Prof Nomafrench Mbombo, A Bloody Difficult Woman

Prof. Nomafrench Mbombo is a distinguished leader with over three decades of experience spanning healthcare, academia, politics, and public service; a woman with an unwavering commitment to social justice, equitable healthcare and the empowerment of marginalised communities.

In this episode of Awakening Doctor, we learn about her humble beginnings in Mdantsane township, her thwarted ambitions to go to medical school, and the fortuitous dismissal and chance encounter that led her to study nursing and attain a Master's in Maternal and Child Health, and a PhD in Gender and Human Rights instead. 

We delve into her tenure as the first female, first Black African, and first health professional to serve as the Minister of Health and Wellness in the Western Cape, and reflect on the complex political dynamics that often overshadow service delivery. The conversation addresses pressing issues such as gender inequality, economic marginalization, and the importance of fostering support structures for young people navigating tough situations.

Fueled by an indomitable spirit and a deep-seated conviction that the only way forward is to leave no-one behind, Prof. Mbombo is unapologetic in her assertion that "it's okay to be a bloody difficult woman” – one who disrupts, demands and delivers in her endeavour to birth a new reality in the world around her.

Join us for an inspiring conversation that is a testament to the power of feminine leadership and a reminder that the past does not define our destiny - our ability to adapt and persevere does.

Chapters

• 0:00 Empowering Health Systems
• 4:38 Overcoming Adversity and Pursuing Dreams
• 12:07 Navigating Career Transitions and Personal Growth
• 22:40 Delivering Babies
• 27:42 Leading Through Crisis and Unity
• 38:05 Rescue and Empowerment in Healthcare
• 46:48 Balancing Health Professional and Politician Roles
• 55:01 Navigating Politics and Public Health
• 1:08:02 Supporting Young People in Tough Situations
• 1:18:07 Empowering Women and Overcoming Challenges
• 1:26:21 Embracing Vulnerability and Personal Strength
• 1:40:01 Awakening Doctor

Transcript

Prof Nomafrench Mbombo: 0:00

Of course, in a bag of apples you'll have one or two rotten ones, but generally it's about the team - where they bring their hearts de spite all these challenges that we have. That's what made me be all over. When you go to Matzikama in the West Coast, there are towns there that are nearer to the border of the Northern Cape, others to Namibia, where they will say go to the clinic, like Kliprand, also Molsvlei. And then they say, we have never seen a Minister in our lives. We are five generations in this clinic. Never. It's the first time.

Prof Nomafrench Mbombo: 0:38

And then for me I used to say if a ballot paper, the IEC ballot paper during elections, could be able to cross the rivers, could be able to cross the whole of whatever, and then land to a person who's supposed to vote, there will be IEC staff who's going to go to this [place] for people to vote. How come I cannot be able to go there? Because those people were voting for us to go there. There are no roads. But you know what? There is a clinic sister who's there, there's a nurse who's there, there's a doctor who goes there once a month. There are bloods that are being collected, specimens. It means there is something that's happening there.

Prof Nomafrench Mbombo: 1:17

So why can't I go and support my staff? Because most of the time, it's not about I'm going to Auntie Sarah. I'm just going to support the staff who is providing service to Auntie Sarah who has never been anywhere except to that place. They were born there, they did their training, their nursing college and then they worked there. They've never been anywhere. So when I go there in these small places where no one goes, the excitement that is there, oh, you haven't forgotten about us. I said I'll never. You are part of the 33,000 of the staff members. Everyone matters.

Dr Maria Christodoulou: 1:50

Sjoe. I love that, thank you.

Prof Nomafrench Mbombo: 1:52

So that's why you have to think systems. We are the only ones who think systems.

Dr Maria Christodoulou: 1:57

And when you say we are the only ones, who are you referring to?

Prof Nomafrench Mbombo: 2:01

In the Western Cape government, among the 10 departments, when we are presenting or others are presenting, we will poke holes t hat you are only talking about.... We look across, because most of these are absorbed by health. So, if you don't say anything about the child malnutrition - about agriculture, do something. If you don't say about the school - about... make sure that you have got this counselling, the after hours, you'll end up absorbing all these young people with suicide or getting into crime. So we have to help the others so that we can help ourselves, because they don't understand in terms of how health system works. They mustn't only focus, how many beds do you have? Those people are already sick. We are not the Department of Sickness. We are the Department of Health. Therefore, you have to look beyond the health facilities but for the whole system. Y ou make sure you strengthen all the building blocks, as according to WHO. For the whole 10 years, for me, I don't think I was at work. They say get the job you love, you'll never work a single day. For me, it was never about work.

Dr Maria Christodoulou: 3:07

Welcome. I'm Dr Maria Christodoulou, and this is the Awakening Doctor podcast, a space where we discover the personal stories of those who work in the medical and health professions. Join me as I explore the hopes, the fears, the aspirations and the real-life challenges of those who carry the title, responsibility and privilege of being a doctor. Joining us today is Professor Nomaf rench Mbombo, a distinguished leader with over three decades of experience spanning healthcare, academia, politics and public service. Professor Mbombo served as the first female, first black African MEC of health and wellness in the Western Cape until very recently, and was responsible for spearheading many of the initiatives that have earned the department its reputation as the best in the country. Professor Mbombo has a Bachelor in Nursing Sciences, a Master's in Maternal and Child Health and a PhD in Gender and Human Rights. She has dedicated her multifaceted career to the empowerment of marginalized communities and the implementation of integral approaches to equitable health care. Welcome, Professor Mbombo. It's a real privilege to have you with us today.

Prof Nomafrench Mbombo: 4:20

Thank you very much, Doc, for having me. Thank you.

Dr Maria Christodoulou: 4:23

My pleasure. I'm looking forward to getting to know a little bit more about the story of the woman behind the credentials and the achievements, so I'm going to ask you to tell me where is a good place for us to start telling your story. Where would you like to begin?

Prof Nomafrench Mbombo: 4:40

Born and bred in Mdantsane, in the Eastern Cape. Township. So when I finished high school, and I'll also share with... among, especially with the young people on resilience, and also for them that their history is not necessarily a determination of their destiny.

Prof Nomafrench Mbombo: 5:00

So when I finished high school, unfortunately there was no money. I was intending to do medicine. I was already accepted at Medunsa and also at the Natal Medical School, but there was no money. At that time, it was not uncommon, once you are done with the basic schooling, you'll go and find some work. If you are a boy, you'll be a garden boy whilst you are still hustling, and for a girl, you do the domestic work. So for me, of course, it was about where now I ended up finding domestic work. Mind you, I was one of top students, a top learner. T hroughout my schooling I've always been... I've never had any other position in class other than position one. Never. So I was fired, I think two or three times in between in this kind of job, but the one that I always make an example of it's when I was fired for the last time.

Prof Nomafrench Mbombo: 6:01

So I used to be so sad when I get fired. I think probably they think I was lazy. So... but on this particular one, I know that it was on a Monday because I was reading Sunday newspapers, Sunday Times. I remember I was paging through that, which is... it's a normal kind of, as domestic workers, you pretend as if this is your house. Because I'm coming from the township where you are sharing the matchbox house with many of your, not only the siblings, but also the cousins and all the relatives. Despite that, we are three siblings, but at the time there will be the others from the aunties and from the maternal and paternal two grandparents. We were a lot. As a result, I only knew it when I was doing matric that actually we are three. A s I'm saying that, it's a normal behavior where you pretend as if it's your house. So on that day, I took one of the best dresses from the wardrobe, the madam's clothes.

Prof Nomafrench Mbombo: 7:00

I took one of the best, and then I took one of the best stilettos, and then I sat on the couch and then I took the best tea set. I would know that round about 10-ish or something I'll get up, because I know that she normally comes with the kids when they're back from school, r ound about 2 or 3. Four o'clock, I'll take a train back home.

Prof Nomafrench Mbombo: 7:21

So, it was one of those where you're just sitting reading newspapers pretending it's your own house.

Prof Nomafrench Mbombo: 7:28

And then unfortunately, on that particular day she came early because she dropped the keys and came back and she forgot something. So when she entered the door there's only one main entrance. So the eyes were like popping like that, and what she said, s he said, you don't belong here. Pack your bags and go. You don't belong here. Those words, a s I'm saying that... I was fired before, and I'll be sad.

Prof Nomafrench Mbombo: 8:01

But those ones, they were so profound, I get so excited. I don't know about it, but it just opened up that, of course, damn, I don't belong here. So I took off the dress and took off my pink apron that was underneath, put it in my backpack. It was like there's that freedom, because what I used to do when I get fired, I'll call one of our school mates who was also doing some of the chars, and all of those. She was so connected. She was one of those seniors, she was so connected. Don't worry, let me phone my madam, I think Mark, one of their w hatever, will need someone. And then you move from this one and then go probably to another building.

Prof Nomafrench Mbombo: 8:45

This time it was about I don't even want to do anything, but in a way I felt so free. But because it was at the beginning of the month, meaning my whole of my monthly ticket, a train ticket, was still unused, so I didn't tell anyone I was fired, but I used to get up in the morning and then I'll walk the whole Oxford Street up and down doing the window shopping, like, one day I'll have that dress, one day... Until probably, it was almost two weeks, I bumped into one of the nursing sisters who was a neighbour, S ister Mseti, who was working in one of the clinics. Nursing sisters. I've been looking for you. Did you know that at Fort Hare, they've opened a new program at Fort Hare, a nursing degree where you don't have to pay a cent. Actually, they'll be paying you. Go now and apply and then I want a feedback.

Prof Nomafrench Mbombo: 9:33

So I took the train, went to Cecilia Makiwane because it was the branch at the Cecilia Makiwane Hospital. I applied. W e were the second group. They had already started with the first one. Where later I was accepted because they were taking only 40. So that's how it started. So for me it becomes a base and a foundation when I'll remind especially the young people that, don't look at me and say that, oh ha, that one was an MEC, she's a professor, I'll never be able to do that. I say that you must know that your destiny, your future, is not determined about your history. So, that part of you don't belong here, it's about... for me, w hen I look around, then I see that I have got a whole lot to contribute to.

Prof Nomafrench Mbombo: 10:21

say that I'll never be a number two in what I'm good at. That's how it started. It was the issue about how about, come that you will not be able to afford it. Despite that, the there were bursaries, it of the SysGai provincial Ciskei administration, the homeland system, although it was taking longer, but it was about go get some money, as you are processing this, and then you'll be able to get. But in the issue that we didn't even have a money even to go to how dang Gauteng to go to debon. Durban.

