Medicine and motherhood in Mpumalanga

Medicine and motherhood in Mpumalanga

One of our Dutch doctors, Dr. Marthe Zeldenrust, shares her story of life in the province of Mpumalanga, which borders Mozambique and Swaziland. It also includes the southern half of South Africa’s most famous nature reserve, Kruger National Park, home to the Big Five, and the iconic Blyde River Canyon, Africa’s second largest canyon, at over 4500 feet deep.


Since I started working in Tonga Hospital, I have gone through several life stages – and it has only been 18 months!

I first came to Tonga in 2012, to visit friends who were working there. When my friends showed me around, I was immediately impressed by the facilities. I was coming from a remote hospital in Somaliland, in very primitive settings, where we had almost no laboratory facilities, only two doctors for the whole hospital and virtually no referral options. So when I visited this rural South African hospital, I was impressed: About 10 doctors to discuss and share work (and night shifts) with, advanced facilities for newborns and monitoring of the fetal heart rate during labour, extensive laboratory facilities, in a hospital that was built only 20 years ago, with referral options and even a chopper standby… and not to forget: Many weekends off to enjoy Kruger and other beautiful parts of South Africa. So I made up my mind and decided to start the process of applying for a job at Tonga Hospital. My partner Thijs, who is a mechanical engineer by training, saw options to work in a nearby sugar mill.

For all foreign-qualified doctors the process of registering as a doctor is quite lengthy. But fortunately AHP helped me a lot with this, and before we knew it we set off to Tonga!

Being trained in a Tropical Medicine and International Health training programme in the Netherlands, I felt prepared to work in a rural African hospital. But even doctors who haven’t done such training can still share their skills and learn a lot on the job – so did my three British colleagues, who started a few weeks after me. The team I started working with consisted of South African doctors and clinical associates, and doctors from Europe and other African countries: Each of us with a different set of skills, complementing each other, yet working as generalists. I started working in the Maternity team and really enjoyed the work, being able to save many lives. Since all my colleagues lived on the hospital premises, it was easy to spend after-hours together. Also, weekends were well spent with the Kruger National Park, Swaziland and Mozambique just around the corner. To Thijs’ relief, we also made quite a lot of ‘non-medical’ friends, who didn’t talk medicine all the time.

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Meanwhile, Thijs was trying to get a job at the sugar mill, but this turned out harder than he thought. Nevertheless, he was happy to (finally) have time to start working on some longstanding projects for himself, without the financial pressure that he would have in the Netherlands. After a few weeks, he also became involved in an after-hour school programme, working in a nearby community, helping to prepare the smart and interested kids for university. They teach them literature, critical thinking, social skills, English, physics and more skills to improve their chances in life. So even though Thijs didn’t find the job he initially hoped for, he was able to get involved in the community, and there was never a dull moment – and then, of course, he could always spend a day at Kruger, which is only 40 minutes away!

Sometimes it feels as though time stands still here, that you can grasp and enjoy the moment, and yet it flies at the same time. A big change to our lives was on the way – we were expecting a little baby girl. In June, we went back to the Netherlands, and that is where our daughter Mette was born. We spent most of my maternity leave in the Netherlands with family and friends. After three months in the Netherlands, we came back to Tonga with our little addition. It was nice coming back to our little community in Tonga, seeing our friends again, and it was time to start getting back to work. Although it would not be hard to find a nanny, we decided Thijs would stay with Mette while I went to work, at least for the first few months.

I must be honest, getting back to work was a bit tough, especially since I was still breastfeeding. But living on the hospital premises was good at this stage; it made it quite easy to combine working and breastfeeding, a luxury that not every new mother has.

But of course life is not a fairy tale – there are always frustrations. A quick impression of things that can upset me: A lack of personnel, the feeling that we are losing lives unnecessarily, but also the extreme impact of poverty and lack of education, patients acting stubborn and leaving the hospital against our advice when they are really ill, the HIV and TB epidemic, and how patients fuel them.

Yes, Tonga is quite a rough diamond, but I am happy with the lives I save and with the pace of life. Coming from a busy city, I love how life here is more pure and simple, how you don’t have to plan months ahead, and how you can achieve a lot with relatively few resources. And I love seeing my baby grow up in the middle of so much nature, with a father who cares for her and still has time to invent useful things.

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Blyde River Canyon image courtesy of: