Dr. Zolelwa Sifumba on Self-Care

July 4, 2021
9 min read

Zolelwa Sifumba was just 22 when she contracted multi-drug resistant tuberculosis as a student doctor. The treatment was life-saving, but harsh. It turned Sifumba into an advocate for the wellness and protection of health-care workers.

Then in 2020, while doing her community service, Sifumba found herself on the frontlines of another pandemic—Covid-19. Once again, she fearlessly advocated for the rights of frontline workers, speaking up for access to personal protective equipment, but also for the mental health of her colleagues.

This year, she stepped away from the frontline, choosing to take care of herself before others, even if it was her profession. She spoke to The Thread about what self-care means to her.

We know that self-care is not just spa days and chocolate cake, it’s also a radical decision for women, particularly women of colour. How do you define and practice self-care?
To me, self-care is providing for myself the things I need in order to be holistically well, not just preventing myself from falling ill but constantly working to maintain a state of wellness in all areas of my life.

 This involved firstly getting to know myself, my traumas and then learning about my personal needs and putting them above all else at all costs—even above the needs of others—something exceedingly difficult to do particularly for women of colour. Often, the demands placed on us by ourselves, families, communities and society at large have us living more concerned about the needs of others, putting them before our own; many of us being praised for such.

Sadly, my role as a health care worker would further demand I put myself last, which was why I made the decision to leave when I did. I don’t think the demands placed on us are humanly possible and I strongly believe that these demands need to be addressed.

Self-care for me has been learning to heal myself through the work I do, the food I eat, the way I interact with myself and those around me as well as the way I handle myself and my needs. Learning self-compassion, radical acceptance and how to be kind to myself saved my life. Learning how best to live with myself, that is self-care.

All my patients knew that when I encouraged them to do something to help them heal, it was and is because I did it myself first and as a result understand the difficulties that come with healing.

You’ve described contracting and beating TB as facing your biggest fear. Then you had to work during the global pandemic. What was it like to put yourself on the frontline again, this time as a TB survivor and how did you take care of your mental and physical health each day?
Putting myself on the frontline again as a Multi-Drug Resistant TB (MDRTB) survivor was one of the most difficult and frightening things I have had to do in my life. I knew that I could contract COVID19 on the frontline and possibly die and nothing would be done about it.

Years ago, I contracted TB as a result of the profession I chose, due to global systemic failures in ensuring the health and wellness of health care workers is a priority. To be faced with the same danger years later in another global pandemic, after just as many years fighting and advocating for the improvement of those circumstances broke parts of my spirit, my love for the profession and the work I was doing, especially because when I tried to care for my physical and mental health, or fight for that of others, my profession would not accommodate for it, there was just too little time, space or money for it.

One should not have to choose between their health needs and that of their patients. I struggled to take care of myself all year due to demands placed on me, which left me both mentally and physically depleted and ill requiring time off and an admission to hospital, a challenge faced by many health students and workers globally currently and in times past.

You contracted tuberculosis while working as a student doctor in Cape Town. What was some of the physical and mental toll this took on you, and how did it change your approach to caring for others and yourself?
Contracting TB took a huge physical and mental toll on me, it traumatised me. I had no idea that I could contract TB because of all the negative stigma that exists, but later came to understand that what left me at risk was just the fact that I breathe.

I was ill all day on an 18-month treatment regimen while trying to function normally and progress, struggling with nausea and vomiting, diarrhoea, joint pains as well as excruciating pain from the daily injections affecting my mobility, to name a few side effects.

I was also severely depressed and suicidal, suspended in fear that my life would end due to the TB, its treatment or by my own hand to end the daily suffering that seemed to last a lifetime. To me, my life had ended. With a 40% chance of survival, I was dying, but I fought and survived. 

This experience taught me that caring for myself is my job and that I must fight for it, even when my fight looks different to others or defies what is expected. 

This experience coupled with my studies taught me more about the health system and the people that rely on it than my studies could have done alone and gave me first-hand experience of what the patients I would treat would go through. All my patients knew that when I encouraged them to do something to help them heal, it was and is because I did it myself first and as a result understand the difficulties that come with healing. It made me a better doctor to my patients, it made me relatable and taught me how to heal myself and others.

For some reason I feel you can trust a doctor who has been ill and helped heal themselves.

Being punished for trying to bring about meaningful change has been a huge stumbling block for my career but the triumph though, was getting to use my voice to tell of the hells faced by health workers globally and the help we need.

During the Covid-19 pandemic, you spoke out about the lack of protective measures for frontline workers, the physical risks you and your colleagues faced and the mental toll of working during the pandemic. What were the triumphs, but also the potential losses, of speaking up and demanding greater care? 
Sadly, I faced greater losses than triumphs for this. The problem is that as health care workers we are expected by the health system as well as generations that have come before us to grin and bear the impossible load rather than see it for what it is, a human rights violation. 

Even though I was raising the alarm on pertinent issues faced globally in the health community, speaking up made me a target of bullying where I worked. I was threatened and mistreated by people senior to me, some of the PPE we needed was even taken away as punishment and issues of addressing the shortages were ignored. 

My remaining months were made to be hell with seniors accessing classified information about me, sometimes even refusing to assist myself or other junior colleagues with work tasks, work tasks that meant life and death for members of the community. It was horrible and contributed to me leaving. 

Being punished for trying to bring about meaningful change has been a huge stumbling block for my career but the triumph though, was getting to use my voice to tell of the hells faced by health workers globally and the help we need. 

Yes, I would do it all over again, if it meant getting the support needed globally, without hesitation. Help is needed.

South Africa is currently experiencing a third wave and it is not only testing our resources, but also our resolve as a nation. You’ve chosen not to be on the frontline during this time – what is it like to face the third wave as a so-called civilian and what advice do you have for our community to get through this new terrible peak?
Facing the third wave as a civilian honestly has been a lot more peaceful, my health has improved, and my sanity has returned; and it’s sad that leaving was what it took. Being tasked with saving humanity on the frontline was not easy at all, but it has also been a scary time witnessing from the outside our health systems collapsing. 

I know that I can bring about more change as a civilian, especially with the knowledge and experience I have gained. Being expected to fight and win this war without the adequate tools and support to do so as a health care worker is a daunting and impossible task.  

As a civilian I am constantly trying to find ways to support those on the frontline. Those tasked with saving humanity need saving too, the profession is extremely demanding. The advice I have for our community to get through this is for us all to look carefully at how we support the health care workers in our lives and health care systems. 

For years I have been advocating for systemic changes that seem impossible and far off, systemic changes in the health system that the frontline is in dire need of and will likely strengthen our health systems helping us rid the world of all illness and other pandemics, including the COVID19 pandemic. We can all be responsible for saving humanity by supporting those praised as heroes and asking ourselves how we can for a change help them to help us.

We all need to ask ourselves, who heals the healers?

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