Prof Nomafrench Mbombo: 10:50

My mother was working throughout at cafes, baking chips. M y father, unemployed, alcoholic, and I'm coming from a small but big family. When I'm saying small but big family, I have two aunts, paternal side one aunt, and their cousins, and then when you calculate yourself, you find that you're about 26. So that's how it went. So I ended up being the first one. So it started with a basic nursing degree at Fort Hare. I did the Masters in M aternal and Child Health at UKZN and then, when I relocated to Cape Town I did the PhD in the social sciences. So I was the first graduate. I've always been the first (in my family). First graduate, first person to buy a car, first person to have a house and all of those. So I've always been there.

Dr Maria Christodoulou: 11:40

Right. What do you think makes that possible? I'm listening to you talk about that environment growing up in a small township, settlement, a huge family, lots of cousins, the first one to do all of these things. What is it inside of you that made that possible? What is it that made you, when somebody said you don't belong here, you didn't collapse. You went, you're right, I don't belong here, and you had a bigger dream for yourself. What made that possible?

Prof Nomafrench Mbombo: 12:06

For those words. She opened my eyes in the sense that if I would have stayed there, it would have been the same generational..., because even my aunts, none of them... it's either, others would have been tea girls or something like that. S o it would have been the cyclical same kind of... I think it was about opening my eyes that it cannot be that I've been blessed with brains.

Prof Nomafrench Mbombo: 12:29

In the township at the time I was one of those kids, even whilst you are playing, and then I'll be called by the neighbours to write letters on their behalf. Like some of the families in the mines. Nomafrench, can you please write this letter? Or even filling in forms, application forms and all of those on behalf of the others, or the competition. So I used to be that kind of like a nerd. It's not necessarily a surprise that even my teachers, when they bump into me, they say that, we knew that's where you will be. So I think for me it's about being blessed and that's why my spiritual balance in regard to always, in terms of everything there's a spiritual significance. I'm a very spiritual person, so I always reflect and discern and look in terms of, what is it that I'm told to do, I'm supposed to do? Just for example, now, when I'm jumping... When I was informed that you are not returning to cabinet. So some people might be about yes, it's a surprise, but I reflected, I said okay, thank you. I didn't argue, I just declined the other offer that they're offering and said I'll discern and see what is the significance of this and the significance, for me, it was about... J ust like when I left academia after 15 years and then I joined politics, I used to say it's an extension of my ministry. Although I'm not a minister, I'm not a pastor, it's an extension of my ministry, but now I'm being put in a different situation so that I could be able to contribute. So similarly, after 10 years of being the MEC Provincial Minister of Health, w hen they said, you're not coming back, I said but it doesn't mean that's the end of the journey, because even when I left academia, or even when I left as being a clinician before I joined academia, it was about that. Now I'm doing quite a lot, despite that I'm not there. Actually, I'm in a better position now to juxtapose all of those. T he politics, the government, the civil society and you have got no boss.

Prof Nomafrench Mbombo: 14:38

When I was an executive, you cannot just leave, because t here's only one provincial minister. You cannot just leave. You cannot just do... For example, like recently, I was coming from Dubai on the issues of medical tourism. I wouldn't have been able to go to it because it's not aligned with what the province is doing, medical tourism. B ut now I could be able to contribute, because I'll just say, okay, what I was supposed to do? I was supposed to be in parliament. Okay now, can you please stand for me? I'm just going to Dubai. That's it.

Dr Maria Christodoulou: 15:11

Right. So there's a certain kind of freedom that comes with no longer being the MEC.

Prof Nomafrench Mbombo: 15:18

Of course. Oh, of course. Of course there is a lot of freedom. Actually, I was talking to my daughter. There's someone who wants to deliver some Christmas present.

Prof Nomafrench Mbombo: 15:28

And then I was reflecting that when you are the MEC, you need to be considerate in regard to the gifts. Some of them you have to turn them down because you don't want to take a gift, let's say, from a private hospital, only to find that they are applying for licensing. Once they will have seen that, oh, the minister, provincial minister, got a microwave. Ah, so that's why. F irst of all say, okay, why am I getting a microwave? No, thank you. Now it's about, I'm nothing in the sense that, whether you give me a car or whatever, I'll just disclose the car but it won't have an impact in terms of the ethical integrity.

Dr Maria Christodoulou: 16:08

Was it a surprise when you were told you weren't going to be the MEC for health and wellness anymore?

Prof Nomafrench Mbombo: 16:12

Of course, I was surprised in the sense that, despite that, when you work, you are not working for recognition. A s I'm saying that when I was working, in the 10 years, it was an extension of my ministry. I was fulfilling a purpose. But you feel good when it impacts on the others, especially during the COVID. So there was not a single time where it would have been oh, you didn't do ABC. With all the scores, for example, randomly in terms of the visibility, who's the most visible? So I was on the box. So for me, what I was expecting at the time it was about we are changing you to another portfolio. That would have been expected. Before.... being told that... I know it's politics because, as I've said, politics is about power, it's about interests.

Prof Nomafrench Mbombo: 17:08

That's the main reason for the politics. Service delivery is secondary. So when the politician says that, no, I want to be in government so that you'll deliver. If someone is already... if the other party is delivering better, why would you want to say you want to deliver, if you are fine with it, for example? So it just shows that it's all about the power, it's about the interest. So for me, it's about I delivered. Fine that you could remove me saying that okay, you've been here for 10 years. We need you. We need the same skills to another portfolio that you understand. But when you are being told that, no... I can understand

Prof Nomafrench Mbombo: 17:48

if it was about... If there was a prior conversation. I t's not necessary that there should be, because you serve at the discretion of the premier, so it's not necessary that there should be, but you'll be assuming when you are colleagues you'll have that kind of a conversation. So there was no conversation. But again, being spiritual, I said God might have been in a room or sitting at the table where I was not there and listened to the conversation. Maybe it's protecting me from those conversations, but with my skills and talents and everything, as I always say, you may not be at the seat of the table, but wherever you are, the table is going to shift towards you. That's how it works. You don't have to be at the table in order to make a difference.

Dr Maria Christodoulou: 18:41

Right. I read somewhere that you live by the mantra that where you are planted, you will grow. Tell us about that.

Prof Nomafrench Mbombo: 18:52

Having been exposed to the different settings, there are people who come with a privilege. P rivilege in the sense that there are people where they don't have to sweat a thing, but you find that the environment or the universe it will favour them, Coming from families, way of influence, or the networks. For me, from Mdantsane, as I'm saying that I've always been the first fi rst. Even among my friends, the first, first, first. F irst one being a professor, first one having a PhD, all those kind of things, because when I joined UWC there used to be some black Africans but they didn't last. Because I was recruited by my former professor from UKZN who joined UWC as a head of department, Professor Kortenbout, because I was her student then, because they needed a community-based lecturer, because at the time, UWC Faculty of Community and Health Sciences, so the community aspect of teaching and all of those, because I'm coming from that background, when I was working for the East London Municipality as a primary healthcare nurse. So my point is about, you'll always rely on you, no one else.

Prof Nomafrench Mbombo: 19:59

So it means that the work that I do have to speak for me because nobody knows me, whereas if probably I will be Felicity or I will be John. John, it will be, oh yes, your father, oh yeah, yeah. Yet John doesn't need to sweat. But for me, I have to sweat so that, even if among the list they are putting the names of the list, it must never be about ah, this one is going to be a token. People know I will never be a token. So in terms of the where I'm planted I grow, it's about, I have to make sure I leave a legacy behind. Have to, because I've got no one else. No one. So it's only me and my talent and my skills that have to speak on my behalf. From a decision prior that you put me there, I'll show you. But also there's an evidence, wherever I have been, that I will grow, because that's the only thing that I have, is only me.

Dr Maria Christodoulou: 21:02

So, on that note, I'm curious if we go back a little bit. You spoke about being in high school, being the top student, really wanting to do medicine, getting in at two different universities and then destiny taking you in a different direction. Nursing and being a doctor, p articularly in those days, I think the curriculum was really very different and there would have been very different demands and expectations on you. How was that adjustment? How was it to enter nursing school b ecause finances were the main motivator.

Prof Nomafrench Mbombo: 21:32

Yeah, they were, they were. At the time, Bachelor of Nursing Science was taking about four and a half years, because you have to do also psychiatry at the two psychiatry hospitals in the Eastern Cape. After we'd done training, I worked at Frere Maternity. I was more interested in maternal and child health from the word go. Actually, when I was training in Cecilia Makiwane, the better place to work that I favoured was in labour ward. I enjoyed delivering babies as a midwife.

Prof Nomafrench Mbombo: 22:01

Immediately when I completed my four and a half, I got a job at Frere Maternity Hospital, but in the white side. During our time there was the ground floor, was the black side. The white side was also for all other races who are private, and I've been one of the first because the others who would have been allocated... But it's managed by one matron. If there's a high pressure there, there must be allocation as well of those black ones upstairs, b ut they won't last. So I'm one of the people who lasted the longest.

Prof Nomafrench Mbombo: 22:33

Because I always describe myself... I'm water. Any container that I occupy, I'll just assimilate to that shape. When it comes to the interpersonal skills it's one of my strengths. But also you use the environment or the platform as a classroom. Some people are unable to reflect and see what they cause to the other people, so it makes sense, without being threatened, to have that kind of a conversation.

Prof Nomafrench Mbombo: 23:00

That's where I ended up, but money-wise, I worked for the East London municipality at the clinics, but even there I was doing mostly the antenatal care, the family planning. That's when now I decided to do the Masters in M aternal and child health. A lso advanced midwifery. I was not only based at King Edward but I was doing more of the outreaches in the rural areas. So what used to happen, the principal obstetrician will go with a registrar and an advanced midwife and then you are being provided.... Ulundi, mostly in northern Zululand, all of those places where you are all by yourselves, and then he will come now and again and check. Y ou'll

Prof Nomafrench Mbombo: 23:39

do your ultrasounds, everything all by yourself, but part of the program being the change agents, because we are not only trained for clinical masters but also as a policymaker. And then my research was on the HIV/ AIDS under five years old , because it was at that time that the HIV/ AIDS was starting. So when I was used to work at the clinics, the whole issue of the under five babies with all these symptoms, but also as a primary health care nurse w e are working closely with not only the community health workers but the communities. Like you get a list from Frere Hospital for the referrals, you take a mobile and then you visit. It's in the informal settlements. So that's when now the community aspect and the clinic aspect they came together. And then that's when for me it was about primary health care, working with the communities.

