Zamani – the hero of Hlabisa
From taxi driver to TB-care champion, Zamani Dlamini brings hope to the sick in rural KwaZulu-Natal
‘What bothered me the most was when a sick person got into the taxi and you saw how the people around them would discriminate against them. They didn’t like sitting next to a sick person,” Zamani Dlamini recalls. “And when a nurse got into my taxi I would get really excited and ask them about the work they do.”
Nine years ago, Dlamini was a taxi driver. Five years later he graduated as a professional nurse and realised his dream of working to end the discrimination against people like those he used to pick up as passengers.
Dlamini’s interest in nursing stems from when he was still a teenager. In 1999, when he was in grade 11, his grandmother fell ill with diabetes.
“I realised that I could have helped my grandmother if I knew more about how to care for a person with diabetes,” says Dlamini. “But I didn’t have the skills. That is how I developed a fascination with nursing because I saw that, in my area [Hlabisa in rural northern KwaZuluNatal], there were no nurses. At that point my aunt was the only nurse around. I saw that people in my village were sick and they needed help.”
It would take nearly a decade for his dreams even to become even a possibility. Dlamini had no way of paying for a nursing education. In 2006, he heard about a bursary opportunity offered by the Friends of Mosvold scholarship scheme — now the uMthombo Youth Development Foundation, which offers financial support to young people from rural areas to help them become “qualified healthcare professionals in rural hospitals” in northern KwaZulu-Natal and the Eastern Cape.
In 2007, Dlamini received a bursary and started his studies at the University of Zululand’s campus in Ungoye. In 2011 he completed his studies with distinction.
After graduating he worked at Hlabisa hospital. In June 2015 he moved to Pietermaritzburg to join Jhpiego, a nongovernmental health organisation affiliated to Johns Hopkins University in the United States. The organisation is currently conducting research on the importance of nurses in the care of patients with multidrug-resistant tuberculosis (MDR-TB). Dlamini is based at the Doris Goodwin hospital in Edendale, KwaZulu-Natal — a specialist MDR-TB hospital.
“But I won’t stay here [in Pietermaritzburg] because the people of Hlabisa need me more,” says Dlamini. “When you work for the people in your community, people you understand, they are honest with you because you understand their beliefs and their problems.
“So there is this bond that develops between you and the community. Even if somebody has a question, they know you’re from the community, so it’s easy for them to approach and ask you.
“The people in Hlabisa believe strongly in traditional medicine. So people would often present late at the hospital after they’ve been to different healers and sangomas. You find that they bring the person to hospital at a late stage and then people say that the hospital is ineffective. They think that if a person goes to hospital they go there to die.
“So, as the TB co-ordinator, I got the chance to visit the 21 clinics served by the hospital and preach this gospel that people must go to the hospital early so that they can get treatment at an early stage before their illness advances.”
Dlamini believes that being from the area made it easier for him to raise awareness about the disease and for people to trust him. His beliefs are supported by research.
A 2011 study published in the South African Medical Journal found that rural health workers “felt significantly more accountable to the community that they served” than their urban counterparts.
The study, which surveyed 174 public health practitioners in rural areas and 142 in urban areas, also states that rural medical professionals “were more than twice as likely as the urban group to have been exposed to rural situations during their undergraduate training, and were also five times more likely than urban respondents to state that exposure to rural practice as an undergraduate had influenced their choice of where they practice.”
These findings are supported by a 2013 study in the African Journal of Health Professions Education, which looked at the career and practice intentions of health science students at three South African health science faculties.
According to the study, “rural preference was strongest for respondents of rural origin — consistent with evidence that a rural background is the single factor most strongly associated with rural practice”.
For the 31-year-old Dlamini, this is only the beginning of an already stellar career. In 2014 he was recognised as one of 200 Young South Africans, a flagship project of the Mail & Guardian that celebrates the achievements of notable up-and-coming South Africans under the age of 35.
This year, he received a Leading Lights Award, an initiative of the International Council of Nurses to reward individuals making an “outstanding contribution to tuberculosis prevention, care and management in their local facility and/or community”.
“I’m most interested in nursing education,” Dlamini says as he waves a greeting to a group of patients sitting on the concrete lawn furniture between the red-brick buildings of the hospital. “Maybe one day I might be a nursing tutor or lecturer.”