Dr Pfunzo Machimana gets to the heart of healthcare-seeking behaviour

If it was up to her, she'd launch a massive national campaign to educate people on how fundamentally their behaviour affects their lives, especially when it comes to taking responsibility for their health.

Like her colleagues nationwide, Dr Machimana spends an inordinate portion of her time dealing with preventable illnesses, nevermind seeing the same people return to casualty time and again with bullet or stab wounds.

A large part of her approach to medicine was instilled during her MBChB training in Cuba where primary healthcare is the chief focus - something South Africa has been struggling to adapt to at great cost over several decades.

"Can't we just tell people that it's better to die from non-self-inflicted causes? I think I'm a closet social worker," she says with a wry chuckle.

At first, the high school top achiever studied mining engineering with a scholarship her father secured for her. But in 2006, Dr Machimana earned a bursary from the Limpopo Department of Health to study medicine in Cuba.

Cuban training a huge influence

The scholarship helped her to realise a childhood dream born of witnessing the miraculous return to health of family members after a visit to their local doctor.

She returned from Cuba with a working knowledge of Spanish and completed her clinical adaptation year at Sefako Makgatho University Medical School in Ga-Rankuwa. After that, she did her internship at nearby George Mukhari Academic Hospital and her community service years at Donald Fraser Hospital in Venda.

Dr Machimana spent her first few years as a medical officer at Hayana Hospital in Thohoyandou near her home village of Maniini. Working out of Jubilee District Hospital and George Mukhari Academic Hospital, her fourth-year research project goes to the heart of healthcare-seeking behaviour.

How complete is the Road to Health booklet?

With her Discovery Foundation Rural Individual Award, she's auditing the Road to Health booklet at the Temba Community Health Centre in Hammanskraal, 40 km from Pretoria.

The Road to Health booklet, a potentially powerful primary healthcare tool, is only as good as the entries made by the patient and attending healthcare worker.

Dr Machimana's preliminary conclusions are that vital sections about how a child was born, their immunisation records, nutrition and developmental screenings are often left blank - with the book sometimes lacking a single entry.

"One of the early trends emerging from this study of 246 booklets includes absent or poor dental care records, which ties in with notoriously poor dental care in impoverished communities, countrywide," she says.

Living to heal and educate

What she most likes about family medicine is that she's able to explore her patients' emotional needs as well as their environment, including the family and workplace.

"Just a little exploration of what's happening in their lives can reveal a wealth of information and help you to single out stressors," she says. "It could be a family death or neighbour with a brain tumour and now they want a get a CT scan, virtually anything, but you can often intervene more appropriately at an earlier stage," she says.

She believes family medicine will give her the opportunity to live up to her given first name, Pfunzo, which means education in Tshivenda.

This article was created for the 2021 Discovery Foundation Awards and has been edited for the Discovery Magazine.