Prof Nomafrench Mbombo: 24:26

When I started now at UWC it was about initiating a program.

Prof Nomafrench Mbombo: 24:29

The master's degrees, also in maternal and child health, specifically for the advanced midwifery, is the one that I initiated.

Prof Nomafrench Mbombo: 24:35

So that's why Professor Kortenbout, my former professor, recruited me, because you don't normally get people... People will go for, like nursing education, administration. For me, from the beginning, I just wanted to remain in the clinical field, not to do the admins. This thing about leaving no one behind, although now it's linked to universal health coverage... At UWC,

Prof Nomafrench Mbombo: 24:55

that's where I taught, I ran the program but luckily I ended up recruiting students from outside Africa where they'll be paid by their government to come and train. So that's why almost parts of the Africa eastern and southern Africa, most of the professors in the schools of nursing, in the midwifery, or even the DGs of the maternal and child health, are my former students, so I go easily anywhere. Like I was facilitating a session with the UNFPA on the state of midwifery in Eastern and Southern Africa. It so happened that in that room - it was in Jo'burg - half of the people who were sent from these countries across Africa they were my former students. I ended up doing some work with the UN Women on maternal mortality and human rights and also with Harvard on the maternal health. I ended up merging the communities aspect of it, the human rights aspect of it, the activism, policy making, everything. Still delivering babies.

Dr Maria Christodoulou: 26:01

Right, what was it about delivering babies that you liked?

Prof Nomafrench Mbombo: 26:04

Because for an advanced midwife you have to do the difficult risk pregnancies, because they will send it to you, especially in the primary healthcare setting where you might not have on-site obstetrician.

Prof Nomafrench Mbombo: 26:16

So, for me it meant that the issue of whilst you are waiting for the doctor for the breech deliveries, the twin pregnancies, the most common one, of course, is managing eclampsia. Ohh, for the primip, because you are there, for the at-risk patients, you stay close with your patient throughout. Unlike for others. Every pregnancy is risky, but generally for not at-risk ones, you could be changing... Like you'll be monitoring and then you go to the other and then whatever. But with a risk one you build a bond, especially with a primigravida who might be with eclampsia., Y ou are there throughout, throughout.

Prof Nomafrench Mbombo: 26:55

Mom with twins, so you have this journey together until, if you're still on duty, until you even extend, extend the hours. Even if you're supposed to be off, and then you find that it's nine centimeters, you say no, I'm not leaving. You stay there. That excitement. And then when the babies or baby comes out and is alive because, remember most of them, they will have all of these standbys of paediatricians... You end up being in that team. And then when you resuscitate the baby, maybe it's got a low apgar, and then the baby cries... yoh, you all hug yourself.

Dr Maria Christodoulou: 27:36

Your voice changes when you talk about that and you get really passionate and animated when you talk about that.

Prof Nomafrench Mbombo: 27:42

Oh, I haven't delivered babies for a long time. Actually, I've always been subscribed with the South African Nursing Council, just in case. Just in case, because when I was an MEC, if there's a time that maybe I go to some of the clinics and then I feel like I want to do some practice, at least I'm covered. I just put aside the politician, and then I do the midwife.

Dr Maria Christodoulou: 28:03

Is there a place where the politician and the midwife intersect in you, or do you feel like you have to keep them separate?

Prof Nomafrench Mbombo: 28:10

No, they are the same. They are always together, just for example, during COVID, whilst people were stay home and you have got no obligation to go over... Beaufort-West, wherever. For me, people were so scared. But for me, it was about the staff. They don't know this virus, they are scared. They have left their families. They don't know whether when they come back they'll be infecting them. For me to be there, not only as a leader, but to mother them to feel at home. With a child playing around, it can see you, and then you go to another room... immediately the child doesn't see you, Mom? Y eah, I'm here, okay, and then feels safe. It's that part of you that remember, I'm here. I feel what you feel, because midwife is about with a woman throughout. F or me, with staff, as I always say, staff comes first.

Prof Nomafrench Mbombo: 29:02

So that they can make the patient come first.

Dr Maria Christodoulou: 29:06

So I imagine in your position at the start of the pandemic there were so many unknowns, there was so much uncertainty. There you were in this position as the MEC, people looking to you for leadership, feeling this responsibility to hold the space, and all these anxious people who were also dealing with all the uncertainty. What was that really like for you? Like, if we could have a little peek behind the scenes, what would we have seen happening for you in that time?

Prof Nomafrench Mbombo: 29:34

One thing for sure is if you have a team that you can rely on, the issue of trust goes a long way. Simon Sinek says that leadership is about when your team trusts you, thus making them to flourish. They trust you because you trust them. Because the issue is about, especially as politicians, where, at least for me, luckily I'm a health professional, so I understand the health system. I've worked in all other health systems. I understand. But the issue is about when you, as a leader, you don't trust your team. When I used to say, don't tell me about all the best things, I want also the challenges. I'm supposed to assist you so that we all journey together in terms of troubleshooting, coming up with the solutions. So, first things first, it was the team, where they'll say, Minister, we're also scared, and especially when you have got staff dying. L ike in one unit, where we'll find that it was day one is another one, second day is another one. Because when I say, no, let me go there. B ut you can't. But I have to, someone has to. You have got people who are there, who are backing you always, and for them, knowing that I'm there for them... Just to make an example of one case.

Prof Nomafrench Mbombo: 30:51

It's about the vaccines. Politically, the Western Cape is the ones who jump in to say that if the national is delaying... If you remember there was all of these delays, it was AstraZeneca. All of those. Western Cape is ready to purchase the vaccines and we're not only going to do it for the over 60s, we'll do it for everyone. Therefore, team health, get all those service providers, pharmaceuticals who could be able to provide, and then you get at least some of them. People say I'm selling vaccines. I'm selling vaccines.

Prof Nomafrench Mbombo: 31:23

When the team said to me, you do understand the issues of the equity. Whilst we talk about the 7 million population for the Western Cape, it cannot be that you will end up leaving the rest behind, because humans, they move around. You'll also be bringing the whole influx of people coming to have the vaccines here, but you can't leave anyone behind. And then we were called to say, okay, how far are you? We have drafted you. There is the thing... how it's going to be dealt with. So we looked at it and then we changed the whole of the document. We said no, we can't. And then it was a big thing politically. But we said, we are clinicians, patients come first for us. When we think administratively or management, at the back of our mind is the patient. So we have never removed ourselves. It's a whole ecosystem that doesn't leave anyone behind, where we were able to dismantle the hierarchy. Instead of having these formal meetings and the agendas, let's check and regroup, because it was, of course, virtual. Just to have a conversation among ourselves and also to share our fears, especially when we have had senior people who were in ICU and you know that anything might happen. And also for us, it's about where they will say, M inister, we'll rely on your charm on this one. What do you want me to do? Can you please negotiate Whether it's an international... I'd say, but I don't know these people... But with you we could be able to get this. So those kinds of things about where we use each other's skills, it was part of that. A moment that I'll never forget...

Prof Nomafrench Mbombo: 33:04

It's when we would have ran out of oxygen for the whole province. I'm getting reminded, because it was more or less Christmas time. Probably Keith [Cloete - a former guest on the podcast] maybe did share that part of it. T he whole of the public health services in South Africa, t hrough National Treasury, the oxygen was through one company and then the private was through the other. With the private they were the first that used to run out of oxygen. They were having more of the high care beds. For us, we used to take some of their patients, who are not necessarily COVID, so that we can swap and give them all of those, but at least with a high flow nasal oxygen there was no need now for the ventilators. So generally we used to provide them our oxygen, but I'm not saying that when we almost ran out it was because of that. You will have a big tanker truck that used to come on alternate days, I think, from Gauteng and Mpumalanga, because most of the oxygen plants they will be that side, and then for the coastal there will be a smaller tanker that will come from Gqeberha Rebeca. But you'll have, have day, day oxygen, whether from the big tanker from Joburg or a smaller tanker from the Eastern Cape.

Prof Nomafrench Mbombo: 34:14

But now, because of the high demand, there was a time where so many cases, so many people who are in the ICU, when they said let's regroup, we have got a problem. If we don't get oxygen within 24 hours it means we'll be out of oxygen for the hospitals. All them. Imagine. And there was nothing from the private. It was on the 24th. We have to call the National Minister Mkize, who was having an event because it's already Christmas, people are busy, we couldn't get on the call. And then I'm asking people from the KZN, w here is he? I said, now we also share it with the Premier. He also looked from Botswana, Mozambique... Because it was already Christmas the CEOs of these companies also, th ey were nowhere to be found. I've never been so scared, picturing the news where 80% of the patients probably would have died.

Prof Nomafrench Mbombo: 35:07

It so happened that there was now a tanker that was able to be redirected from the Eastern Cape to us. In the N2, where the tanker will come... We got the tanker? Yeah, just passed Plettenberg Bay. And then there'll be one in Mossel Bay, they'll go out of their house just to check. I think it was going to go to Mitchell's Plain, there by Lentegeur, to offload. But the excitement when it came! It entered the gate. Yoh, what a relief. We already have Christmas. What else do you need? People don't understand, behind the scenes... Remember, all of this is happening... We will have lost two or three of the critical staff. You hear that the sister in charge of the clinic in Uniondale has passed on. Normally, you are seven. Every day you are twelve, and then find out three have died. Now you have reduced yourselves. The same people who were part of the management. That was the sad part of it. The excitement is about... when you go to a hospital, and then you were doing the Jerusalema. So the way they're looking forward to do the dance, I will always put it live and then they'll compete. They're like... Bofort West Beaufort- will say that we cannot be that Knysna can a better do Jerusalema Jerusalem than us. Can you please, please, come back. But I said I can't come back.

Prof Nomafrench Mbombo: 36:27

It made us focus on other, at least positive, stuff, more than that they will have lost their own staff members from COVID. Do you like to dance? Of course, of course comes natural, becomes natural whether you're in church, whether you are in the club. I'm that kind of a girl in church, church although I cannot even properly, properly where if you've been sitting at the back, you'll even at with the front. I'm that kind of a girl in the club where everyone that, that okay, it's 2 now,, now let's go. And then I say wait, wait, wait, wait as you go out, and then you hear there's this song... you come back. So I'm that kind of a person. I'm that kind of a person when I regroup, for myself, to re-energize, I'll just put the music loud in the house and then dance in the mirror even all by myself.

