#LGBQTILife: Working as a doctor in rural South Africa

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Dr Anele Mhlakaza is a 28-year-old trans man medical doctor working in rural Eastern Cape. He is currently in his third year as a registrar specialising in family medicine.

What has your work experience been like?

We work in rural Transkei in the Eastern Cape. It is a beautiful place. I love it here. The beach is just right down the road. People are not in a good space here, but they are happy. There is more to life than what we grow up thinking it is, and can be.

I work at a small mission hospital. Work starts at 07h30 every day. We live and work together in this small village. Our neighbours are living in huts, keeping to Xhosa traditions strongly. Work is everything you can imagine. Some things are shocking because you only think it only happens in the cities. Then you realise it happens everywhere. We see everyone from babies, pregnant women, to older folks. There is a great sense of community here. I will be based here for another two or three years.

 How have your experiences been these last few years?

I have been pleasantly surprised these last couple of years, and starting my transition. With everything that society thinks they know about the LGBQTI community, you go in apprehensively. The experiences I have had have been quite eye opening. Regardless of who and where you are in society, whether it be deep in Xhosa land in the middle of nowhere by the ocean. Or in the heart of Transkei in Umtata, everyone is trying to get something and get somewhere. It really doesn’t matter where you are. If you live your authentic truth, society doesn’t matter. It catches on. I guess a lot of Trans people don’t speak about where people actually prove you wrong. Yes, people are still deplorable.But we passively teach people by just being ourselves. I have learnt a lot since I transitioned about society in general, and the people around me. It has been enlightening.

What are thoughts on South African healthcare as a trans physician?

With my own experience access is the biggest issue. Healthcare in general in South Africa is inaccessible. People who need it can’t get it, and can’t afford it. They are too far away, and have no knowledge about what is available to them. They are isolated and the thought of health is secondary. When I started my transition I was a student in Umtata. I was at a historically Black university; Walter Sisulu University. I was in a totally different cultural and social setting that I wasn’t exposed to before. I was a fish out of water thrown into the deep end where nobody had answers. Each time I tried to get access, I was told maybe I can access the healthcare I needed in Johannesburg or Cape Town. None of the general practitioners had any idea where to begin or what to do. The majority of the rural and neglected areas don’t have access.

Trans people don’t have access to healthcare. It is not something that is taught in mainstream medical training, including psychiatry and family medicine. You hear about it from other sources. But honestly most people don’t know how to deliver healthcare to Trans people in these areas. I believe in advocacy for everyone equally. I believe childhood malnutrition needs me to go just as hard for them, as I would for the 12-year-old Transgender girl who is trying to start her journey. I think I went into family medicine because I believe everyone deserves all of it. I am giving you everything I can when I am doing my job. It is why I am doing this.

 What can be improved?

As a medical professional our training needs to transform from the inside out. It is not just our responsibility as healthcare professionals to hold space for LGBQTI people- who deserve healthcare the same as everybody else. But also to be advocates. We need to fight for healthcare in general to be transformed, and definitely the healthcare that Trans people are getting. It is slowly happening.

Any parting thoughts?

We need to listen and believe in the child that we once were. As children we are so raw and so open. We actually know so much about who we are as children. Then the world comes in and tells us everything we are not and can’t be. It tells us what we should be, and what is required of us. We forget everything we believe when we are children. I think the minute we as Trans folk regardless of where we are, when we remember that we should trust it. Don’t let anyone stand in your way. You have known yourself before you met yourself. The minute we start trusting what we know about ourselves we can live, breathe and we can become. That is what I am learning.

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