The Doctor Confronting COVID-19 After Decades of Fighting HIV

Dr. Nombulelo Magula, head of internal medicine at the University of Kwazulu-Natal, is helping shape South Africa’s pandemic response on both local and national levels.
December 14, 2020, 2:00pm
​Image: Michelle Urra
Image: Michelle Urra
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There’s one patient that Dr. Nombulelo Magula will always remember. 

He was a young man suffering from Kaposi’s sarcoma—a cancer common in people with late-stage HIV—and he visited regularly for help at the King Edward Hospital in Durban, South Africa, where Magula was training to become a specialist in internal medicine. This was 2000, and although she did what she could, effective antiretroviral therapy wasn’t available at the time. 

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“He lived with a rotting leg until the day he died,” said Magula, who now heads the department of internal medicine at the University of Kwazulu-Natal in Durban “I don’t know how, but someone from his family called me and said to me that, on his deathbed, he had told them about me. They invited me to his funeral. I went. I met his family.”

“Then, I remember this so clearly, one of my colleagues came over to me and said: ‘You’re going to be attending a lot of funerals.'" 

Some of those funerals were for her peers. But throughout these tragedies, Magula remembered that it was at this very hospital that she had first felt the calling of a career in medicine. Her mother, a nurse, took her to King Edward’s for a dental appointment when she was 13.  Looking around, she remembers seeing the long queues of people in need of help and thinking: ‘I want to be a doctor.’ 

Magula has delivered on this dream: She has been instrumental in the fight against HIV in South Africa—home to the world’s largest HIV epidemic—and led the Adult HIV clinic at King Edward’s hospital for ten years, before she assumed her current role at the University of Kwazulu-Natal.  

With more than two decades of experience researching and fighting infectious diseases, Magula now faces the devastating COVID-19 pandemic. She’s not only helped to lead the response in local hospitals, but also the national response as a member of the Ministry of Health’s COVID-19 advisory committee. She has even shaped the global response as a leader of a trial on managing COVID-19 patients, sponsored by the World Health Organization. 

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Her work has been relentless. While helping doctors on the ground manage space for patients in overflowing local hospitals, Magula has also had to find the time to advise the government on its pandemic game plan. 

During weekly calls with the Ministry of Health and health authorities in her own province, she advocates for a holistic response that’s engaged with the community. 

“What I’ve advised again and again is that we have to look at the pandemic as a football game,” Magula said. “The attackers are public health officials who go into the community and educate people. The midfielders catch the people who get infected and help them not spread the disease to others. The defense is the hospitals and the goalie is the ICU.” 

“Nations tend to put all of their focus into the defenders and the goalie, when the midfielders and the attackers need attention too,” she noted. 

To help bolster the country’s frontline offensive, she’s appeared on videos produced by the government and national television to educate citizens about the virus. It’s integral, she said, that others in the backline defense do the same.

And yet, despite decades of experience, Magula has constantly found her voice falling on deaf ears—especially as an African woman who entered  academia during apartheid in South Africa. 

“I have to work 150 percent harder just to get noticed; 200 percent harder to get an opportunity,” she said. “You would think that 24 years of medical experience would be enough to actually be heard, but it isn’t. Since my voice is coming from somebody of my gender and skin color, either my voice doesn’t count, or I have to work so hard to make it count. That’s very painful.” 

It’s that same pain, she added, which allows her to empathize with those who are struggling, and which fuels an approach to medicine predicated on the importance of solidarity, community, and her most fundamental motivation: Justice. 

“Justice for everyone,” Magula emphasized. “Justice for those who don’t have their voices heard. Justice for those who die because they are voiceless. I end up having to fight a lot of people when I try to advocate for others. I end up pulling long hours, sleepless nights. But I want to actually see a difference in people’s lives.”