Dr Maria Christodoulou: 37:17

I love that. I've been guilty of that too. I also love music and I love to dance. I'm inspired by this idea that you let the music move you, because it feels like you've done that with your career as well, and the metaphor of being the water and being able to occupy different kinds of containers and fill the space. I think that takes courage.

Dr Maria Christodoulou: 37:35

As I'm listening to you, I'm so aware that your career has spanned so many different things and that there's so many different aspects of it that we could talk about, so I'm going to ask you, maybe to pick out some of the highlights. Like you've just shared this powerful story of this experience in COVID, are there any other moments in your career or in your life that stand out for you as wow, that was big.

Prof Nomafrench Mbombo: 37:57

The building that collapsed in George. So the disaster team, which is led through the local government, are the ones who have been on site, as always. Despite that, they were saying, okay, we don't need as many people, but for me, at the end, the rescue team is the EMS. So I went there just to support and I gave the national minister a call as well to come, just in terms of assessment, but the highlight for me when I went there, it's about the team. Te disaster team from the health, where they will orientate you.

Prof Nomafrench Mbombo: 38:28

After that, the next day, I went to see the patients, some of them that they managed to take them out alive. There were those who have got no face, others who still... no legs, but one lady was saying that... because two of them, they were not even South Africans. They said that, they came back, they came back. I don't know exactly what she's talking about. They came back. L ike he's hugging you, they came back. I thought they would have forgotten about me. They would have left me there. We have had many disasters, but when they describe to you that they will hear us, because they are underground and we are talking. T alking on top that they were looking for them. They never gave up. T hese ones, t hey didn't even know how many days they were there. S o, that they could hear... They drilled, and then, when they drilled, they would be calling, but they were separated with one of these big bricks. It so happened that the first person that they could see is that guy she was talking to. Now the guy told them that there's a lady also that side and then they said we won't be able to, but don't worry, we'll be back, and then it went quiet. So while she can't remember what happened probably maybe she was unconscious, but out of the blue she just saw the light that was coming. They put water through the pipe and there's some oxygen and they came back. She was there almost a week.

Prof Nomafrench Mbombo: 39:55

After I'd met all these patients, I went back now to the team. R emember, with the team, they rescue and then pass on to the rest, to the hospital. They don't know, they might read from the news. They've never heard about the stories from these victims or the patients on what they are saying about them, because when I say, okay, there was this one, oh, meisie, oh, that was Dion. Dion, come, come, come, listen what meisie said. Oh really? You know, those kind of things. Yoh, when they hear all about what they've been doing. Now they're getting that feedback.

Prof Nomafrench Mbombo: 40:27

When now everything was done, they said that no one will ever be able to be surviving more than a week. And then Gabriel... They were done, done done. When they found Gabriel, because Gabriel was not even talking but they found him alive, with no scratches. So when one of my staff members was saying that they found a person alive, I said never. I ran there because the ambulance was already there going to take him to the George Hospital. The excitement of now having someone. But the team, the best team. I've never... because I mean, since my first experience would be the MEC, all teams, all categories, whether you are a paramedic, whether you are a nurse, you are a doctor... F or the whole province, of course, in a bag of apples you'll have one or two rotten ones, but generally it's about the team where they bring their hearts, despite all these challenges that we have. That's what made me be all over.

Prof Nomafrench Mbombo: 41:22

When you go to Matzikama in the West Coast, there are towns there that are nearer to the border of the Northern Cape, others to Namibia, where they will say go to the clinic, like Kliprand, so Molsvlei. And then they say, we have never seen a minister in our lives. We are five generations in this clinic. Never. It's the first time.

Prof Nomafrench Mbombo: 41:47

And then for me, I used to say, if a ballot paper, the IEC ballot paper during elections, could be able to cross the rivers, could be able to cross the whole of whatever and then land to a person who's supposed to vote, there will be IEC staff who's going to go to these [places] for people to vote. How come I cannot be able to go there? Because those people were voting for us to go there. There are no roads. But you know what? There is a clinic sister who's there, there's a nurse who's there, there's a doctor who goes there once a month. There are bloods that are being collected, specimens. It means there is something is happening there. So why can't I go and support my staff? Because most of the time, it's not about I'm going to Auntie Sarah. I'm just going to support the staff who is providing service to Auntie Sarah,

Prof Nomafrench Mbombo: 42:35

who have never been anywhere except to that place. They were born there, they did their training, the nursing college, and then they worked there. They've never been anywhere. So when I go there, in these small places where no one goes, the excitement that is there. O h you haven't forgotten about us. I said I'll never. You are part of the 33,000 of the staff members. Everyone matters.

Dr Maria Christodoulou: 43:00

Sjoe. I love that. Thank you.

Prof Nomafrench Mbombo: 43:01

So that's why you have to think systems. We are the only ones who think systems.

Dr Maria Christodoulou: 43:06

And when you say we are the only ones, who are you referring to?

Prof Nomafrench Mbombo: 43:09

In the Western Cape government, among the 10 departments, w hen we are presenting or others are presenting, we will poke holes that you are only talking about... We look across, because most of these are absorbed by health. So if you don't say anything about the child malnutrition, about agriculture, do something. If you don't say about the schooling, about make sure that you have got this counseling, the after hours, you'll end up absorbing all these young people with suicide or getting into crime.

Prof Nomafrench Mbombo: 43:42

So we have to help the others so that we can help ourselves, because they don't understand in terms of how health system works. They mustn't only focus on how many beds do you have. Those people are already sick. We are not the Department of Sickness. We are the Department of Health. Therefore, you have to look beyond the health facilities but for the whole systems. You make sure you strengthen all the building blocks as according to WHO. For the whole 10 years, for me, I don't think I was at work. They say get the job you love, you'll never work on a single day. For me, it was never about work.

Dr Maria Christodoulou: 44:17

Is there anything y ou look back on with regret?

Prof Nomafrench Mbombo: 44:21

Nah. I don't. I really don't, because I'm reflecting.

Dr Maria Christodoulou: 44:26

Amazing.

Prof Nomafrench Mbombo: 44:27

But now I'm still inundated by the people, communities. We have been waiting... But you know I'm no longer Minister of Health? Ja, ja, ja, we know, but can you please ask her? I said that's her number. No, no, no, she won't understand. So you also get people where they abuse you. Just because, at the time it was about, yes, like even my staff used to say, do you have to? I said you have to, because if it's about a well-to-do person, why would you jump? If, say, the member of parliament from national parliament is asking about the mother who's in Karl Bremer and you'll jump, but if it's Auntie Sarah asking the same thing, why can't you do that?

Prof Nomafrench Mbombo: 45:04

So we jump for everyone unless you are saying you're not gonna deal with any other one. So part of it was the hotlines, where I even asked for community outreach officers to be able to deal with that. Luckily, half of my ministry staff they're all health professionals, so that was a benefit. Of course, they were my former students. It's obvious. So I recruited from my former students, completed, qualified... who worked, so we could be able to resolve some of them ourselves. But of course we did draw a line in terms of the after hours, especially phone calls. Rather personally, if you WhatsApp, because it was easier for them to send it. I mmediately send it to the CEO of Somerset Hospital, who will respond and then talk and then you send it.

Prof Nomafrench Mbombo: 45:47

But now, when you look at it, it's about aha, now here the ministry has got nothing to do with those kind of things. It must be done by the department. So that's when I reflect that probably we did spoil some others in that sense of. always available, always being there.

Dr Maria Christodoulou: 46:05

I'm very aware that often people talk about the fact that you are the first female to be an MEC of health and wellness in the Western Cape. You are the first black African to be an MEC. You're also the first health professional to be an MEC. What's it like to carry that responsibility? Because I'm sure people look at you and expect things of you that they might not expect of somebody else in the role.

Prof Nomafrench Mbombo: 46:29

Ja, ja. R emember it started with the staff, because when it started there in 2014, I think I had about six or seven months at sports, and then I went to health. So in health, when I started there, we find that there were files. They were all over the office, big files. I said, what are these brown files? These ones in t hat corner is the leave forms coming from all over, but the bulk of them will be from, like, Groote Schuur, from the head of clinical units.

Prof Nomafrench Mbombo: 46:57

Like if you want to attend a conference at WHO in Geneva and then asking me to grant leave. I said, I don't even know how things are working there. How will I be able to say yes? You're supposed to say yes so that you know that the unit is covered.

Prof Nomafrench Mbombo: 47:11

I said no, I don't want to do that. And then the HOD said but in terms of the Public Service Act, you are responsible for the whole HR. I said I refuse. Bring a solution where, while I'm still responsible, but I could be able to delegate. I cannot. "No, you don't understand." But before that it was Professor Househam who was saying that, no other ministers, they will come.

Prof Nomafrench Mbombo: 47:35

The other part of it is, I suppose, I was from academia. T his thing of like you come in the morning and sit in the office like you're at work, you sign, you sign, and then come five o'clock you take your briefcase and then go. It doesn't work like that. For me, I'm more interested in the outputs and the outcomes. I can sit in my car, I can sit at the restaurant and do the work, so that one is easier. But that thing of there is an HR corner for the leave forms. There is that other HR corner, it's for the grievances, for the staff. It might be a cleaner who felt like she's not getting enough salary, because also the supervisor wants to kick her out. So now I must read those kinds of things.

Prof Nomafrench Mbombo: 48:24

There's another pile, it's for the private hospitals, other private service providers, health professionals asking for their license, and then we have got all other things that are there. It's all files. I said why are there so many? I've taken over on the first, but there was an MEC before, so didn't she sign? She said that, every day. No, she's signing. T hat's what they do, they sign. I said I don't have time for that. At least if it would have been the other ones who doesn't understand the health system, no, you have to like... you'll be scared that you have to, but I'll know that I have got no obligation because the delegations I could be able to do that and also I knew what was my focus, because at the time it was about Western Cape was known for hospitals.

Prof Nomafrench Mbombo: 49:08

It was more hospicentric and less on the preventive and promotive, although there was the 10-year primary health care plan that they had. So I was focusing on the WHO building blocks of strengthing health systems. Health financing, in formation systems, leadership and governance, social services. So for me, it was about HOD. Health is complex. It's big. When I say human resource, it's a system on its own among the whole health system. If you want to bring the communities, there's a social contract with the communities, but it's because we also want them to be co-carers. We cannot all have the whole burden about... A person has been discharged, and you still now depend 100% on the health workers instead of empowering the communities to take care of themselves.

