What a year

Today is a sad day.  It is a day of too many goodbyes to too many amazing people that have come to the end of their Madwaleni adventure.  What strong bonds we form here in such a short time!  I am continually amazed at the incredible people that keep arriving at this place year after year, who creep ever so quickly into our hearts, families and lives.  While the time I have spent with you feels way too short and your departure premature, I am so grateful for the time we have spent and the memories we have made together.

What a fitting end to an incredible year it was to dine, laugh and reminisce on Nkanya beach and swim late into the night in bright green, phosphorescent waters.

It feels surreal that the homes we have come to see as your own, are now being swept and cleaned for a group of new faces.

I haven’t felt this way before in four years, which should tell you something of the year we have had together and the kind of people you all are.

Thank-you for what you have brought to this place – it is so much better off for it.

I feel incredibly jealous of the people who get to spend 2017 with you… I am sure you have incredible times ahead sailing after schools of Yellow-fin, travelling in India, doing PhD’s, starting OT practices, saving fynbos and rare toads, buying camera’s, starting up photography, drinking Hobgoblin’s with special friends and carving insane moves on huge icy-cold waves.

We love you guys!

P.S. We’ll be booking our tickets to Cape Town soon


3 years down, more to go

Madwaleni Hospital has been my job and my home for just over three years now.  It has been undoubtedly the most memorable, rewarding and special time of both Jade and my lives.  The richness of friendship shared with the most wonderful people who all share a common calling.  The vibrancy of a community of diverse but dependently connected people that has flourished from a handful of doctors to a myriad of different walks of life.  There is such joy in the hope we all share for the place as we see our dreams unfolding, while enduring perpetual challenges that seek to, but never seem to snuff out the flame.  We get to escape so many of the distractions of city life, living rather the life of full, but quiet rural living.  I have found so much joy in things I hadn’t ever imagined, like planting indigenous plants and trees and watching them grow.

Together with Jade, building a home and a family to fill it with, has been a taproot deep into the ground that sees me through many a difficult day or week.  Our home is a very special place for us, one that we love sharing with as many people as possible – it makes us so happy, and I know I can take a lot less than half the credit for it, thanks to the most incredible person I get to come home to several times a day.  What I can take at least half the credit for, is our two kids, Sam and Rosa, who quite literally fill our lives to overflowing, sometimes quite overwhelmingly so.

Work cannot become everything.  It’s a lesson we’ve all learned, mostly the hard way.  Life outside of work is so easily neglected but is the thing that keeps your heart and soul energised.  Food, music, running alone, running with mates, ultimate frisbee games, braai’s, movie nights, weekends away exploring the beautiful Transkei, date nights, church gatherings, gardening, building decks and pizza ovens, cups of tea, good coffee, cold beers, delicious wine and most of all conversations about things other than work are some of things that keep me in the game.  It’s times when I’ve had to or inadvertently sacrificed these things that life has become the most difficult.

It has been a time of self-discovery.  One cannot fully describe the transition that takes place when one is plucked out of one’s comfort zones, friends, family, routines, comforts, spiritual support systems and mentors and left to figure things out for oneself.  Removed from the business of church life with all its meetings, sermons and high profile, inspiring people, I found my faith wilted and neglected.  How often do we ride the coat tails of other’s beliefs without the time or space to nurture the courage of one’s own true convictions?

However, what initially started as a downward spiral of uncertainty with many questions has progressed into a new, refreshing, Christian faith that is my own, a process that as a couple Jade and I have learned so much through, and I must add, have a long way to go still.

I get to work with incredible people – both colleagues and patients, who live in a world I am just barely starting to understand with all its rich culture and complicated belief systems.  It is a community who are so far behind the front lines of equity, human rights and empowerment it is scary.  While the fruits of post-apartheid democracy are still so far away, the disgruntled voices are becoming more audible with service delivery protests a regular occurrence.

Rural medicine in the Eastern Cape is a stormy sea, a beastly roller coaster ride of epic proportions with unnerving turns and dives that throw your whole world upside down to be turned back around in an instant.  Initially these ups and downs really did throw me into a spin, but with time I have become accustomed to them and somehow one develops this ability to just stick it out, as things will probably work themselves out as they always seem to do. Along with the spins come exhilarating highs with a soul quenching feeling of fixing what’s wrong with the world and making a difference to people who need it so badly.

