Medicine Man

Chang­ing SA health care – on a bike.


Ac­cess to health care re­mains one of the big­gest chal­lenges fac­ing South Africa’s pub­lic sec­tor. Sizwe Nz­ima is work­ing on chang­ing that. By de­liv­er­ing chronic med­i­ca­tion door to door, he’s im­prov­ing the lives of thou­sands of peo­ple.

TThe Khayelit­sha clinic was filled with peo­ple wait­ing to col­lect their chronic med­i­ca­tion. Among those wait­ing were the el­derly, the sick, women with their chil­dren – and Sizwe Nz­ima. He was col­lect­ing his grand­par­ents’ med­i­ca­tion, a task he gladly car­ried out for them. He knew how te­dious the col­lec­tion process could be.

Glanc­ing around the full wait­ing room, the young busi­ness stu­dent was struck by an idea – he could of­fer to col­lect chronic med­i­ca­tion for those wait­ing with him, and de­liver it straight to their doorsteps. They would no longer have to queue for long hours and walk long dis­tances ev­ery month. All they needed to do was pay his small fee of R10.


The first time Sizwe rode a bi­cy­cle, he fell in love. He was eight, and his older cousin de­cided to teach him how to ride. “It was my cousin’s bi­cy­cle, but I loved it more,” he says, laugh­ing. “My mom couldn’t af­ford to buy me a bike, so even­tu­ally I just adopted his.”

His mother lived in Jo­han­nes­burg, so he was raised by his grand­par­ents. They took care of him, and made sure he went to school. At the time, his grand­mother worked for a doc­tor who lived in Camps Bay.

Even as a young boy, Sizwe worked hard, and passed well. His hard work didn’t go un­no­ticed. The doc­tor of­fered to pay the tu­ition for his high school. This al­lowed Sizwe to at­tend Harold Cressy High. “It wasn’t a posh school, it was a nor­mal school,” says Sizwe, “but back in the day, if you went to a school out­side the town­ship, you sort of had a bet­ter ed­u­ca­tion and you were seen as bet­ter. I was lucky to go, and I per­formed re­ally well there.”

What Sizwe didn’t re­alise then was that he was re­ceiv­ing

far more than an ed­u­ca­tion. He was be­ing equipped with life skills that would serve him well when he came to start­ing his own busi­ness.

Ev­ery year he par­tic­i­pated in ath­let­ics, an in­di­vid­ual sport that forced him to be­come self­mo­ti­vated. “With ath­let­ics, no mat­ter how much the coach teaches you, your suc­cess de­pends on you. You’re alone in the race. So if you cheat on your train­ing, you’re only cheat­ing your­self.”

Sizwe wanted to pur­sue a le­gal ca­reer af­ter school. In­stead, he was swept up by the idea of be­com­ing a busi­ness­man. His ini­tial ap­pli­ca­tion to the Ray­mond Ack­er­man Academy was re­jected, but that didn’t de­ter him in the least. His grand­par­ents had al­ways raised him to aspire to more, so giv­ing up was never an op­tion. “My grand­mother al­ways used to say to me, ‘You’re prob­a­bly go­ing to be the first multi-mil­lion­aire in the fam­ily.’’’ These words con­tinue to mo­ti­vate him.

He ap­plied again, and was even­tu­ally ac­cepted into the academy. To fund his stud­ies, he would sell snacks to stu­dents at UCT’s Grad­u­ate School of Busi­ness. BUMPY RIDE

It was while study­ing that Sizwe first started Iyeza Ex­press. He started out with 10 cus­tomers, all re­ferred to him by his grand­par­ents. “My first de­liv­er­ies were tough, be­cause peo­ple didn’t trust what I do. Peo­ple were re­ally anx­ious about my ser­vice. ‘Is this boy go­ing to bring my med­i­ca­tion? What if he runs away with it, what if he loses it?’ – these were all ques­tions peo­ple had.”

Slowly Sizwe built the trust of the com­mu­nity. While he waited to col­lect the med­i­ca­tion for his first clients, he ex­plained the ser­vice he was pro­vid­ing to oth­ers in the wait­ing room. In this way, he didn’t need to spend money on mar­ket­ing; in­stead, he re­lied on word of mouth to gather new clients.

At the Academy in 2013, he was named Best En­tre­pre­neur­ial Stu­dent. The award came with R10 000 – his first fund­ing. Fi­nally he was able to pur­chase a bi­cy­cle of his own, a day he had been look­ing for­ward to since his cousin first taught him how to ride. He was also able to reg­is­ter his busi­ness and buy a lap­top.

This fund­ing changed the game for Sizwe. He no longer

needed to de­liver med­i­ca­tion on foot – in­stead, he could trans­port it by bike. His two new wheels took him fur­ther than walk­ing ever could.

