Dr Alulutho Mazwi deserved better – We have failed him
I was completely shocked and disheartened by the callous way Dr Alulutho Mazwi was treated. How could we have let this happen? When I heard that his death was one of four healthcare worker deaths in KZN, I couldn’t help but ask: what is happening here? It is a dangerous misconception to believe that doctors are immune to illness and vulnerability. Nothing could be further from the truth.
The right to become ill comes under legislation protected by Basic Conditions of Employment Act – which applies to all citizens, including those who devote their lives to caring for others.
South Africa is a developing nation with skills shortages and an overwhelming chronic disease epidemic. And so, how do we respond to the very individuals who attempt to assist us in such disrespect? The issue of inadequate support for healthcare workers is evident and undeniable, as demonstrated by the intervention of the South African Human Rights Commission, 2025 )
The National Health Act 61 of 2003 states clearly: that healthcare professionals must be safeguarded and provided with a healthy working environment. It is the responsibility of the system to guard their welfare and rights. And yet, they made Dr Mazwi work even when he was ill. This turn of events reveals a hard truth: we can do better in looking after our medical professionals – not just for them, but for all of us.
The Disconnect between reality and policy
The National Department of Health published a detailed strategy document for the protection of healthcare workers. It explains occupational committees for health, which are responsible for monitoring the medical surveillance of health workers and enforcing workplace safety. It also focuses on training employees on self-screening, symptom reporting, and staying at home when ill. The deviation of these practices from Dr Mazwi’s case is what has enraged citizens (Parliamentary Portfolio Committee on Health, 2025). (Parliamentary Portfolio Committee on Health, 2025)
Rather than sympathy, Dr Mazwi was allegedly coerced to work after he had already twice collapsed on duty following a message to his supervisor indicating he was unwell. The issue here is not one bad supervisor; an ombudsman has already initiated an investigation into her behaviour. It’s a system that views young professionals and doctors as disposables (Parliamentary Portfolio Committee on Health, 2025)
The Public Servants Association’s Mlungisi Ndlovu did not hold back. He stated Dr Mazwi’s death “would have been prevented if the department had listened” to concerns they raised in August 2024 and again in February 2025. Despite the tragedy at this hospital, the PSA still lent a helping hand – during the fire crisis period, when there was no water, and now during this crisis. Ndlovu said they were prevented from entering the facility after Dr Mazwi’s death because staff members were afraid of victimisation.
As expected, a typical sequence of reactive measures is initiated following the incident. The KwaZulu-Natal Department of Health suspended a supervisor and launched an investigation Health Minister Aaron Motsoaledi is now calling for an “urgent probe” – because, naturally, urgency is reserved for after death. The Health Ombudsman , Taole Mokoena, is also investigating.
However, let’s get real – for Dr Mazwi and his family, the sentiment of ”we should have, they should have” is too little too late. Unfortunately, the system only remembers its duty once there’s a body and an outcry – a ritual well ingrained in South African DNA.
A Hospital in Crisis with a system breaking down
The death of Dr Mazwi is a sad but inevitable result of a health system weighed down by structural faults. Prince Mshiyeni Memorial Hospital reflects the decay occurring in KZN’s public healthcare facilities, where, as per the 2024/25, Provincial Health Budget Review, 62% of public hospitals failed to meet safety compliance tests.
Only three months prior to his death, the hospital experienced a week-long water outage , with staff having to carry buckets from ward to ward and infection control being compromised. Patients spoke of having to use plastic bags for toileting, while others simply discharged themselves rather than tolerate the conditions.
In February, the Public Servants Association appealed to the South African Human Rights Commission, saying that it was an untenable situation for medical staff to be expected to work without proper hand-washing facilities.
The problem extends beyond crumbling infrastructure to a culture of bullying. Dr Nomusa Zulu, who completed her internship at Prince Mshiyeni and now works at a private hospital, told News24 that the paediatric ward where Dr Mazwi was working had a “militaristic management style” where questioning decisions made by senior staff – even on patient care – was punished, mostly in the form of longer shifts.
If true, this would then explain how Dr Mazwi, despite twice fainting on the job, was threatened with having to repeat his rotation if he refused to work. This underscores the abuse of power as a tool of coercion over junior doctors’ well-being.
The South African Medical Association Trade Union, in their press release, emphasized the “critical necessity” to address the unacceptable working conditions and treatment that most junior doctors, especially interns, receive at the hands of their seniors. They explained how rotation sign-offs – the paperwork interns need to progress – are used as weapons to silence complaints about unsafe working conditions.
Dr Thandeka Moyo’sviral Twitter thread on May 15 detailed how these rotation demands create “hostage situations where you’re choosing between your life and your livelihood”. Unfortunately, hospitals are not isolated from the broader power dynamics of society. The same structural inequalities that silence victims elsewhere take root in medical facilities, where hierarchies determine not just who gets heard and who is ignored.
At What Cost?
The DA KZN Health spokesperson, Dr Imran Keeka, stated that the R4.7 billion overspending by the KwaZulu-Natal Department of Health in November 2024 has caused a crisis with dire consequences.
Fiscal irresponsibility creates a wave of repercussions on the health system: fewer staff members must do more work, safety protocols become futile, and employees’ concerns fall on deaf ears. Here we see the tragic tale of Dr Mazwi, a heart-wrenching example of humanity falling due to systemic breakdown – that starts with top leadership and trickles down to department heads, ultimately leaving junior staff to carry the heaviest load.