Not everyone can work in rural.  Some don’t manage to accept the things they can’t change or that don’t work and become overwhelmed with everything that’s wrong, driving them soon towards a less diseased system.  I’m not saying that apathy and acceptance is what’s needed, but it’s about picking one’s battles and keeping a positive outlook. Of course none of us get it right all the time and there is a constant pendulum swing between idealism and pessimism or worse still apathy.

I often get asked questions like, ‘So, what are you going to specialise in?’ or ‘How long are you going to stay at Mads?’ We came to Madwaleni for community service, a twelve month contract after which you are free to choose your own way (the department of health hasn’t quite got this concept yet though).  Some time in our first month, Jade and I realised we had already decided in our hearts one year was never going to be enough.  The Madwaleni bug had bitten, and has continued to grab onto our hearts, such that we now wonder how we will ever tear ourselves from this adventure.  I sometimes get to catch up with friends who studied around the same time as me and find out what’s been going on in their lives.  During these conversations, I used to feel like I’d been left behind, when hearing of the various specialist degrees people were enlisted in, or the city houses people had already bought.  Fortunately I don’t get those feelings anymore, as while slightly alternative, the career path I’ve chosen for now is no short of exactly where I want to be.  The above questions remain unanswered, but that’s okay.  I like living in the now, enjoying what I’m doing without the distraction of what’s next.  In my experience, medicine throws open doors the like and timing of which you probably wouldn’t expect, and I’m sure new and exciting career opportunities will come my way.

I sometimes think about how we’ve managed to do what we’ve done in the last three years.  The coming together of so many variables resulting in something quite remarkable.  No matter how long we’ve stayed, what we’ve built up always feels fragile, like a house of cards that regularly seems ominously poised, but it never falls down.  There is the strong presence of a mastermind at work, leading us in the right direction, adding the right people at the right time.  This leaves me feeling like I can take little credit for what has happened and confers a quiet confidence of the way forward even though it will inevitably continue to be an obstacle course with unforeseeable challenges.

So as I reflect on my Madwaleni journey I get the distinct feeling that for now there is no-where else to go and that our time here is far from over.  I’m excited for what’s to come and most of all the people I get to share this adventure with, because after all life’s about loving people. IMG_3341-3

The Mad Walk


Joyce and Norrie Gibson, both doctors working in the Eastern Cape for over 20 years, are going to walk from East London to Madwaleni Hospital along the coast, some 200km, in order to raise funds for Layitha Foundation. This is an NGO started by members of the Madwaleni Hospital staff to support the work they do – see their websitelayithafoundation.weebly.com
Madwaleni Hospital is a district hospital situated near Elliotdale in the Eastern Cape.

They do amazing work under difficult conditions and need funds to continue/expand their footprint
We ask you to support the foundation by sponsoring us in this walk.
Depart East London Saturday 23 May and should arrive at Madwaleni Hospital on Friday 29 May
Day 1 East London to Chintsa
Day 2 Chintsa to Morgan Bay
Day 3 Morgan Bay to Wavecrest
Day 4 Wavecrest to Mazeppa Bay
Day 5 Maxeppa Bay to Dwesa Nature Reserve
Day 6 Dwesa Nature Reserve to The Haven
Day 7 The Haven to Madwaleni
If you would like to support us in this attempt to raise money for the foundation, please go to their website where you can read their mission statement and access their bank details.
Please email Joyce Gibson at nwgibson@sainet.co.za with your donation/pledge, either Rand per km, per hour or a lump sum

Mad walk 2 Mad walk 3 Mad walk

Two available Grade 1 Medical Officer Posts

Hi everyone, I’m Dylan Gibson and I work at a legendary rural Eastern Cape Hospital called Madwaleni.  This blog post serves to get the word out there that we have two Grade 1 Medical Officer posts opening up from the 1st March 2015.  Along with the posts is a lovely two bedroom, fully renovated house.

If you are amped on a rural hospital experience, come and join this committed team of young doctors!

If you’re interested, please contact:

Dylan     060 5645 415

Andrew 072 6113 354

Or for more information, visit madwaleni.weebly.com




Com Serve Doctors wanted!

Are you or anyone you know still looking for a com serve spot for 2015? We have the perfect spot for a rural Eastern Cape com serve experience! After the long-awaited release of the com serve placement list for next year, it seems Madwaleni hospital has been somewhat overlooked.  Aside from really needing the extra manpower of a group of legendary com serves, we feel that Madwaleni is an awesome spot for a fun rural com serve experience.