Prof Nomafrench Mbombo: 49:52

People used to call me... "O kay, the holiday time is December, we'll be going on holiday, but now mom will be all by herself. And then say, o kay. ", she's diabetic, but can you please keep her in hospital for the two weeks?" You know that kind of thing. It's about no, hospital is not for that. This is not a hotel. Hospital is for the sick people. It's your responsibility to take care of your mother. "Now my mom called the ambulance and then the ambulance came. They've now discharged her again. No, I cannot. I cannot. I've got a lot of work to do. I said that's your responsibility. But to have someone who could be able boldly and tell, as it is, because you have to protect your staff as well. They know that they're supposed to say so but they can't. But I could be able to say so, and then even put a circular out around that and then I sign it boldly, and then I'll still even go to that facility where I said that it's not going to happen and face the people and answer. If, let's say, you go to Mitchells Plain, the district director, whoever, management at Mitchells Plain, have to accompany the politician so that to protect him or her. T hey will know the communities will have those demands, plus also to make sure that they are bringing the answers.

Prof Nomafrench Mbombo: 51:06

So from the beginning it was most of those volatile communities where they will say we want to have the hospital now or else. There was one time, in Gr abouw, for two weeks, where they put everything on hold. The N2 was closed, where the farming communities, they demanded a hospital. When they said to me that there is a Caledon district hospital, they explained, the staff. I said, okay, fine, we'll never be able to give them a hospital. So let me go and tell them. No, no, it's going to be worse. I said, but that's the truth. They're not going to get the hospital, not now, not never. But we could be able to progressively bring them the 24 hours [services]. They already have the 24- hours maternity. You can give them the 24- hour EC. We can extend the hours for the others, especially on a Friday or something. We can have even end of the month, a Saturday, to open. Can you do that? Yes, we can. Okay, can we do it in phases as we rob Paul and pay Paul in terms of the budget? Yes, we can do. Okay, fine, let me go and tell them. No, no, let's tell them.

Prof Nomafrench Mbombo: 52:10

It put me in a better situation because I was privileged in the sense that when the team provides suggestion, immediately, I'll not only grab it, but I also can be able to tweak it and I could be able also to criticize it. You are scared. Okay, leave it, leave it, leave it. This is going to be my project. To cover you, yourself, t hen I will run with it. So you keep on assisting me, so I'll run with it. It's a similar thing with the kidney dialysis, where people are waiting.

Prof Nomafrench Mbombo: 52:43

So I said, whoever from across the province, has got the [.... inaudible...], must come and present their case so that I could be able to be convinced. And then I take it politically. Plus, also, what is important, you must share it with your colleagues, politicians, so that they don't feel pressured about yoh, we've been asked about this. I said, guys, this is how you're going to respond. Yoh, but it's going to be too much. I said let it be, but you must say that Mbombo is saying and there's an evidence that is accompanied by that. So there was a privilege for me being a health professional, in the sense that I could be able to understand immediately and also I could be able to take responsibility, especially to cover the staff when there is a need, but also boldly, where I can say I refuse to be signing these things every day. I've got a lot of other stuff to do. HOD, do the delegation. Okay, you can delegate ABC. That's what I wanted.

Prof Nomafrench Mbombo: 53:36

So tell me where you'll find that I would have broken law if I don't do it. If it's doable, let it be. I have got many things to do just to sit there and sign and sign and sign.

Prof Nomafrench Mbombo: 53:47

And also the other thing there used to be, whether every week or every day, the HOD must come and meet the politician i n terms of the updates, and these are the media statements. For me, I said, I don't want to see your face every day, HOD, I don't even have to. We have a job to do. So if there's a need for us, monthly we'll have a slot, whether we use it or not, but just to pick up a phone, it makes it easier. We're a team, we're a family, so it came with an advantage in regard to that part of it.

Dr Maria Christodoulou: 54:21

Did you ever feel torn between your role as a politician and your role as a health professional? Because it sounds like it was such a gift to have that health professional experience and to be able to use that as you implemented policy and made decisions, but I'm wondering if there ever was a conflict for you between what politics needed from you and what your ethics as a health professional was about?

Prof Nomafrench Mbombo: 54:45

No. P art of the values and principles is a separation of State and also of politics and civil society. You know the 'drie-bene potjie' of it. They need to be separated. So society must be independent, not the civil society that is, extension, as a branch of the government. Similar with a party.

Prof Nomafrench Mbombo: 55:01

Just make an example of the NHI. So, whilst political party side of the response is about, no NHI, we're going to take you to court, blah, blah, blah. A re you not going to take the national to court about it? Because it was about that. We said no, we are not. It will depend, because you'll need to repeal some other laws and others, you'll need some regulations and other acts that you need to implement first before you could be able to do all of it. Also, from a health perspective, NHI is just financing. Our goal for us is universal health coverage and we want to assist the national on how they can even pilot the universal health coverage, using us as a classroom, whilst we are looking in terms of which parts within that NHI Act to form part of what we want to achieve. Central supply chain, where they say they'll centralize, so everything in the supply chain is going to be at the national level.

Prof Nomafrench Mbombo: 56:01

We said that is not going to happen, but we don't have to jump now and take them to court, but on the day that they will come up with it, because before they do that they have to have a legislation that will now take the powers away from the accounting officer and then give it to the DG at the national level.

Prof Nomafrench Mbombo: 56:19

So once that happens because they will impact on the constitution, schedule 4, schedule 5, because the provincial HOD is the one who's responsible as an accounting officer. So it cannot be now when he has to sign off for a linen in Beaufort West, now it has to go to Pretoria. So once there's that part, once we see that, we could be able to argue and take them to court. But each and every time the national DG tries to do a regulation, now they take them to court. So that's why, for us, we said don't confuse the party. It's their job because besides that, they are the opposition at the national level, so it's their job to be an antagonist. So they're doing their job.

Prof Nomafrench Mbombo: 57:01

We are government. For government, we journey because there's one South African public health system with a national responsibility for norms and policy and standards. The provinces are the ones who are actually delivering the services. So therefore, when there's a need that they impinge on what we are supposed to do, we will fight.

Prof Nomafrench Mbombo: 57:22

But there's no need for me to stand there and keep on saying that you know we're there. No, because I'm the executive, because the issue of separation of the party and state, it's very clear. Don't ask me about BELA [Basic Education Laws Amendment Bill], but what I'm saying when it comes to the NHI. That's why it made it easier for them to say, although I'm even out now, they still, at the national level, they'll say, how can we approach ABC? Because remember, now the MECs for health, there's no one who has got a health background, but at least some of them, they are coming back again.

Prof Nomafrench Mbombo: 57:56

Where we'll say, okay, make some of the members from the Western Cape government... I mean, specifically from the Department of Health officials, to be part of the task teams of the NHI. Take our CFO to be a task team on the financing part. Take one of our team who is a clinician like Dr Kariem, to be part of it because he's a COO, understand? So that we journey all together instead of creating binaries, the same with the private. With the private [sector]...

Prof Nomafrench Mbombo: 58:22

Whilst in other provinces it's difficult for the government to work with the private hospitals, but for us here we work all together because we are saying that we're not going to create binaries, we are all talking about one patient. So that patient could have gone to the GP with his or her R3. 320 - GP in the township. A nd then get referred to Groote Schuur to the public [sector] and then find that he has got a long queue and goes back to the private. So that's why for us, we look at 'us' as the provincial health, as a steward for health for all 7 million, irrespective whether you are insured or uninsured, but how to help each other. So there's never been much of a tension being a politician, being in the government.

Dr Maria Christodoulou: 59:08

But by your own admission and I also don't know of any current MEC of health and wellness that is a health professional. So it's rare for a health professional to be in the kind of role that you've been in. How did you get into politics?

Prof Nomafrench Mbombo: 59:23

When I was an academic, I did indicate that when I ended up doing a lot of work across Africa, I ended up understanding other health systems.

Prof Nomafrench Mbombo: 59:33

Of course as an activist, I joined other... like the P eople's Health Movement that used to be led by the late Prof David Sanders. Part of it was about whether you are protesting to the ministers of health on behalf, also with the communities, but also scholarly activism. So I dived into intersectionalities of the gender and human rights as an approach to access public health. So that's why my PhD was on the gender and human rights aspects of the maternal mortality. It was a social science. In most of Africa, if you look in terms of the health system in Africa, there's always that centre of the community aspect of taking responsibility. L ike in Kenya, even now, before you go and deliver in maternity, you need to have all of your stuff. There's a whole lot of out-of-pocket where you buy your Syntometrine and all of those things.

Prof Nomafrench Mbombo: 1:00:26

I ended up knowing all this international network. So, to cut the story short, the one now that drove me to be more interested in politics... So, with these chairpersons, the parliamentarians, how they can use human rights and policymaking, and then you ended up engaging with the politicians. When I joined politics in 2014, I was based in Gabon to develop the master's program. So there you liaise with national ministers of health, higher education, universities and foreign ministers. So I ended up being now involved with all these politicians and then at the same time, as part of the activism, you also protest. I don't know how many times I used to go to the former MEC for Health in the Western Cape, Theuns Botha, with the People's Health Movement, demanding services. Now, being exposed to the political environment

Prof Nomafrench Mbombo: 1:01:13

that's when now I focused in terms of the powers. Where are the sources of power? Because I remember one time when we went to Uganda with an organisation that focused on maternal health and human rights, where it was about politicians, where they were fighting us. A t the time, they might send us to jail, and then that's when I realised actually, the power rests with the politics. I've been an activist with the civil society. We have been everywhere as clinicians, but all these things will never be able until you convince the politician. In those platforms, y ou'll meet in Zimbabwe a politician who's an opposition, but you'll talk to that person about what needs to happen, about the people of Bulawayo who don't have ABC. That person will make sure it happens. Yet that person has got no other powers other than being a politician.

