The Sunday Mail
Fatima Bulla-Musakwa
WHEN a historic surgery to separate Siamese twins was conducted at Sally Mugabe Central Hospital in 2014, Dr Kudzai Sarah Munanzvi was a junior learning the ropes in paediatric surgery.
In a normal setup, she would not have been considered to be part of the delicate procedure to operate on babies who were joined from the lower chest to the upper abdomen.
They also shared a liver.
About 50 local health specialists were involved, in one way or the other, in the process to separate Kupakwashe and Tapiwanashe Chitiyo.
Dr Munanzvi performs an inguinal hernia repair at Sally Mugabe Central Hospital in Harare recently
However, veteran paediatric surgeon Dr Bothwell Mbuvayesango, who was leading the team, entrusted her with the onerous responsibility of taking part in the life-changing experience.
During the eight-hour operation, Dr Munanzvi had the task to separate the twins’ shared liver.
“It was a huge task because a lot of specialists had to be involved. A lot of really senior doctors had more experience than myself, but you find that when you are working as a team, everyone listens to every member of the team regardless of their rank, training or experience, because every member has something valuable to bring to the team,” she said.
“So, it was a really eye-opening and humbling experience going through the surgery.”
But this was just the beginning.
Dr Munanzvi has been involved in many other delicate surgeries since then, with varying results.
During the Covid-19 pandemic, she was part of a team that tried to separate conjoined twins who shared part of their intestines and bones.
Medical experts had to join forces for the best possible outcome.
The operation took 24 hours.
However, one of the twins died two months after separation, while the other succumbed to pneumonia after eight months.
It was heartbreaking.
“That was hard. We always want our patients to do well, but sometimes they don’t do so. That’s the reality of the job we do,” she said.
“We actually have another set of conjoined twins we are caring for, who were delivered in South Africa. They are almost a year old now and we are looking into whether or not we can separate them,” she said.
Dr Munanzvi, who has been a paediatric surgeon for almost 10 years, is probably the face of female medical specialists who are being trained locally and absorbed in the once male-dominated field. She graduated from the University of Zimbabwe and the College of Surgeons of East, Central and Southern Africa.
It is, however, still rare to see an all-female team conducting a surgery.
She only went through such a “once-in-a-lifetime experience” when a day-old preterm baby weighing 1,8 kilogrammes needed urgent surgery. When the specialists took the baby to the theatre, they discovered that the anaesthetists, surgeons and theatre nurses, among others, were all women.
It was a moment to cherish.
“For that patient, it was quite a serious surgery and had a lot of anaesthetics risks. All the specialists in the room had to focus on the patient . . . And we got a good outcome . . .
“Eventually, the patient went home. I think people will always question you and second-guess you sometimes when they don’t realise you have been trained like anyone else and you are able to do what needs to be done.”
Paediatric surgery is a unique field that involves surgical care for children from the time they are born all the way to being younger adults.
Conditions that require surgery are either congenital or develop after birth.
More women are now taking up spaces in medicine and specialising in different fields such as neurosurgery, cardiac surgery, general surgery and urology.
Female doctors are also similarly specialising in anaesthesia, radiology and gynaecology.
Dr Munanzvi usually finds herself fielding questions on whether female surgeons are as good as male ones.
“The truth of the matter is that all specialists, when they are appropriately trained, have the requisite skills to do what needs to be done for patients. And I will choose a female surgeon and female anaesthetist any day of the week because I know my child will be well taken care of,” she added.
For her, every surgery is memorable.
She fondly remembers operating on a baby from Mutare, who was born with a condition known as gastroschisis, where the belly button allows the intestines to extend outside the body.
The baby developed numerous complications and its heart stopped on three occasions.
While the baby was successfully resuscitated in all the instances, the experience left Dr Munanzvi emotional and close to tears.
The baby eventually pulled through and is now six years old.
“She is in ECD (early childhood development); she is so beautiful, but when you look at her tummy, you can see all the scars from having her intestines out.
“That’s when you know her story,” she said.
“And it reminds me that we always have to do the best we can for these babies. Children are amazing. When you think they are now going to die, they will fight through, recover, do well and live long.
“Paediatric surgery is special in that we touch children once and they are able to live the rest of their lives . . . Therefore, it’s important that every child has access to safe surgery.”
