Covid Crisis No Match for Old Collegian

Dr Ayanda Trevor Mnguni, who matriculated from College in 2002, has since gone into a career in medicine and has been vital in the Western Cape’s fight against the Corona Virus. Dr Mnguni is the Head of the Department of Internal Medicine at Khayelitsha District Hospital, a 300 bed hospital serving no less than 10 surrounding clinics and an estimated population well over a million. The massive population of this township made it the Western Cape’s biggest hurdle leading into the hard lockdown in March. Dr Mnguni and his staff had to deal not only with the threat to their own health and the worry of running out of vital supplies and protective personal equipment (PPE); but had other concerns like overcrowding of their emergency unit, lack of beds, lack of isolation wards and a decreased ability to offer high flow nasal oxygen to potential Covid-19 patients as the infrastructure (diameter of the pipes) was not able to deliver oxygen at high flow rates.

It was only through the work and dedication of Dr Mnguni, his staff, strong relationship with their referral hospital (Tygerberg Hospital- department of Internal Medicine) and collaborations with big organisations such as Doctors without Borders that the hospital was able to admit a total of 644 patients in single month during their peak, the highest number since the hospital’s inception in 2012.

It was through the values he learnt during his time at College that he was able to overcome the colossal challenges that came with this job, even when a peak in staff infection rates made service delivery more challenging than ever.

As if that wasn’t enough, he had to face his own personal challenges which was to sit his final exams as a sub-specialist in field of Pulmonology during the peak of the provinces infection; an exam that has been elusive over 4 attempts spanning over the past three years. Dr Mnguni credits his time at College for preparing him to work towards his goals and strive for excellence no matter the odds. “My achievements have not been without many challenges, ranging from growing up in a township in Imbali, taking 3-4 taxis per day to get to school, not having the financial background to study at Maritzburg College, almost losing my spot at medical school due to not being able to afford registration fees in my first year.” Dr Mnguni says that without the core values taught at College such as discipline, courage and perseverance, he wouldn’t have been able to finally pass his pulmonology exam to become the first ever Black African to do so through the University of Cape Town and Groote Schuur Hospital.

We chatted to Dr Mnguni to find out a little more about his experience on the frontlines and reminisce on his time at College.

What would you say has been your biggest challenge during this time?

Definitely the preparation. I think we all went into it expecting the worst and so the preparation was frantic and extensive. Khayelitsha District Hospital is fairly new as far as hospitals go, and like many others around the world, was not designed to withstand a pandemic. The challenge of having to isolate hundreds number of patients with a limited number of isolation beds available in the hospital combined with the existing burden of other infectious diseases such as Tuberculosis-which require patients to be isolated combined with the separation of patients who are admitted with general medical conditions from patients who are infectious posed a significant hurdle.  Once we navigated this hurdle and our structures where in place, caring for our patients became easier and our systems became more efficient during the pandemic -so yes, the preparation phase posed a significant challenge.

Which of your patients has had the biggest impact or effect on you and why?

That’s a difficult question as there have been so many throughout this pandemic. One of the difficulties with being admitted with COVID is that patients are isolated from their loved ones at a time of vulnerability and uncertainty. This contributes to significant anxiety not only for the patient but also for the family.

So I remember, we admitted two sisters (in their 60s) who were high risk patients who both had severe Covid-19 disease and were very unwell. We were able to admit them in the same ward, same room and their beds were next to each other. It was really nice to see them encouraging each other on the days when either one of them were not doing well. It was nice for them not to have to go through it alone. Thankfully, as if they had synced immune systems, both sisters started to recover simultaneously and were moved to a field hospital we had set up across the road to help cope with numbers. These sisters were initially reluctant to be transferred to our field hospital as they felt that it would impact on their recovery and they weren’t aware that we also provided clinical cover for our field hospital. When they eventually moved and I went across to see them they were both so thrilled to see me and said they hadn’t wanted to move because they wanted to stay under my care at the main hospital. Having to isolate from most of my family and friends it was nice to have built such a strong relationship with them. Watching them go through the worst together, being there for each other and then recover together was very special for me.

Did you know from when you were in school that you wanted to be a doctor?

Not really, I wasn’t too much of an academic when I started at College. I was definitely more interested in sport, mainly cricket and soccer, and actually thought that’s what I would do professionally. Then, later in high school, we had an away rugby fixture at Pretoria Boy’s High School and I broke my arm during my game. When I was taken to the hospital, it was that experience and watching the orthopaedic surgeon at work that sparked my interest with regards to medicine. Of course, not being an academic, I had to get my grades up. That meant dropping to second team soccer and some other sacrifices I had to make along the way in order to achieve my goals.

What were your favourite subjects in high school?

I always loved biology. Even when my focus was sport, I still had an interest in biology and physics. I’ve actually also always loved accounting and even considered doing it at a tertiary level but ended up going the medical route. Another subject I really enjoyed was Mr Mhlongo’s IsiZulu class. Mostly for social reasons, the way he teaches made the lesson an interactive experience, so we all used to really look forward to his lessons.

Do you have any words of advice or encouragement for the College Community with regards to the Covid-19 pandemic?

I guess if anything, I would say don’t fall into the trap of relaxing as the regulations are being eased. The fact that the regulations are easing up, does not mean the virus is and it certainly doesn’t guarantee the worst is over for us as a country. We need to come together… by continuing to wear our masks, washing of hands and keeping our distance.

Then to the students and 6th formers in particular… having had to sit my pulmonology exam during this time, I can relate to what the matrics are going through. I cannot stress this enough to those boys, that preparation is key even in the midst of the challenges! This pandemic has allowed you an opportunity to learn some new skills, to learn to adapt, that is a blessing in disguise. The skills gained will hold you in good stead as you move forward as self-study and online learning forms a big part of your learning and development at tertiary institutions.

To the teaching staff at the school, I would also like to thank them for their effort in being able to provide teaching and learning opportunities to the boys under atypical circumstances.

And in closing, I think that it’s important to highlight important issues apart from COVID that are currently plaguing our beautiful country and society. The issue of gender based violence and race relations – as men, young and old we have a collective responsibility to treat the woman and children of our country with love, compassion, kindness whilst offering them safety and protection. We also have a great opportunity to start having honest conversations pertaining to race relations and come up with solutions which will ensure that future generations of College boys and Old boys work together for the greater good of not only the school but society at large. Maritzburg College naturally being a leader, is perfectly positioned to take the lead regarding how we navigate these issues and thereby forming the blue-print for other schools and society to follow. I would love to see and look forward to my alma mater continuing to make a real difference in our society at large.

‘Pro Aris Et Focis’

Ayanda Trevor Mnguni(OC2002)