Prof Nomafrench Mbombo: 1:02:08

So at the time I was on sabbatical. M y research was on HIV/ AIDS. I was funded by PEPFAR, so I bought myself out so that I could be able to explore. So I was two years on sabbatical. Then I was teaching in most of these universities, reading now because I was interested. I was dealing with the politicians. In Africa, yo u'll find that the reason health systems, specifically, collapse. The history is that they are coming from the liberation movements who will have liberated them, at the time, during the colonisation. B ut once they get into power and moving from being a liberation movement to a political party that is in government, that's when, now, things change. A nd in order for them to make sure they deliver, you need a strong opposition. O therwise, if it's going to be a free ride, you'll see all these 90-year-old presidents of these countries who want to be there for a lifetime, yet they've been liberators.

Prof Nomafrench Mbombo: 1:03:08

So in South Africa now, I was looking, because I used to meet with some of the South African politicians as part of the SADAG. So that's when I realized that if they ended up going unchecked, we'll have some of these problems.

Prof Nomafrench Mbombo: 1:03:23

That's when I realized that, actually, things are changing now. Therefore, there is a need for a strong opposition, but a strong opposition [that] looked like me, because at the time it was about, w hy are you, Tony Leon, saying that? You are a racist!

Prof Nomafrench Mbombo: 1:03:38

So when Tony Leon is white it ,means that whatever is being said is taken another way around, or probably that Tony might have wanted to say something, but on hindsight, that no, I shouldn't. So that's when I said, uh-uh. I've been part of this ANC. I understand, in terms of how the system works, and my worry is about... If something is not done, i n terms of having a strong opposition, it means that we'll be late c ompared to all these countries. T he only countries that I haven't been to in Africa is mostly the Muslim, upper Africa. That's where, now, I joined politics.

Prof Nomafrench Mbombo: 1:04:15

Politics is about power, it's about the interest, and for then, I wanted to do national. Then I was asked to do the province, and then the interest is about, how do we make sure... Because I didn't know I was going to be in the executive. I was just assuming, because I'm new in the political party space and therefore I'll still be learning. And also, at the time at UWC, I used to do my goals five, five, five. I still do five, five, five-year goals, because the first goal was about, I need to have a PhD. Second goal was about I need to be a professor.

Prof Nomafrench Mbombo: 1:04:44

I need to formulate my own discipline, which is maternal health, and then have my small unit, although it was not yet as a unit, but with a post-grad, and then I was doing it in Africa as part of the advanced midwives and maternal child health post-grads, and then with another five years, it's about now I profess my beliefs. So that's why I was gallivanting in the last five years. When I took time off of the two years, it was about what's next. Other universities have been recruiting me, but at UWC you are a big fish in a small pond. Other universities I will end up being a small fish in a big pond. So at UWC I served in all the structures, like I could be able to do anything that I wanted to do. It was easier there.

Prof Nomafrench Mbombo: 1:05:28

So it was about, do I go and leave and go to UKZN or go to UCT? What's next? Let me take time off. I n those two years, now that's when politics found me. So for me it was about how to raise a voice to make sure South Africa's constitution... because we believe in constitutional democracy. But it needs someone to keep on checking. And also, for me, it's about whatever I say, even if they say that, oh, you are a puppet of the whatever, it's fine. They know that I'm not.

Prof Nomafrench Mbombo: 1:06:01

But at least they'll be able to listen and also I knew that I'm going to join either a higher education portfolio or a basic education portfolio, or a health portfolio or social, any of those or all of them. I'll make a difference there.

Dr Maria Christodoulou: 1:06:17

You were Minister of Sports and Culture for a while.

Prof Nomafrench Mbombo: 1:06:21

I think for six months or something.

Dr Maria Christodoulou: 1:06:24

When you look back and if you imagine a young woman who is 16, 17 in school today, thinking about her life and her future, no money but wanting to be somebody in the world one day, wanting to maybe be a doctor, you think back to yourself in that place and that time when you didn't have the money to go to medical school and you were working as a domestic worker. What advice would you have for somebody in that situation today?

Prof Nomafrench Mbombo: 1:06:52

Education first. It opens all doors, because when you have no education at all, it becomes difficult. However, having exposed to the different settings of the communities, I've seen people who have never had much of education, specifically from the white communities, no qualifications, no, nothing. But with the networking and exposure to access, economy, like to have a business. So that's why we have to individualise and not generalise, because there are people... L ike I have daughters. One of them has got even honours, even went overseas and then came back and started to get a job. So that's why it's about you need to say, for Nomafrench, if Nomafrench ended up... didn't go to school, I would have been prepared and ready when the opportunity came. Because it's about always have all the tools just in case. Don't want to say that you know, just in case, might get a tender. T hat one is not sustainable. Education first, so that by the time an opportunity comes, there is a preparedness. That is the first and foremost. In this kind of environment you always need support, support, support, support.

Prof Nomafrench Mbombo: 1:08:02

I've seen how the mental health has been affecting the young ones. I was talking at one of the organisations when they were graduating s ome of the young people. G irls specifically, who have been exposed to the gender-based violence as young as 17, 16, b ut you'll find that they ended up going to some of these NGOs because there's no support. Remember now, there's no such thing as a nuclear family. A ctually, not even then. For us, w e are not necessarily coming from the nuclear family, although you'll have parents, but you'll have had extended parents, you'll have your aunt.

Prof Nomafrench Mbombo: 1:08:34

Some of them might be coming from Limpopo and then staying in their shack because they came looking for opportunity. But that part of support structure if there's no family, it matters. For me, I'm widowed. I was widowed whilst actually still busy with my PhD teaching at UWC. If it wasn't that my mother-in-law, my sister-in-law, my mother, my aunt coming, my kids were still young, the youngest was four. So if at the time they couldn't come from the Eastern Cape and give me support, I would have collapsed.

Prof Nomafrench Mbombo: 1:09:06

So the power of the support. So that's why I always say we, as young once, O-N-C-E, we must always go out of our way to support the young ones, O-N-E-S, even if they are not famous. A s leaders, you'll get a call from a child, from Khayelitsha, just wanted to know about, not even about education. He said, Mama Nomafrench, I saw you on the social media. I really don't know where I can whatever, like, I have no place to sleep. Someone said I must come to come and work. So they might have... not necessarily people to come to your place, but that girl providing support and even checking on them. You still have got people who say, how is it going at varsity? You will cross my mind. T hat's part of it, because it's tough out there. In as much as that there might be some kind of resources. So for me, the main, main thing is about basic education. Make sure that at least you get that right so that by the time the opportunity comes you are prepared and grab any other role models in order to be able to give you support throughout, to check, and also to provide some information if there are bursaries, because some of them they don't have this kind of access.

Prof Nomafrench Mbombo: 1:10:17

Self-leadership is about your choices because it doesn't mean.... Because it doesn't mean some of us... You know, growing up in the township th ere were no carrots that were hanging. There would have been stats of teenage pregnancy, some of those that I went to school with, they never succeeded because they were pregnant. So for some of us, it's about where you took a stand. Wh ere you said that, I'm not going to be in a relationship with a boy until I finish matric. Full stop, full stop. It's a choice. It's not that the boys were bad. Choices where you say that I'm not going to drink alcohol, especially in an environment where there are no friends. So we need to have tough love sometimes, tough love to those young ones, to those mini Nomafrench's in terms of the choices. [Dr Maria Christodoulou: What keeps you going, what keeps you motivated and passionate?]

Prof Nomafrench Mbombo: 1:11:06

I work hard, I play hard, I pray hard. Whilst people say that you work so hard, I'll always know that there's a cherry on top. I will make sure that I do the payback by playing hard. Playing hard it means that I socialise a lot. I've got many friends as far as childhood, and luckily some of them are around in Cape Town. I've got the church friends. I've got university colleagues, like this weekend now, I've got the grandkids, although they're not staying with me, but they'll be around. It's about... Let's open, now it's D ecember, which is... That's what I normally do, where they, everyone, bring their kids, and I've just hired now a jumping castle. J umping castle not only for the kids, also for us. At the back, I've got a trampoline, which I said it was for the grandkids, but it's for me.

Prof Nomafrench Mbombo: 1:11:50

So I do that trampoline, so it's part of the playing hard. And then when there are these shows like Kirstenb osch, I go there and have fun, and pray hard. I still do the whole balancing. I'm one of the co-founders of African Languages Services of the Methodist Church in Bellville.

Prof Nomafrench Mbombo: 1:12:10

In as much as that, I don't go to the church frequently but, I also go to the other churches, but I also do some of the work, like now I'm busy with a disciplinary, because I used to be part of the disciplinary task team within the church. I'm busy. [Dr Maria Christodoulou; I can hear, I can hear.] Because I've just done now even the courses on being a board director. So you see, I wouldn't have been able to do this if I was a MEC.

Dr Maria Christodoulou: 1:12:34

And you've just begun touching on what would have been my next question, is what do you hope is next? You normally have a bit of a five-year plan. What does the next five years include for you, in your mind?

Prof Nomafrench Mbombo: 1:12:45

When I didn't come back to Executive, one option, which is... P robably, t hat's what people, some of them, will have thought I would have done, is to exit. Because I've got many options. I will have gone back to university, I will have a consultancy, whatever. So in exchange, the advantage is, because there's a gratuity money that you get paid based on the number of years, which is I'll have two terms, 10 years. But for me it felt like I'm not done yet. Again, the platform, political platform, it gives you the leverage. When the constituency head for George...

Prof Nomafrench Mbombo: 1:13:20

There are many things that are happening there, especially in terms of the municipality, and like now, I was dealing with the issue of the airport. Now I'm saying that no, we must fix the airport. It cannot be like, if you are going to East London, everything gets cancelled. It comes from the member of parliament. Now, the main thing, I've never been in full time in the legislature. Now, I'm making the executive to account. I n the budget committee, in the standing public accounts committee. I'm there. Also, even these, they are also at the Africa level, that I could be able now to see clearly the budget, how they go to the department, instead of only looking for the health budget.

Prof Nomafrench Mbombo: 1:14:01

Yes, as part of the executive, you'll see. But now you can be able to say there is a waste. W hy are you moving this two rand from this to here and yet you complain. We'll be able to do that. And the national treasury comes and present to us and say we're giving Western Cape this amount, we give Eastern Cape this... So they give the whole picture like now, we just had the budget adjustments where they presented to us. They will say, okay, we're going to give this one this, going to give this. W estern Cape, we're going to give you about 1.2 billion for infrastructure. I say, where's the money to add more teachers, to add more nurses?