Madwaleni Hospital is an up and coming rural hospital situated in the Eastern Cape, just 16km from one of the most beautiful stretches of coast line in the country.  We have an exciting team of young doctors looking to make a long term impact in this incredibly needy community.  Check out some of the other posts on this blog as well as our website for more info on the hospital itself and life in the Transkei.

Here are a couple of pics of some of the cool things we get up to…

FotorCreated  FotorCreated1


So if you’re intersted, or even if you want some more info, feel free to contact me on 072 978 7122, or drop me an email, gibsondylan@gmail.com

Dyl Gibson

Friday tie day

At Madwaleni, we’re all about bringing class and tradition back to rural health.  A couple of weeks back one of our latest additions, Dr John-D, ‘Danger’, Lotz began arriving at work on Fridays in his bow tie.  At first we thought it strange – maybe we felt we couldn’t pull it off, I don’t know.  But nevertheless, here we are, several weeks later, joined by many enthusiastic Madwalenians to celebrate Friday tie day.  You stay classy Madwaleni.

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Farewell Inge


Madwaleni is a place of change.  People come and go, and tomorrow we bid Inge farewell.  It is sad to be losing such a passionate colleague who has added so much value to our team of doctors and to the development of a well-run MDR-TB (Multi-Drug Resistant Tuberculosis) program.  

Inge is an experienced consultant in TB from the Netherlands who has spent many years working in Sub-Saharan Africa in a variety of hospitals.  Coming to Madwaleni in 2012 expecting to run the TB and HIV program, she arrived to a bustling rural hospital where she would be tasked with running the entire hospital as the only doctor for the better half of a year!  She took it in her stride and gave far over and above what was expected of her – for this we are all grateful.  

As more doctors began to join her in 2013 she was also tasked with the role of chief medical officer and our team leader, a job which often took her away from her first love, TB.  

During her time here, Inge has invested hugely in the management of TB, particularly MDR-TB, a growing problem in this area.  She knows all of her patients by name and has impressed local and regional TB experts with her outcomes.  She, however yearns for a day when we see the advent of home-based management of MDR patients in the Eastern Cape, where their daily injections are overseen at home, making treatment much more manageable for them.

Inge is leaving us to join an exciting new team of experts, including local expert Douglas Wilson, in Pietermaritzburg.

Thank you Inge for all you have invested in this place.  We wish you all the best in your new job and look forward to seeing wonderful things from you!

With love, the Mads team.

                                         IMG_2934  IMG_5667                                                          Mad doctors-2  IMG_6583  


2013 – Belated reflections on our first year at Madwaleni

I wrote a journal entry reflecting on our first year at Madwaleni a while back… I thought it would be an interesting insight into our experiences.  I post it now for those who may find it a helpful aid in deciding to join us in some capacity in the future.

 “So much has happened this year.  I think back to arriving at a wet, overgrown run-down ghost hospital with a hangry (a combination of hungry and angry) pregnant wife and a group of excited, expectant friends.  We arrived to meet the girl we’d heard so much about, Thandi, who would turn out to be a dear friend.  We also became quickly acquainted with Inge, the Dutch TB specialist who’d been soldiering away on her own for several months.  She was very burnt-out and frustrated, but she too has become a good friend and colleague and has recovered a lot from the stressful experiences of last year.  I think back to the wonderful surprise it was to find out there was a Dutch couple who were also pregnant who were to start along with us – the memory of having supper with Mark and Jet on New Year’s eve is very vivid – East London ‘Nina Deli’s’ Beef Lasagne with black Rooibos tea.  The group from that evening were to become a strong team and a special community.

 I clearly remember our first encounter with Mrs Pencil, the ‘Madiba’ of Madwaleni.  Little did we know what an incredible woman she was and how devoted and passionate she was about the hospital.  I remember how our working year started… sitting in her office signing documents, Sister Kweza, whom we would soon get to know very well, poked her head the office and very calmly said that there was a cord prolapse in labour ward.  Mrs Pencil calmly nodded her head after which Sister Kweza gently closed the door and walked off.  The three of us weren’t quite sure what to make of this, knowing that a cord prolapse is a serious obstetric emergency! We asked Mrs Pencil if she thought we should go and help, and she agreed.  Andrew and I, dressed in shorts and slops trotted over to the labour ward where we found a woman who was fully dilated and about to deliver.  We quickly put on some gloves and got ready.  Andrew quickly confirmed there was indeed a cord prolapse, so he followed the necessary steps while I went off to fetch the ultrasound machine.  As I put the probe on the woman’s tummy I was sure there wasn’t a fetal heart beat so I told Andrew I didn’t think the baby was going to make it.  With the next contraction, she delivered a 1,5kg baby, which initially looked lifeless, but suddenly started to cry!  With delight, Andrew picked up the baby and took it over to the resuscitation area.  While he was busy with the baby, the lady promptly delivered a surprise second 1,3kg live baby along with a gush of amniotic fluid which drenched my clothes completely!  In the days that followed unfortunately one of the twins died, but I followed the course of the second twin, who did very well.  What a first day at work!

