Inside Dr George Mahembe’s fight for healthcare in rural Eastern Cape
At Wilo Clinic in Jojweni Administrative Area near Mqanduli, a rural part of the OR Tambo District in the Eastern Cape, a woman arrived in labour, nine centimetres dilated and on the verge of giving birth. The clinic nurses had not delivered a baby since completing their training. Ambulances were unavailable because of protests blocking roads.
The clinic staff were stumped. They didn’t know what to do.
But instead of panicking, they turned to a WhatsApp network connecting clinics, community health workers and doctors across the district.
One of the doctors attached to the district happened to be doing outreach nearby. He drove over and helped deliver the baby.
The WhatsApp group is part of the Zithulele Network, a collaboration of healthcare workers and facilities across the district that has become woven into the everyday delivery of healthcare, helping clinicians share expertise, coordinate referrals and solve problems in real time.
For Dr George Mahembe, the moment captured the reality of rural healthcare more clearly than any policy document could. In parts of the Eastern Cape, survival often depends on who answers the phone.
Mahembe is a family physician and senior lecturer with Walter Sisulu University, based at Zithulele Hospital. He is also the hospital’s only family physician. His days move between clinical work, supervision, governance responsibilities and community projects that stretch beyond the walls of the hospital.
He grew up in Zimbabwe in a family shaped by nursing. His mother was a midwife. The women around him worked quietly, steadily, without spectacle.
“I often joke that my mother carried an injection in her handbag for everything,” he said. “But honestly, it was their quiet example that shaped me long before I realised it.”
After studying medicine at University of the Witwatersrand, interning in Bloemfontein and completing community service in Lady Frere, he found himself pulled back toward rural medicine. City work left him feeling detached from the reasons he had entered healthcare in the first place.
“These patients are sick,” he remembered thinking at the time, “but they’re not the ones who need me.”
These days he spends his time at Zithulele Hospital situated in Mqanduli, Eastern Cape.
In the communities surrounding Zithulele, distance itself has become a health risk. Some patients travel more than 50 kilometres to access care. A hospital visit can require two or three taxi rides costing up to R200. Patients unable to sit upright often need to hire a bakkie for transport, sometimes at the cost of an entire social grant.
The result is predictable. Follow-up appointments are missed. Conditions worsen quietly at home. Clinics become overcrowded with preventable complications.
Mahembe believes technology could ease some of that pressure. He imagines community health workers visiting patients at home, collecting information digitally and sending it directly to doctors for review, reducing unnecessary travel and helping patients stay connected to care.
At the same time, he is cautious about presenting technology as a miracle cure. Rural hospitals are still battling basic failures.
Zithulele, once regarded as a national example of rural healthcare innovation, now faces ageing infrastructure, medicine shortages and high staff turnover. Around the hospital, waste has begun piling up in open areas because of weak collection systems, creating conditions for disease outbreaks.
Mahembe wants hospital-led waste management systems, stronger district surgical services and more opportunities for healthcare workers to train without leaving rural areas.
He speaks often about networks. Not abstract partnerships assembled for conference presentations, but practical relationships between healthcare workers trying to solve immediate problems.
In one district hospital, doctors skilled in skin graft procedures became a referral point for neighbouring facilities because they had the equipment and expertise others lacked. Elsewhere, clinicians routinely share medical supplies when stock runs out.
For younger healthcare workers, those connections can determine whether they stay or leave.
“Working in rural areas can feel isolating,” he said.
When he first arrived at Zithulele, fellow family physicians from across the country phoned him daily, offering guidance and reassurance. Most barely knew him. But they understood the weight of the work ahead.
That solidarity, he said, changed everything.
Today, he and his wife are preparing to launch a seedling project for school gardens while also developing a teenage pregnancy awareness campaign for local schools. The projects sit alongside his hospital responsibilities because, in his view, healthcare cannot begin and end at a bedside.
“I realised you can’t change the health of a community at the bedside alone,” he said. “I tried it. It doesn’t work.”
At Zithulele Hospital, change still moves slowly. Administrative processes drag. Staff shortages remain severe. Systems resist reform.
But somewhere between the clinic WhatsApp groups, the outreach drives and the unanswered ambulance calls, a different healthcare model is being pieced together quietly by people who have stopped waiting for perfect conditions before acting.