Prof Nomafrench Mbombo: 1:14:38

The service pressures, it's still the same. It's still in here until end of April. But we know December or January is a festive season period. We've got the drowning, we've got the road accident. How come you will prioritize 1.2 billion that needs to be utilised by end of March, instead of at least adding? I would have only been fighting, only howling for health.

Prof Nomafrench Mbombo: 1:15:00

But now I can howl for everything. Actually, what I've just realized is that it's quite a powerful platform. But of course, I mean my colleagues and I, because I know both sides, so that's why, in the beginning, you'll find that, eish, you ask so many tough questions.

Prof Nomafrench Mbombo: 1:15:17

Of course, it's tough questions. Now I know with every cent where it goes to. Next year it's going to be the 2025 - 2026 budget for April. After the national finance minister, after the SONA by the President, I'm waiting, like in anticipation, what it's going to be, especially that there hasn't been an economic growth in South Africa. The GDP money goes to the debt. But I'm more interested now to be able to see what slice we're going to get, but not only us. Aware of everything that goes to everywhere in South Africa, province by province. W ith the five years [plan], it's about enjoying myself to be a legislator and making the Executive account.

Dr Maria Christodoulou: 1:16:01

I applaud you for that. I'm struck by... Y ou spoke earlier about, that it gave you an advantage in a sense. T hat there was some privilege in being a health professional in a political role because you had insight into the health system and you could leverage that insight. And now I'm struck by the fact that, as a previous member of the Executive Council, you have insights and experience that you can then bring to legislature and you can influence in a completely different way. That's very powerful. And I'm also struck by the number of times you've spoken about team, the number of times you've spoken about community, even your own family living in this home, where you didn't even realize until you were in high school that you were only three siblings. You thought you were part of a much bigger family and now this holiday season, you're surrounded by family. I feel such a sense of you being really strongly rooted in a much bigger network. And you've spoken mostly about women and it's interesting also, you're a mother.

Dr Maria Christodoulou: 1:16:54

You did your degrees in nursing, in maternal and child health, gender equity issues, issues of gender-based violence... And I remembered a moment ago reading about a talk you gave in... I think it was 2019, on Women's Day. A t the time you were the federal leader of the Democratic Alliance Women's Network, and the title of the talk stayed with me. The title was, Women Shall Rise and Break Their Silence. I've heard you talk about power. I've heard you talk about making your way through all these different systems and finding yourself now in a place where you really feel you can leverage that power, and I'm wondering, if you allowed yourself to rise and break the silence what would you say?

Prof Nomafrench Mbombo: 1:17:44

Yoh, you did your research.

Dr Maria Christodoulou: 1:17:48

I did. Well, let me say this also. T he story that I tell myself is that those subjects become a passion for somebody because they speak to one's own personal story or one's own personal experience, and so I'm curious about what that means for you. What would it mean for Professor Normaf rench Mbombo to rise and break the silence?

Prof Nomafrench Mbombo: 1:18:07

Part of it is this whole issue of the missing 'bottom', which is... the majority of women, still, they are missed in that platform of economy.

Prof Nomafrench Mbombo: 1:18:19

We have seen the face of the unemployment, of poverty, is a woman. W hich is, of course, it's generally, it will be internationally. B ut whilst we are progressing, in some of the other parts we'll find that we still, we are regressing. For me, that we're still, in South Africa, w e're the country that has the highest gender-based violence for the whole world. We are part of that. In the Western Cape, young boys, it's where we find that the majority of [them, they're] not even reaching their adulthood because of the gang violence and the interpersonal injuries. How do we ensure that, at least a woman, not only me, but the whole of the Auntie Sarah, [...], how they can be able to access the space of economy, able to feed their children and all of those that... ?

Prof Nomafrench Mbombo: 1:19:12

I was listening to the president. He talks about, because he's a chair of the G20 now, about tackling hunger and poverty. There are people, ordinary people, who go to bed without food. They are there. A nd some of them you'll find that they are getting their grant, but you get this grandmother who has got six other grandchildren she has to feed out of that 1,000 rand. Their parents probably have died or they're nowhere to be found.

Prof Nomafrench Mbombo: 1:19:37

How can we make sure that those women who are being left there, who are in the periphery, missing there, still at the bottom, will be able to be here?

Prof Nomafrench Mbombo: 1:19:47

Yes, we do have steps like the World Economic Forum. They talk about where things are in regard to the gender equality in terms of... T here's improvement in access to health and health services. There's been improvement in most of the countries, access to basic education and also the children, they can be able to finish primary school, but the issue of the economy, where it will take us more than 120, whatever, years, to be able to bridge the gap. So for me, it's not about see as many women in the JSE companies. It's not about seeing as many women to be CEOs. Of course, you have to be, ideally, in order to do decision making, in the higher position, to make an impact, but how do you make sure that all of those... W e journey with them so that at least they could be in the middle instead of there, for me, at the bottom? And then, of course, the cherry on top, to see a South African female president?

Dr Maria Christodoulou: 1:20:40

Sjoe.

Prof Nomafrench Mbombo: 1:20:41

That's a cherry on top for me.

Dr Maria Christodoulou: 1:20:43

Is that perhaps a personal ambition? Is that something you would like for yourself?

Prof Nomafrench Mbombo: 1:20:47

For me, it's not about what do I want. It's about, if it so happens that the time is there... Not like, I am doing this. You know, when you're going to enter Miss South Africa, it's about to make sure you start modelling. You lose weight. No, I'm not in that space. It's about, if a need arises, at that moment in time and then I'm being asked, or the opportunity arise, I will be ready. I'll make sure that I'm ready for that. So that's why I'm saying that... Keep on working on yourself so that when the opportunity comes, you are prepared and ready.

Dr Maria Christodoulou: 1:21:19

Nothing that we've left out or nothing that you feel is important, that you would like people to know if they're going to hear your story?

Prof Nomafrench Mbombo: 1:21:25

When you share this thing, people will say that, oh ja, we know.

Prof Nomafrench Mbombo: 1:21:32

In the platforms I normally use myself like, as a testimony, so that's why you'l I find that my stories, most of the things are out.

Dr Maria Christodoulou: 1:21:45

Is there anything about you that if people found out they would be surprised?

Prof Nomafrench Mbombo: 1:21:51

No, nothing, nothing. But remember also the issue of... B ecause I worked in the gender space, where they talk about the private is political. So whether there's been a GBV, you can't say that it was a domestic issue, because it will go to the hospital. It's a public hospital. It will go to the police station, it is a public [service]. So that's why I'm saying that, in most instances, I talk about myself, so that people can understand. W hat is happening in my private space, it's political. S o that people can learn from it. So that's why I don't have, I don't.

Dr Maria Christodoulou: 1:22:28

And if we could fast forward time and... Y ou don't know this, but I know it because it's public record, your birthday is exactly the day before mine, so we are the same age and you were born on the 6th and I was born on the 7th of September, in the same year.

Prof Nomafrench Mbombo: 1:22:43

Oh, okay.

Dr Maria Christodoulou: 1:22:46

So if we could fast forward time and we're both 90- something and we bump into each other and we sit down to have a coffee and I say to you, Nomafrench, do you remember that conversation we had back then where you told some of your story? Now, looking back, so now you're in your 90s, w hat's the thing you celebrate the most about what has happened in your life since then?

Prof Nomafrench Mbombo: 1:23:10

I think for me, when I retire, I'll be that person who will be doing the skydiving, who will be bungee jumping, who will be country to country to make sure that, okay, the summer now is in Bahamas, I'll be there.

Prof Nomafrench Mbombo: 1:23:26

And then the winter now is in Greenland. I'll be there. Whilst I'm having fun, whilst I'm sipping a champagne, and then there'll be people who'll be asking in terms of consulting, in terms of how can they do their business or their whatever. For me it's about that, because they normally say, oh, you will always travel. I said, there will be times where I will be sitting in the wheelchair with a mohair rug on our knees. So when that time comes, I want to make sure that I've lived. A s I always say, we live every day, we die once. So for me it's fun, fun, fun. That's where things will be. W hen you ask me a question, m aybe I'll be shark diving at the time.

Dr Maria Christodoulou: 1:24:08

I think you dive amongst sharks just generally. I don't think you need to literally get into a shark cave to go diving. And if I said to you, to summarize in one or two words, or even just a sentence, who is Professor Normaf rench Mbombo, what would you say?

Prof Nomafrench Mbombo: 1:24:35

It's that young girl from the township who grew up struggling but yet, surrounded by a loving family environment, who's supportive. Managed to beat all odds to acquire the education and navigated all the spaces... C linically, academic, political, and now navigating the space of corporate as well. But, most importantly, never left anyone behind in the space of activism and leaving no one behind.

Dr Maria Christodoulou: 1:25:06

I love that. Thank you. Amy, is there anything you'd like to ask?

Amy Kaye: 1:25:11

I'm so grateful to that woman that fired you and said you don't belong here, because I just feel like you belong everywhere. You are just somebody that I think is always welcome. The way that you described all those small little towns that you went to that nobody had ever gone to, to go speak to the people that were forgotten about. T he way that you showed up at a hospital disaster and you were there and you came back. I think you're a powerful woman, but also your energy is just completely contagious. I also work really, really hard. I'm so burnt out. It's been an incredibly difficult year, but just hearing your story and hearing your testimony, I just think, no, I've got to work harder because if Nomafrench can do it, then I can do it. You have this incredible vitality and energy that gives life and just thank you for everything that you've done, thank you for everything that you'll continue to do and just, you're a powerhouse. Keep going. I can't wait to see what you're going to do next. It's incredible. It's incredible. So thank you.

Prof Nomafrench Mbombo: 1:26:17

Oh thank you. Thank you very much. But I also must add to that my younger self. At the time that I was striving, I used to take vulnerability as a weakness. When I started at UWC, like, you are excited, you are studying for a PhD, you have got a full program that is being recognised, and then like, as if now you are being parachuted, and then the colleagues... You'll find that there is some, whether it's jealousy or whatever it's about, where they'll gang up against you in the sense that, oh, we wrote to the Dean that your time off, you mustn't get it because you need now to teach another... I was teaching community health for undergraduates, and then I taught... because I was developing the advanced midwifery one, and then I was teaching undergrads, now for the midwifery, whilst I was doing this. Now it's about no, you must also teach others because you've got time. At the time I had just relocated to the Western Cape. My husband at the time was still not working, and then I had a newborn, then the other one was bigger.

