Doctor determined to achieve the impossible in rural KZN
“THERE is no such thing as an impossible challenge. When you say ‘It can’t be done’, what you’re really saying is: ‘I’m not capable of doing it’.”
Dr Selina Sewpersad does not look like a senior medic. She bears more than a passing resemblance to the delicately beautiful novelist and social activist Arundhati Roy; fineboned and fey, with a slightly eccentric, wonderfully individualistic dress sense and huge, expressive eyes.
She engages fully in conversation, without any trace of the arrogance that often seems to accompany learned professionals. But if she is small in stature, she makes up for it with a passionate commitment to medicine, and an unshakeable belief that the impossible is within reach of anyone with genuine commitment to their ideals.
Sewpersad is the only female chief specialist in government service in the KZN Department of Health and heads the department of anaesthesiology at Ngwelezane Hospital, 20km from Richards Bay.
The facility provides district, regional and tertiary services to the communities of Uthungulu, Umkhanyakude and Zululand.
Earlier this year Sewpersad was recognised for her dedication and vision by KZN Health MEC Sibongiseni Dhlomo, when he presented her with an award for innovation and best practice.
She is also the recipient of a Centre for Public Service Innovation award, presented to her department for excellence in public service and administration.
During Women’s Month, the Sunday Tribune asked the specialist to discuss her philosophy of patient care and how she and others at senior level in state health care face the immense challenge of providing good service with limited resources and manpower to a huge number of state patients.
Sewpersad attributes her service ethos in part to her faith and upbringing. A Hare Krishna devotee, she says: “Love of the Supreme Lord is a coin – on the other side is pure compassion towards all living beings. That is very much part of who I am.”
That said, she also has a core of steel; she can hold her own in any company and puts in hours that would make a lesser mortal quake. A typical day starts at 4.30am and she often does not leave work until 10pm or later.
“I can theorise and debate with the best of the academics, but I can do the work, too. I take a group of untrained people and create over-achievers,” she says without a trace of vanity.
After six years as a specialist in the UK, Sewpersad returned to her home province, but her welcome wasn’t unqualified.
“I was on my way to take up a position in New Zealand when I was asked to ‘help out’ at Ngwelezane in 2012, so I jumped in my car, found temporary accommodation, and I’m still here, with no intention of leaving,’ she says brightly.
“Initially there was a lot of resistance to my presence from the more junior staff doctors. I wanted exacting standards adhered to, and that wasn’t popular – they got together and asked the chief to give me the boot.
“If you’ve been used to arriving at work at 9am, you will be resistant to an instruction to arrive at 7.30am. But it all worked out for the best.”
When she was appointed, a revitalisation programme for state health care was in full swing, which allowed her to order world-class equipment for her department.
Although the programme is now defunct, she continues to train anaesthetists to world standards and is proud that a number of doctors she taught have been accepted into specialist programmes in Preto- ria, Durban and Cape Town, straight after completing their period of community service at Ngwelezane.
“They acknowledge they are benefiting and all say they will return to rural health care when they have qualified as specialists.”
Sewpersad says that, given the critical need for anaesthetic expertise, especially in KZN, “we simply can’t wait for the doctors to become specialists. The reality is I have 16 level-one hospitals in my area where junior doctors have to give anaesthetics without adequate training.
“In the three-year report on state health care, started in 2002, the statistics for anaesthesia-related mortality are appalling. Every time the report comes out, it says the same thing. Thirty times more people are dying under anaesthetic in our country than the international benchmark of one per 200 000.
“HIV/Aids is the leading cause of maternal mortality, but it has a indirect impact on anaesthesia. A precipitous drop in blood pressure or the need to insert a breathing tube are the two main reasons mothers die under anaesthetic.
“Doctors are often secondary victims, as listed in the section on caesarean services in the National Confidential Enquiry in Maternal Death that is published annually.
“Many young doctors are so traumatised by losing patients under anaesthesia that they want to leave the service.”
Sewpersad developed a fasttrack skills upgrade programme.
“I teach my doctors how to use the specialised equipment and equip them with the knowledge they will need to make life or death decisions.
“Specialists like to say it can’t be done. We are proof that it can. And we are part of something much bigger than ourselves.
“Our challenge is to find ways to uplift the lives of all South Africans. You have to have an educated, healthy pop- ulation to be effective as a nation.”
Sewpersad has not married or raised a family. She says in her rare time off she does sometimes reflect it “would be nice to have someone to chat to at the end of the day and travel with”.
She is vigilant about the welfare of her protégés, making sure they have fixed rosters that allow time for family and leisure, to prevent burnout.
“It is very hard to attract doctors to a rural, largely undeveloped place; those who do come are intent on making a difference,” she says.
“They stay because they have inner strength and something to offer.”
The specialist says she would not label herself a feminist – “but change is a difficult concept to bring to a male-dominated world that finds itself comfortable in that dominance.
“I don’t need recognition for my gender, but in my experience men often misuse their privileged positions. Leaders should be fair, just and compassionate.
“Men often forget it is a privilege to be a leader in society and that position comes with responsibilities. Women often ponder the issue more.
“I want to have the potential to change lives and leave a legacy. If you haven’t empowered anybody in your lifetime, then what was your purpose in being here?”