 Over the next few days, the mammoth task of moving in to our new homes and making them liveable began.  There were delays in the delivery of furniture due to wet, muddy roads.  There were houses full of rubbish, peeling walls and mouldy ceilings that needed painting, cleaning and lots of work!  But we all teamed up and helped each other and soon we started to make ourselves at home. 

Work was interesting as we entered a 180 bed hospital that had deteriorated drastically with the near absence of doctors for the better part of a year.  There was no x-ray machine, the wards were mostly empty, the nurses were despondent and the number of patients in OPD had plummeted as there had previously been no-one to see them.  The phones did not work, there was no switchboard operator and we were trying to run a maternity service with no access to theatre and a referral hospital that was 2 hours away, aside from the delays in waiting for an ambulance.

 For these reasons, we entered a stage of rebuilding where we slowly began to restore the services from scratch.  Along with this there were many tragedies of unnecessary patient deaths which was hard for all of us to cope with, particularly maternity and paediatric deaths.  Besides the challenges of life within the hospital, challenges outside of work also took its toll on us – frequent water and electricity shortages were hard to cope with, while life with a baby was at times tiring! Some of us got a bit burnt out as we learned to deal with all the frustrations of the hospital, but slowly we all began to learn about ourselves and about life at Madwaleni.

 We were a small team, especially those of us doing calls, so we were incredibly relieved as our team gradually began to grow. First came Elpitha Bruce, a Brittish-trained doctor from Cyprus who arrived with her younger sister who was to spend a couple of weeks volunteering at the hospital before she started medical school in England.  Next came Phindiwe Palie, a lovely doctor from Mqanduli who was originally a nurse by training and also had two small children back in East London.  Last but certainly not least came Bob Solomon, an American Paediatrician, who, with all his eccentricities and first world background looked to be a round peg in a square hole to start, but has slowly become a much valued member of our team.


As the months went by we gradually started to make clear progress.  We got a new x-ray machine and a working outside landline to make referrals.  We managed to start up a 24 hour Caesar service, an MDR TB programme and even a clinic outreach program where each of the feeder clinics were being visited monthly.  We have made small steps toward getting better equipment, such as servicing our anaesthetic machine, getting several CTG machines, IVAC fluid administration units and a new ECG machine.  Our lab has also received a Gene Xpert machine and a new FBC machine.  We recently performed our first general anaesthetic where we did a skin graft for a burns patient.  I’m sure this is the first general anaesthetic done at Mads in many years!

 In parallel to the growing disappointment of the NGO we found when we arrived, the Donald Woods Foundation, has been a growing excitement for the birth of a new NGO we have created, called Layitha foundation.  While the work of the NGO has yet to get started we are very excited for the role it can play in achieving our dreams for the hospital and broader community.

 Each of us were investing a lot in our nurses and slowly we began to win them over.  We discovered many special characters amongst the nursing staff and have since made some good friends.  As time went by, we noticed fewer ‘tragedies’ and I think we are all very encouraged to see the fruits of our hard work.


The management of the hospital has always been difficult as good strong leadership is so necessary to run a hospital.  Dynamics in our team have at times been difficult as we have lacked a clinical manager.  It has been difficult to run a team that is half a democracy, and half led by our CMO, Inge.  There was bound to be friction, with 9 doctors and no clear leadership, especially when it comes to things like housing and leave policies.  These challenges were greatly accentuated by the bitter-sweet arrival of the new hospital CEO, who initially promised everything, but was soon found out to be a very difficult woman, with very poor leadership and people skills.  There have been many clashes and fights as we’ve tried to work under her leadership.  At times it has felt like no CEO would be better than her, and we all longed for what could have been if Mrs Pencil had taken on the role.

 Another very challenging aspect to our year was when the terrible news of the murder of James Thomas, Sarah’s father arrived.  This was a terrible blow to Scott and Sarah, who had already been finding life in their small park home very challenging.  We all mourned with them and supported them as best we could, but Scott and Sarah soon decided it was time to head back to Cape Town, to support their families. 

