A nephrologist with a vision for justice in health care
- Wacango Kimani
Dr. Nolubabalo Unati Nqebelele has been awarded a PhD in nephrology. She is the first black woman to earn a PhD in internal medicine at Wits University.
A first at Wits
Nqebelele has been awarded a PhD in nephrology, becoming a specialist in Chronic Kidney Disease (CKD). She has also been recognised as this year’s recipient of the Ken Huddle Clinical Role model award. She is the first black woman to earn a PhD in internal medicine at the University of the Witwatersrand.
With a heart for social justice in medical and health care, Nqebelele says physicians are not only about treating individual patients. “We also must pursue universal health care for everyone as a fundamental human right. The unacceptable inequalities in health care are a moral, political, social, and economic obligation of every doctor.”
Her achievement is no small feat. Nephrologists holding PhDs in South Africa are a select group of fewer than 10 physicians. Nqebelele follows in the footsteps of other medical women firsts at Wits, including legendary Wits alumnae Dr. Mary Susan Malahlela and recently elected Chancellor, Dr. Judy Dlamini.
While she is proud of her achievement, Nqebelele wonders why it has taken so long for women at Wits. “There have been many women before me who could have achieved the same qualification. Women doctors face social pressures and professional prejudices on their path to becoming specialists,” she says.
The importance of mentorship
She knows for sure that one way to boost the number of women doctors moving beyond their first degree into specialisations is through mentoring. “Even though it is not easy to be what you haven’t already seen, a mentor’s encouragement makes a big difference. Because women are traditionally encouraged to pursue non-science careers, when one person stands out, that inspires others. Even though the road is tough with barriers and hurdles, winning against many odds inspires others to dream; to have limitless ambition," says Nqebelele.
Nqebelele is grateful for the support and encouragement from her mentor, Emeritus Professor Saraladevi Naicker in the School of Clinical Medicine, under whose guidance and support she realised the importance of mentorship. From her own experience, and recognising the value of mentorship, she is a host mentor for the International Society of Nephrology’s Fellowship programme, whose goal is to provide relevant nephrology training to specialist physicians from countries in the global South. She has mentored doctors from Uganda, Mozambique, and Nigeria who successfully completed their studies and have become Fellows of the International Society of Nephrology.
Despite a study in 2016 that indicated more women than men are enrolled in undergraduate medical studies in South Africa, women face challenges moving beyond their first degree. Fewer women than men are moving into medical specialisations and, when they qualify, they are not automatically accepted as specialists. Men are still perceived to be better suited as medical specialists. Additionally, there are few women doctors in leadership positions in academia and professional societies.
“As in many professions, women’s determination and passion are the qualities needed to deal with cultural prejudices. Having supportive family and friends is also critical”, says Nqebelele. “We need buffers to cushion us after long hospital hours, and often with very limited resources. A special ring of caring individuals is important to support women doctors to believe in themselves and persist beyond the challenges. It encourages us to keep working hard.”
Kidney credentials
Nqebelele was born in Umtata where she often visited the local hospital with her mother, who is a nurse. Nqebelele qualified as a doctor at the University of Cape Town in 2000 and began her medical career at the Umtata General Hospital in 2001. After a short stint as a medical officer at the Gloucestershire Royal Hospital, Gloucester, UK, in 2003, she moved to Gauteng and worked at the Chris Hani Baragwanath Academic Hospital and the Charlotte Maxeke Johannesburg Academic Hospital.
Her career at Wits has included serving as Registrar in the Department of Internal Medicine and leader of the Chronic Haemodialysis Unit at Charlotte Maxeke Johannesburg Academic Hospital. Before turning to full-time PhD studies in 2014, she served at the CMJAH as a Specialist Physician and Senior Consultant Nephrologist.
Nqebelele is a Nephrology fellow and a fellow of the College of Physicians. She has won local and international medical awards and scholarships, beginning with the Noristan Award for Best Medical Student in 1995. Her research has been recognised by the South African Medical Research Council’s National Health Scholarship Programme; the US-based Carnegie Foundation; the AstraZeneca Research Trust; the David Hepburn Memorial Award; and the KwaZulu-Natal Kidney Foundation and National Kidney Foundation/Adcock Ingram Research grant. Her research has been shared and published at various local and international conferences and in journals including the African Journal of Nephrology and at the World Congress of Nephrology in Mexico City. In addition to her medical qualifications, Nqebelele has also attended self-initiated learning in medical teaching, finance, management, and leadership.
A member of South African, pan-African and International nephrology associations, she also serves as Chair of the Wits Clinical Medicine Research Committee and is a member of the Ministerial Advisory Committee on Organ and Tissue Transplantation, and the Ministerial Advisory Committee on Renal Dialysis. Her teaching experience includes training undergraduates, medical interns, officers, registrars, and nephrology fellows, and she serves as an examiner of undergraduate and postgraduate students at Wits.
A vision for health care and the skills to realise it
“When a patient walks into a clinic, they not only walk in with an ailment but everything else in their world that impacts their health. When an institution does not provide equal health care to everyone and does not relentlessly work and make changes, it is committing structural violence against its clients. We must not stand by and say there is nothing we can do. While making a difference to one person is great, imagine making a difference to everyone who walks into a hospital. That must be our goal and vision as doctors,” says Nqebelele.
Her vision is serious but is delivered with generous amounts of positive attitude and enthusiasm. Fluent in five South African languages, she also communicates her optimism with her patients in their own language preference. The frequent wedding, birthday and graduation invitations from patients tell the stories of grateful people.
“Mum keeps us in stitches,” said her children, Wonga and Kholo. “We love her company because she is very funny with us.” Nqebelele maintains her positive outlook with travel, family fun, and adventure. She is an intrepid traveller who has made solo adventures to several African countries, including Gabon. She holds a Diploma in French so that she can travel to both English and French-speaking African countries and communicate with patients from Francophone Africa.
At the SA Renal Congress held in October, Nqebelele presented her research findings. Even though South Africa has been on the path towards quality universal medical care for decades, and the resources required to fulfill this national goal are obtainable, quality healthcare still eludes many patients, particularly those with CKD. Nqebelele feels that the unacceptable inequalities in the provision of and access to health care are a political imperative.
Nqebelele serves on several committees in government, university and international organisations, such as the International Society of Nephrology and the Ministerial Advisory Committee on Renal Dialysis of SA’s Department of Health, South Africa.
“These are not for boosting my CV. There are more women becoming doctors and specialists but few are rising in leadership positions at universities and professional organisations. Women must get into public office in order to effect change. Our voice matters.”
If she were the health minister for just one hour, Dr. Nolubabalo Unati Nqebelele would make drastic policy changes to ensure equity, equality and universal access to dialysis for all kidney patients throughout the country. Dr. Unathi has a vision for social justice in health care and medicine.
“Getting kidney dialysis in South African is often a matter of chance; like a lucky draw. The criteria for selecting which patients go for dialysis is interpreted in different ways. Being selected for dialysis depends on who is interpreting the criteria – today you can be luck but tomorrow your luck could run out.”