When Dr Nokubonga Vundla began her medical journey, she never imagined she would end up working in one of the most complex and demanding fields of medicine, clinical haematology, the study and treatment of blood disorders, cancers and bone marrow transplants.
But her passion for transplant medicine was ignited during her specialist training in Cape Town, where she encountered the life-saving potential of bone marrow and organ transplants.
That passion and persistence have now earned her national recognition. Vundla, one of only about 20 clinical haematologists in South Africa, was honoured with a Sub-Specialist Award at the Discovery Foundation Awards held last Thursday. The annual awards celebrate leadership, academic excellence and innovation in South African healthcare.
According to research, the country faces a critical shortage of doctors, with only 5.5 per 10,000 people, and even fewer medical specialists, making professionals such as Vundla invaluable.
Durban-born Vundla, based at Groote Schuur Hospital in Cape Town, said: “I’m a clinical haematologist and a fellow there. I’m already a specialist physician, but this is a subspecialty where you focus on blood disorders, blood cancers and bone marrow transplants.”
Finding her calling
Speaking to the Sunday Times after receiving her award, Vundla recalled how she once vowed never to pursue internal medicine.
“You would admit 30 patients, and by the next morning, you’re certifying 15 deaths. I told myself I’m never going to do this,” she said.
While working as a community medical officer in Port Shepstone, a senior doctor changed her mind. “She said I would make an excellent specialist physician,” she said.
At the time, there were no specialist training posts available in KwaZulu-Natal. Undeterred, she reached out directly to the University of Cape Town.
“I literally emailed the secretary to the HOD and said, ‘Look, I need a post, here are my qualifications.’ They said there were no posts, and I said, ‘Call me when one opens.’ Eventually, I got a call, did the interview and was appointed as a medical registrar in 2016.”
Before a patient can even reach a specialist, they must go through primary healthcare, which can take several days. For someone earning R250 a day, taking that much time off work means losing most of their week’s income. So people default on follow-ups, not because they don’t care but because they can’t afford to go back.
— Dr Nokubonga Vundla
Her training was extended when Covid-19 struck.
“I was supposed to write my exams during the first wave, so I ended up staying in Cape Town a year longer. After qualifying, I returned to Port Shepstone as a specialist physician. But I realised I’d always wanted to do clinical haematology and oncology. I was just gatvol of everything and knew it was time to follow my passion,” she said.
A shortage with deadly consequences
Blood cancers such as leukaemia affect more than 2,000 South Africans each year, yet access to specialists remains dangerously limited.
“The lack of clinical haematologists means that if you have a blood disorder, whether in public or private care, it could take months before you see a specialist. And if you live outside major metros, the waiting time is even longer. In Pretoria, for example, there isn’t a single clinical haematologist,” Vundla said.
Vundla is passionate about encouraging South Africans to register as donors.
“There’s no need to take your organs to the grave. You can leave them as a gift to those who are living,” she said.
She said the beauty of bone marrow donation is that you don’t need to be dead to save a life. “And the process has become much less invasive; we no longer need to go through your bones.”
She said medical advancements have drastically improved outcomes for cancer patients.
“When people hear ‘cancer’, they stop listening to what the doctor says next. But these days, chances of survival are really good, even when the cancer isn’t curable. We can treat patients well enough for them to return to work, to school, and to live meaningful lives.”
The rural struggle
Despite medical progress, Vundla said patients in rural areas face overwhelming barriers to care.
“In rural areas, once a doctor suspects cancer, the nearest referral hospital can be 300km away. Even emergency transport can take a day or two because ambulances are fully booked months in advance,” she said.
Public transport is equally unreliable.
“Before a patient can even reach a specialist, they must go through primary healthcare, which can take several days. For someone earning R250 a day, taking that much time off work means losing most of their week’s income. So people default on follow-ups, not because they don’t care but because they can’t afford to go back.”
And the challenges don’t end after diagnosis or treatment.
“After a transplant, whether bone marrow or organ, patients need long hospital stays and regular follow-ups. For someone living 600km from Cape Town, that means relocating for up to six months. Many have young children at home, and the decision is heartbreaking. Without follow-ups, the treatment fails. And if there’s no follow-up, it’s as good as killing you.”
Despite the hardships, Vundla remains hopeful.
“Make no mistake, we can provide world-class medical care in this country. The expertise is here. What we need is a system that ensures patients, wherever they are, can reach it,” she said.
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