Nosiphiwo Gunuza from Lusikisiki in the Eastern Cape was the first college graduate in her family — she is also her family’s sole breadwinner. In addition, the 43-year-old healthcare worker was recently crowned South Africa’s Rural Nurse of the Year for 2023.

Gunuza relays how rolling blackouts did not quell spirits at South Africa’s annual Rural Health Conference hosted in Chintsa — 40 kilometres north of East London — where an awards ceremony to honour health professionals unfolded to applause. Recalling the moment her name was read as winner of RuDASA (the Rural Doctors Association of Southern Africa’s) top nursing prize, her voice leaps with excitement.

“Yoh the moment they said my name, I had such mixed feelings. I felt so emotional, so overwhelmed. I mean who am I to deserve this recognition? Because the thing is, I’ve never in my life done anything for a reward. Whatever I’m doing, I’m doing it with my whole heart for the purpose of serving my patients. I had no idea that these people would be looking at me, that they would even notice me.” 

One of nine siblings born near Lusikisiki — in the OR Tambo District along the Eastern Cape coast — Gunuza has worked as operational manager at the Ntafufu Clinic since 2021, managing a team of seven nurses. Before that, she was based at Goso Forest Clinic.

Gunuza with her husband Mzuvukile. (Photo: Supplied / Spotlight)

At Ntafufu Clinic patients are treated for hypertension, diabetes, epilepsy and psychiatric conditions, also pregnant women and children are seen for the expanded immunisation programme. But the biggest challenge in the area, she says, remains HIV.

“Currently, the condition still making the clinic overflow is HIV and Aids,” says Gunuza. “New infections are decreasing but it is about dealing with the control of those who are already infected.”

Key area in early ARV rollout

Lusikisiki, formerly the capital of Eastern Pondoland, consists of a bustling centre and roughly 40 villages scattered across a 60-kilometre radius beside the Indian Ocean. The area is a significant health strategy node. From 2002 to 2005 it served as South Africa’s first rural antiretroviral rollout base — a programme spearheaded by humanitarian organisation Médecins Sans Frontières (MSF).

“For the past three years, MSF has been supporting a programme to provide care and treatment for people with HIV/Aids in the local service area of Lusikisiki, a subdistrict of 150,000 inhabitants in the Eastern Cape serviced by one hospital and 12 clinics. Lusikisiki represents one of the poorest and most densely populated rural areas of South Africa. Less than half the population live in formal housing and up to 80% live below the poverty line,” reads a 2006 article published in the Southern African Journal of HIV Medicine. 

In 2012, Lusikisiki was decreed one of South Africa’s 10 National Health Insurance pilot sites.

‘My mom and dad were both crying’

Gunuza is speaking to Spotlight over WhatsApp early in the morning. In the background, a rooster can be heard. Soon she will drive her Toyota SUV to Ntafufu Clinic, in time to open it at 8am. Cell reception is a challenge in these parts, and there is no reception at the clinic, she explains. Her voice tinged with optimism, she adds that Telkom is meant to install an internet connection at the clinic within the week. 

After the RuDASA awards ceremony, it was a big moment when Gunuza rushed home to show her prize certificate to her parents. 

“When I arrived at my parents’ house with that certificate, my mom and dad were both crying,” she says. “My background did not really allow for me to be successful in life. I have a poor background, being raised by people who were never educated, and becoming the first person in my family to graduate.”

Gunuza, the first college graduate in her family and her family’s sole breadwinner, was excited to be able to show her parents the award certificate after the ceremony. (Photo: Supplied / Spotlight)

Gunuza tells Spotlight how each month she delivers food parcels at her family home, to her parents and five surviving siblings. 

“My parents worked so hard to make sure that what they didn’t become in life, I would become. My dad always says when you do something good or bad, it doesn’t end with you. It comes back to the parents. When you are doing a good thing, people will say: ‘that is a child who is born to so-and-so.’ So you see, this award is not about me only. It is about my parents and their honour too.”

Born at the St Elizabeth Hospital in Lusikisiki, Gunuza matriculated in 1997 at the Hillbrow Senior Secondary School in the area, before completing a diploma over four years at the Lilitha College of Nursing’s Lusikisiki campus. (Spotlight last year reported on serious problems with nurse training in the province.) 

“I’ve just always felt a passion to take care of people,” she says. “Even at a tender age, my mom told me I was doing nursing care to my sisters. I was the fourth-born child and took care of the four sisters after me. Later I had that passion planted in my heart: I wanted nothing but to be a nurse.”

At the awards ceremony, Gunuza was accompanied by her husband Mzuvukile, the principal of Ngobozana Secondary School in Lusikisiki. 

Mzuvukile became the principal recently, Gunuza says. When they met, he was a math and physics schoolteacher, who helped her in her own studies to become a nurse. 

Gunuza credits her husband Mzuvukile as being a source of support during her studies to become a nurse. (Photo: Supplied / Spotlight)

“So that man was by my side all the way,” she says, speaking glowingly. “He loved me even before I had a profession. When I began my first class in January, in my first year at nursing college, I couldn’t get the stipend that the others were getting. And he was there for me. He was doing everything for me up until eventually when I got my first stipend in October. I never needed anything, because of him.

“He was even my teacher. I remember a subject known as biological nursing science, which was very challenging. So he would conduct classes in that. I organised for other students, and he explained it to us.” 

The couple wed on December 16, 2006. They have six children; two from Mzuvukile before their marriage, two of their own, and two adopted from one of Gunuza’s sisters. 

‘That feeling of having saved a soul’

A standout moment from Gunuza’s career happened last year in August when she saved a 15-year-old boy who arrived at Ntafufu Clinic with dire breathing difficulties. Due to a lack of network connectivity, the clinic’s staff could not summon an ambulance. 

“When he arrived at the clinic, he was gasping,” Gunuza recalls. “It was so bad. He was in a very, very bad condition. After some minutes of resuscitation, seeing that the prognosis was very poor, I decided sharply that we should move this child to another level of care to save his life. So I took an oxygen cylinder and asked somebody to drive whilst I’m continuing to give him chest compressions, to ensure that I keep his breath until we arrived at the hospital. And by God please, we arrived with the boy at St. Elizabeth Hospital 20 kilometres away, him still alive. He was admitted for a week.”

The teenager was discharged in good health, and able to continue his studies.

“And it was so touching,” says Gunuza. “When afterward he said to me: ‘I thank you so much. I thought I was losing my life’. That feeling of having saved a soul.

“It doesn’t go away for me. Not even for a single moment.” DM

This article was produced by Spotlight – in-depth, public interest health journalism.