The irony lies in the government’s promise of National Health Insurance as a solution while failing to address existing systemic issues (National Department of Health, 2025). Dr Mazwi’s death forces us to confront a harsh truth: those who can’t patch a leaking shack have no business promising to build mansions.
They signed up to heal – not to die trying.
No doubt South Africa’s public health system is under strain. There is evidence to suggest that 89% of community doctors are emotionally exhausted, 94% are depersonalized, and 97% experience a lack of personal accomplishment (South African Family Practice Journal, 2022) . Behind each of these figures are names, faces, and consequences that represent a crisis.
Once healthcare providers fall between these cracks, we can no longer afford to debate whether it is institutional or individual failure; it is both.
A study of rural healthcare workers has concluded that burnout has severe repercussions; it is mostly characterized by emotional exhaustion and decreased personal accomplishment (BMC Health Services Research, 2021).
It is only natural for the healthcare workers to wonder, “Why am I here if I am not in a position to help the patients?” The question, asked during a qualitative study conducted in Mthatha, Eastern Cape, captures the way in which the frontline workers are emotionally exhausted (Psychology Research and Behaviour Management, 2022) .
Depression in African healthcare workers has risen from 2% to 20% since the pandemic (PubMed, 2021) , demonstrating the fragility of our care and support systems.
Globally, the World Health Organization has an ethical duty to address burnout, exhaustion, and any form of injury throughout the healthcare system by protecting workers, improving work environments, and addressing the underlying issues that thwart mental well-being. (WHO Technical Consultation on Health Worker Wellbeing, 2022)
Excellence cannot be expected of burnt-out, unsupported, and emotionally depleted professionals. The right to dignity must exist on both sides of healthcare – for the patient, as well as the practitioner. The South African Constitution protects workers’ rights to equality, dignity, and fair labour practices. Neither illness nor disability can serve as a ground for discrimination under the Employment Equity Act . These protections become utopian dreams when not implemented or monitored. Sadly, silence is the order of the day in most facilities, and it is claiming patients’ and workers’ lives.
REFERENCES:
Basic Conditions of Employment Act, No. 75 of 1997. (1997). Government Gazette. https://www.gov.za/documents/basic-conditions-employment-act
South African Human Rights Commission. (2025). Intervention on healthcare worker deaths. https://www.sahrc.org.za
National Health Act 61 of 2003. (2004). Government Gazette. https://www.gov.za/documents/national-health-act
National Department of Health. (2025). Strategy document on healthcare worker protection. https://www.health.gov.za
Parliamentary Portfolio Committee on Health. (2025). Deliberations on healthcare worker safety. https://www.parliament.gov.za
Public Servants Association. (2025). Statement on Dr Mazwi’s death. https://www.psa.co.za
KwaZulu-Natal Department of Health. (2025). Official communication on incident and suspension. https://www.kznhealth.gov.za
Health Ombudsman South Africa. (2025). Investigation notice regarding Dr Mazwi. https://www.ohsc.org.za
Prince Mshiyeni Memorial Hospital. (2025). Background and safety audit. https://www.kznhealth.gov.za
Provincial Health Budget Review 2024/25. (2024). https://www.treasury.gov.za
News24. (2025). Interview with Dr Nomusa Zulu. https://www.news24.com
South African Medical Association Trade Union. (2025). Press release on intern working conditions. https://www.samatu.org.za
Moyo, T. [@drthandekamoyo]. (2025, May 15). Twitter thread on rotation sign-offs and intern abuse [Tweet]. Twitter. https://twitter.com/drthandekamoyo
Democratic Alliance. (2024). Statement by Dr Imran Keeka on KZN DOH overspending. https://www.da.org.za
National Department of Health. (2025). National Health Insurance rollout overview. https://www.health.gov.za
South African Family Practice Journal. (2022). Burnout among community service doctors in South Africa, 64(1), a5405. https://safpj.co.za/index.php/safpj/article/view/5405
BMC Health Services Research. (2021). Burnout among rural healthcare workers in South Africa, 21, 615. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06543-1
Psychology Research and Behaviour Management. (2022). Frontline healthcare workers’ emotional exhaustion in Eastern Cape, 15, 1307–1318. https://www.dovepress.com/frontline-healthcare-workers-emotional-exhaustion-in-mthatha-peer-reviewed-article-PRBM
PubMed. (2021). Mental health of African healthcare workers during the pandemic. https://pubmed.ncbi.nlm.nih.gov
World Health Organization. (2022). WHO Technical Consultation on Health Worker Wellbeing. https://www.who.int/publications/m/item/health-worker-wellbeing
South African Constitution. (1996). Bill of Rights. https://www.justice.gov.za/legislation/constitution/
Employment Equity Act, No. 55 of 1998. (1998). Government Gazette. https://www.gov.za/documents/employment-equity-act
eNCA. (2024, May 17). Memorial for intern doctor who died on duty. https://www.enca.com/news-top-stories/memorial-intern-doctor-who-died-duty
About the Author:
I’m Aphelele Mtwecu, a proud member of the Activate Change Drivers Network and a 2016 Activator. I am a 33-year-old ambivert who works as a content writer, activist, and creative. My true passion lies in youth development, transformation, and making a meaningful impact. Every day, I encounter the world seeking healing, innovative solutions, and fresh methods to drive social change on my personal journey. My work and advocacy reflect my unwavering commitment to fostering positive change.
