she said.
Healthcare is totally free for children under six and costs for older patients depend on their parents’ income.
“If they can’t afford to pay we cannot chase them away because Madiba’s dream was that no child would be turned away because of their socio-economic circumstances,” stressed Maholwana.
One of the compounding factors delaying access to healthcare services for children is that sometimes they are put on a waiting list because there is a shortage of ICU beds in hospitals across the country.
“A hospital may be ready to operate on a child but then once the child comes out of theatre, they would need to go to an ICU bed. If a bed is not available, it becomes a problem,” she noted.
The Nelson Mandala Children’s Hospital will help if it can when contacted by other tertiary hospitals which cannot accommodate a child.
Happy to heal
Maholwana said the hospital has already had a number of success stories and it staff members are humbled by the impact that they are having on children’s lives.
“It makes a world of difference for a parent to walk out of the hospital after being told that their child will receive help and recover,” she said.
For Maholwana, a particularly heart-warming moment was having a patient come in on a stretcher and a ventilator and later waving that same child goodbye as she walked out of the hospital after receiving medical help.
As a mother of three, Maholwana knows what it is like to worry about a sick child and she can therefore identify with every parent who brings their child to the hospital.
“There is nothing worse than waking up in the middle of the night and finding your child ill,” she said.
As the CEO of the hospital, her vision is to give every child a chance to live and thrive.
She said the hospital will continue to raise funds so that it remains sustainable and provides world-class services. It gets some funding from government, but she explained that it still runs many fundraising services through the Hospital Trust.
“If you are involved in a project as big and impactful as this, the last thing you want to do is to disappoint, because you will be letting the nation down.This is Madiba’s dream,” she said.