The RuDASA Annual Rural Doctor of the Year 2006:
The Pierre Jaques Award

DR VANGA SIWISA

Photo by Izak de Vries
The man who listens to his heart

• He gave up a private practice because people were dying of AIDS
• He runs an HIV clinic in far-flung Taung, with 2876 patients in the HIV programme, close to 2000 on antiretroviral treatment already

Dr Vanga Siwisa received the prestigious Pierre Jacques Rural Doctor of the Year Award at a gala dinner in Empangeni , KwaZulu-Natal on 10 August 2006. The award was presented to him jointly by the Rural Doctors Association of South Africa (RuDASA) and the SA Academy of Family Practice.

Dr Siwisa was recognised for starting the ARV rollout programme in Taung. In less than two years Siwisa and his team have signed up 2 876 patients for the programme, nearly 2 000 of whom are already receiving treatment.

In his short acceptance speech he said: “The award is for the whole team. It is a hard-working under-staffed team. They are dedicated. Without them I don't think it would get this far.”

He is dismissive of the sacrifices he has had to make. Living in Taung is tough for someone who used to be a world-citizen with his own private practice in Randfontein.

By now there are two doctors, but for a while Siwisa was the only medical practitioner guiding the ARV team.

Siwisa is a product of Lovedale College in the Eastern Cape , but went into exile in 1963 – first to Lesotho , then to Botswana . He was allowed entrance into a medical school in Lagos and trained there.

In 1989 he followed his heart and came back to South Africa , but he ran into the Apartheid brick wall. Since he was registered as a citizen of the Transkei , the South African authorities did not allow him to practice. It was only in 1990 that he was given a South African ID and then he was allowed to practice. He worked at Chris Hani Baragwanath Hospital , Life Care and Carletonville Hospital , after which he opened a private practice in Randfontein.

But the government's refusal to link HIV to AIDS made him uncomfortable. “People were dying with AIDS. The government was saying that HIV and AIDS are not related. I felt bad about it, really, and I wanted to learn as much as possible about it.”

He completed two separate courses on HIV medicine, then he “started looking for the earliest opportunity for rollout. Taung advertised. I contacted them and they said I could come.”

Siwisa gave up his private practice and left for the deep rural heartland of Taung. His first reaction of Taung was that it is the “Burundi of South Africa”. His bank does not have a branch there, and “when my car breaks, I am in trouble.”

The clinic, serving the Bophirima region in the North West Province already had a project manager, Mr JK Letsoalo. With Dr Siwisa's help they created the infrastructure and prepared for accreditation. That was in October 2004. In November 2004 they were accredited and the work could start. By now they have nearly 2 000 patients on the rollout programme. Some of their patients are children. Once a month someone from Chris Hani Baragwanath Hospital visits Taung to monitor the children and to assist the team. Dr Siwisa describes the Reproductive Health Research Unit from Wits as their mentor from the beginning; they do a support visit at least once a month.

Afterwards he was asked whether it is easier in Taung now, after having spent two years there. He laughed: “Easier? I think it is the patients who make it easier.”

During her speech at the 10 th RuDASA Annual Conference on Rural Health, deputy minister for health, Ms Madlala-Routledge, congratulated Dr Siwisa on receiving the award and said: “The time for denialism is over. Each of us has to act and act decisively.”

When asked what it was that Siwisa said to the deputy minister afterwards, he answered: “When I spoke to the deputy minister, I said we hope the government would start looking again at our staffing situation.”

Dr Siwisa does calls at the Taung hospital after hours.

Elma de Vries
August 2006