De­liv­er­ing med­i­ca­tion by bi­cy­cle al­lowed Sizwe’s busi­ness to flour­ish. He was able to nav­i­gate hard-to-reach places, squeez­ing through densely pop­u­lated shacks. “Bikes are en­vi­ron­men­tally friendly, and they also al­low me to nav­i­gate the town­ship bet­ter and un­der­stand it bet­ter – that’s prob­a­bly why I un­der­stand town­ships way bet­ter than any other courier com­pany.”

But de­liv­er­ing med­i­ca­tion wasn’t sim­ple. The clin­ics had trou­ble with him de­liv­er­ing med­i­ca­tion for oth­ers, be­cause he wasn’t cer­ti­fied as a med­i­cal courier. “It was a big prob­lem. But then I ex­plained to them what I wanted to do, and what my vi­sion was.”

For the busi­ness to con­tinue, Sizwe needed to be­come com­pli­ant. He met with the Depart­ment of Health to es­tab­lish what the law re­quired, and brought Si­raaj Adams, who had stud­ied phar­macy, on board. While Si­raaj first oc­cu­pied the role of men­tor, he soon be­came Sizwe’s part­ner. “He saw a big­ger op­por­tu­nity for the com­pany. He saw that this could be­come a phar­macy busi­ness. He un­der­stood that peo­ple’s lives are busy, so they need con­ve­nience in their lives – es­pe­cially for med­i­cal prod­ucts, be­cause it’s treat­ment that they need.”

Tak­ing ad­van­tage of the gap in the mar­ket, they po­si­tioned them­selves as the town­ship courier busi­ness that fo­cuses on hard-to-reach places and low­in­come ar­eas. To­day, Sizwe has come a long way from de­liv­er­ing med­i­ca­tion to just 10 pa­tients: now Iyeza Ex­press de­liv­ers to over 1 000 peo­ple around Khayelit­sha. With the ex­pan­sion of his busi­ness, Sizwe was able to em­ploy four more peo­ple to make de­liv­er­ies.

From the courier busi­ness, Sizwe and Si­raaj grew Iyeza Health – a spe­cial­ist health lo­gis­tics com­pany. Along with de­liv­er­ing chronic med­i­ca­tion, they also de­liver self-test­ing HIV kits, for in­di­vid­u­als and cou­ples who want to be tested in the pri­vacy of their own homes.

Sizwe is cur­rently train­ing an ad­di­tional five guys for a new con­tract that he has taken on. “I have part­nered with a com­pany that’s re­spon­si­ble for get­ting the med­i­ca­tion to the clin­ics and pack­ag­ing it. So we are the distri­bu­tion part­ner – we de­liver from the distri­bu­tion cen­tre to the clinic.” Clin­ics from Langa to Strand will re­ceive their med­i­ca­tion from Sizwe and his team. For those de­liv­er­ies, two trucks and two one-ton bakkies were bought.

Sizwe is also in the process of digi­tis­ing his busi­ness. He’s launch­ing an app that will map out the ar­eas he de­liv­ers to. “It’ll show where my riders are and where they’re go­ing; we’ll be able to ping their lo­ca­tion us­ing geo­co­or­di­nates,” he ex­plains.


The idea of so­cial en­trepreneur­ship is quite new in Sizwe’s com­mu­nity. “You’re ei­ther an NGO, or a full-profit busi­ness. While I am a full-profit busi­ness, I have a so­cial im­pact that is aligned with the prof­its we make,” he ex­plains. His busi­ness is based on al­le­vi­at­ing a prob­lem that ex­ists in the com­mu­nity.

As Sizwe’s busi­ness has grown, he has felt the pres­sure to pro­vide for his fam­ily. “When you start a busi­ness, your mom or your grand­par­ents start ask­ing, ‘Chief, where’s the money? It’s been a year, it’s been two, why aren’t we see­ing the ben­e­fits yet?’”

But main­tain­ing a bud­get while try­ing to es­tab­lish a busi­ness can be com­pli­cated. “In a small busi­ness it’s very dif­fi­cult, you have to live. You have to feed your­self and your fam­ily, but you also have to give money back to the busi­ness.”

But Sizwe is am­bi­tious. He’s worked hard to get where he is now, and has a clear vi­sion for the fu­ture of the busi­ness. “When peo­ple see my busi­ness, they only see med­i­cal lo­gis­tics, on bikes. They think that my busi­ness is small. But I don’t see my busi­ness as small,” he says.

While the busi­ness he is run­ning now is still not the busi­ness Sizwe en­vi­sioned four years ago, he knows the steps he has to take for his vi­sion to come to life.

“What I’m do­ing is build­ing a geo­graph­i­cal lo­gis­tics com­pany – one that has the abil­ity to map out town­ships, and be­come the god of town­ship lo­gis­tics,” he ex­plains. “Any­thing that has to be moved in the town­ship or to the town­ship, I can be that. The goal has never been just med­i­ca­tion. Med­i­ca­tion was only ever the start­ing point.”


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