 It has been a very exciting year for Jade and I, spiritually.  Our faith felt very exposed when we left the support of a thriving church community and we both felt like our relationship with Jesus was distant and luke-warm.  This feeling climaxed in our trip to Turkey when we really began to feel desperate for a life that reflected our convictions.  We soon received an invite from Dylan Sharp to go to a conference with him in Durban where a man called Todd White would be speaking.  We went along and found our hearts stirred as he shared his testimonies of a life that we longed for.  We went home stirred and expectant and have been digging into God again, allowing his love and grace to fill us and forcing ourselves to step out of our comfort zones to share that love with others.  I have for the first time in my medical career, started to pray for patients and share my faith with them, which is really exciting.  There is so much more for us we are trusting for God to explode back into our lives again where we see Him working through us all the time.

 As the year has started to come to a close we look forward to what the new year brings.  Stuart Poole and his wife, Leanne are joining us with their young son, Caleb.  They are a strong Christian couple and talented medical team in a doctor and a physiotherapist – I’m sure they’re going to add impetus to the work we are doing.  Beside a large group of rehab com serves, Garick Barber, a former church-on-mainer, digsmate and friend is going to be joining us.  His gift with administration and making things happen is going to be greatly needed!  Unfortunately we also mourn for the departure of Scott and Sarah.”

One Life Church visit to Madwaleni


On Thursday, Madwaleni was lucky to welcome a legendary team all the way from One Life Church in PE for a weekend of fellowship, encouragement and fun.  Dave Shepherd and his wife, Meghan, whom Jade and I know from our Church-on-main days in Cape Town have recently planted One Life Church in PE and have been excited to come and visit us at Madwaleni ever since they heard of our plans to come here last year.  

They brought with them two super-cool families who arrived in style in two contrasting landy’s.  Michael, Wendy and their daughters, Hannah and Emily arrived first in their Discovery 3, while Mike, Deanne and two of there whopping six children, Isabelle and Thomas brought up the rear in their legendary defender after some sub-optimal route-taking decisions 🙂

Soon we were sharing laugh’s and stories over a much-needed glass of cold coke.  Once everyone had settled in and unpacked the hoards of food and luxurious treats we got to preparing for the evening’s festivities… The Madwaleni gang together with some guests, including Sarah’s mum and dad, James and Colleen, and their family friends John and Di, were treated to an evening of good wine, delicious ‘spag bol’ and sharing stories.  Only one emergency caesarian section interrupted the evening!


The following morning the team set out on a prayer escapade around the hospital.  They spent well over an hour praying over the hospital and got a chance to pray for many nurses, security guards and even a car of delighted politicians who where in the area for the grand opening of a community clinic near the hospital.  That afternoon, the team who boasted an impressive skill set of electrical, DIY, farming and gardening talents got to work on our garden leaving behind them a wake of weeds, grass and satellite cabling! As the afternoon was drawing to a close we set out on a tour through the hospital itself, carrying with us several bags of Easter eggs for the children (which were in the end better received by all the nurses!).  It was a nice opportunity for the team to meet some of the legendary nurses we get to work with every day and to see what the various wards actually look like on the inside.  After a long but fruitful day we put fire to the blitz, charged our glasses and sat back to enjoy the smells of Deanne and Mike’s tasty chicken potjie simmering over the coals. It tasted even better than it smelt!



Saturday morning we were treated to a delicious full-house English breakfast.  Once we had eaten our full, we headed off to the beach to find that the windy city weather had joined our PE friends in the form of a wicked Westerly that sent the volley balls and ultimate frisbees sailing towards the river mouth! We lasted just over an hour before retreating to the hospital for lunch.  After some free time, we headed over to Andrew and Katy’s place for Katy’s birthday braai.  We cooked excessive amounts of tasty meat under the rain-shelter of the giant rubber tree and enjoyed home-made Earl-grey flavoured ice-cream by lantern and candle-light for ‘earth hour’ – a lovely evening.


By the following morning the previous day’s Westerly wind had brought with it a rainy cold front which prevented us from going on our picnic breakfast at the river. Instead, we had a time of worship, prayer and some teaching from Dave before breaking bread together.  Unfortunately it was then time to start the mammoth pack-up.  


We were all left with a unanimous feeling that this was the beginning of a special partnership that wasn’t to end with the weekend.  

Thanks to Dave, Megs, Mike, Deanne, Tom-tom, Iza, Michael, Wendy, Emily and Hannah for a lekker weekend!  We are so encouraged by your visit and are excited about what the future holds for us.