Prof Nomafrench Mbombo: 1:27:23

But the point is, those things they will hurt you. At the meetings, being mean, and then you keep quiet, you swallow all of those things, and then you go to your office and then you cry, cry, and then you get home as if nothing happened. So, about the vulnerability at the time, I used to hide. L ike when you say, you are super, like a powerful woman, you must know that there's a power. There's also vulnerability. What I've learned as I grow older is about, it's okay not to be okay. I t's okay not to be a superwoman, because you'll find that people, they'll rely on you sometimes, because they haven't done anything, but for you to rescue them. And also, lastly, I've also embraced that it's okay to be emotional, to be a BDW, bloody difficult woman, and it's okay to show all those emotions, especially in a patriarchal environment where you'll find that they don't even see. Like, they'll gaslight you, mansplaining, and they don't see. Because what I pick up is about... you mustn't make an assumption. W hen they belittle, showing this paternalistic, they don't know. That's how they've been socialized.

Prof Nomafrench Mbombo: 1:28:41

When someone says thank you, Minister, Dr, whatever, and then they'll say now to us women... S ay that, hey, Nomafrench... Like they're introducing, this is Normaf rench, this is Debbie, and then this is Professor, Dr, whatever, Minister, Dr, whatever - the males. And then once they say, can you please Nomafrench, pass me a sugar whilst I'm speaking? He's not aware about what has he done. So previously, probably, I would have just kept quiet and then maybe some time I'd say, do you remember what you did? I didn't like it. B ut now I've realized that I'm educating the whole society. So it's not only about me and that person.

Prof Nomafrench Mbombo: 1:29:19

And it's not necessarily that person. It's the system. We have to dismantle the system and we have to do it then and there, and also especially, they are young ones. They must understand that. Bring your tears and bring your emotions there at the seat of the table. If they are saying that they're going to take money from orphans and give it to build a bridge. Throw tantrums there and there. Say that that is not going to happen. If you continue with that, I'm not going to support this and also, I might even share it in my social media. Throw the tantrums there and there. Throw the tantrums. P rofessor or Doctor, for you. When they say Mister or Doctor or whatever, Minister, and then they say Nomafrench, say whoa, Doctor or Professor for you, thank you. So it's okay. When they say you are petty, I love it. Do you have to be petty? I said, I love it. Because now, the others wouldn't have known. Especially when they're mansplaining, which is very common, they are not aware. When someone says that, oh, you're a Minister of Health, oh, okay.

Prof Nomafrench Mbombo: 1:30:31

Oh, no wonder.

Prof Nomafrench Mbombo: 1:30:32

Because I was wondering why would.... But anyway, I guess... Because they just realized now that you are educated. I say, you were wondering about what? No, no, no, no, no, leave it. I said no, no, say it, say it. Wondering about what, about what? That a black person will be in charge of the whole big department with a big budget, and blah, blah, blah, is what you wanted to say? No, no, no. As I grow older now, maybe it's the hormones as a backup system.

Dr Maria Christodoulou: 1:31:03

I can attest to that. I do think hormones play a role.

Prof Nomafrench Mbombo: 1:31:07

It's like you don't care much. W aking up and then you take chips and then you eat. I mean, then you'll say, why would you be eating chips? And then you'll say that of course, I've been healthy for all of my life. Who cares? It's my chips. It's okay to be a bloody difficult woman.

Prof Nomafrench Mbombo: 1:31:22

It's okay to bring your emotions, as long as you do the job. Bring your emotions. W hen they say, you are emotional. B ecause remember, previously, when you were very young, they used to accuse us as managers, oh, we can see now. Oh, it's that time of the month. They'll put all those menstrual cues against us, but now it's okay to say, actually, it is that time of the month. In case, if you want to say that it's that time of the month, say it. Say it. So as we grow older, it's okay to be vulnerable. Vulnerability is a strength on its own and also it shouldn't be, especially when you are with the young ones, portray as if everything is okay. It shouldn't be, when we share our barriers or when we say, oh, when I grew up I was poor, but when now you are in this leadership position, you make things as if everything is okay. It shouldn't be. You need to tell them that, actually, that I ended up delivering this speech or this report.

Prof Nomafrench Mbombo: 1:32:22

It meant sleepless nights. I didn't sleep. I didn't sleep the whole night. I didn't sleep the whole weekend. I've been practicing in front of my mirror and then the whole of information disappeared from the computer. And then, whilst I thought I've got it, and now I've got a colleague who just told me ABC. It's okay not to be okay.

Prof Nomafrench Mbombo: 1:32:37

Also to remind them that it's okay actually to seek help, because they mustn't think that just because we're professionals, we don't need to seek help. So for me, as the doctor has indicated, for me, I'm blessed that I've got a support system throughout. I've got friends where I can call them 2 am. Okay, French, okay. I'm not asking for a response, but just to vent. Vent, vent, vent, vent. Okay, are you done now? Mmm. Okay, bye, bye, fine, I've got those kind of friends. And then you've got some of the people when things are happening, like from the church, someone, a bishop, even Archbishop Makgoba, even anyone, like even the deputy president, where people... You didn't know that these people know you. They'll say, don't worry about that, it's okay, we know you work hard. Those random messages from the people that know them from afar, it makes things okay.

Dr Maria Christodoulou: 1:33:33

Thank you for sharing all of that. It actually feels like this last piece that you shared brings the balance, because so much of what you talked about was about the achievements and the strength and the power and the way you have used your voice and the platforms you have found yourself on, and it feels like now you've showed the vulnerable side of that and that it's taken a lot and that you've been through some really difficult times, and I feel like we've just skimmed the surface of some of those difficult times. I think you're quite good at not hiding the vulnerability, but...

Prof Nomafrench Mbombo: 1:34:03

Being a threat. That thing of, when Amy was speaking, it's about, if I pitch up, when I come. It's about people feel that, oh Nomafrench is here, it's a blessing. No. I n some, it's about, oh my gosh, so now she's going to take the whole shine. So it's not nice when you know that some people might not have an issue because it's you, it's because you've been put in the platform, but they've got an issue that it is you again.

Prof Nomafrench Mbombo: 1:34:35

Again. Unfortunately, as I indicated that, if I'm in a club or when I'm in the church, I'll be that girl who's going to come at the front. It will be the one who will be singing or dancing. So there's no way that in a platform where I know I'm number one in terms of the talents and skills, and then I shrink and reduce myself to be number two because I'm afraid of what people are going to say. It doesn't work like that. So they will need to jump to the highest whatever. J ust to make an example, i n the health space, it cannot be when you are discussing if let's say, in that platform and then I know these things and then I have to shrink because I have to protect.

Prof Nomafrench Mbombo: 1:35:13

No, it doesn't work like that. If you have to jump, go and jump, but I refuse to shrink in the platforms, especially where, at the end, it might reflect on my performance, because I always protect myself and the integrity. It cannot be, if I'm part of that team I have to shrink just because to protect the others. It doesn't work like that. But luckily, I always... For these things of setting the boundaries, if you are... T he part of the team it's about okay, t his is the kind of the boundaries that you are setting up for yourself. You need to understand, both as a weakness and a strength, I'm a perfectionist. Therefore, I expect people to work more than 24 hours. If there's a deadline, it's a deadline. You cannot still be alive after I've crossed that deadline.

Prof Nomafrench Mbombo: 1:36:08

I mean, why is it called a deadline? You're supposed to be dead. So that's why, if you know that you won't be able to be alive by then, it means set yourself your ICU line. Simple. S o you know that, okay, this is the ICU line. If now I cross this, it means that I'll go to the mortuary. So it makes it easier to know that now, when we do now our performances or we share, we work as a team. If I'm the team leader, you crossed the deadline and you didn't even indicate that, ok, you'll be able to submit or whatever, but you just sit as if nothing happens. Yoh, those kind of people must understand that I don't like that, because we are supposed to be a team.

Prof Nomafrench Mbombo: 1:36:51

But previously, when I was young, it was about okay, give me, and then I'll do things on their behalf. But now I've changed. You cross the deadline, you are dead. You are out of the team. O ut. D ead. It's exciting to grow old.

Dr Maria Christodoulou: 1:37:06

I agree. There's a different kind of freedom that comes with it. I've also just remembered that you grew up in Mdantsane and that boxing culture is very big there. Some of our greatest boxing legends come from that region of the country, and did I read correctly that you have a boxing bag and gloves?

Prof Nomafrench Mbombo: 1:37:23

Yes, I do kick boxing. It's on the balcony. The advantage is because when I feel like... maybe I'm working or it's even in the middle of the night, I can just go there. Especially when you're angry, when you want to ventilate, it's just so good to punch, punch, punch. So the trampoline and my punch bag oh, I love those. I don't need a psychiatrist, these are my psychiatrists.

Dr Maria Christodoulou: 1:37:47

But for me there's something in that metaphor. I'm not a boxer I did some boxing lessons for a while but there's something in that thing of being able to gauge your opponent and knowing when to strike a punch. And, as you're speaking, I have that sense of…

Prof Nomafrench Mbombo: 1:38:03

Yes, the upper... the middle and the upper cut. It's not just punching, it's about you are gauging that there's an opponent. So that thing of bobbing, that's why I'm saying it's a psychiatrist, because you don't need an individual therapy. It's a therapy on its own. It's not about wanting to be fit, it's about the energies, it's about the concentration and everything about it. It feels so good. So that's why I prefer kickboxing, so that it also corresponds with the whole of your body. That one, yoh, I love it. With the trampoline, i t's about being in the air, jumping. You are not thinking about anything. It feels so good.

Dr Maria Christodoulou: 1:38:39

The entire time you've been speaking... and I'm going to call you Prof, because you've called me Doc a number of times, and I took the liberty of calling you by your first name. I did wonder about... Th e one thing we haven't actually spoken about is the nurse-doctor dynamic and whether that was ever an issue for you in your career? The fact that you had a degree in nursing and you were often probably interacting with medical doctors in your line of work. Was that ever... the power differentials there?

Prof Nomafrench Mbombo: 1:39:07

No.

Dr Maria Christodoulou: 1:39:08

No?

Prof Nomafrench Mbombo: 1:39:08

Because you will always work as a team.

Dr Maria Christodoulou: 1:39:10

Right.

Prof Nomafrench Mbombo: 1:39:11

It has never been like that. You'll always know what is your responsibility and also in terms of how you can complement and supplement one another, because, remember, within a team there are people who actually don't even have or don't contribute with their actual skills per se. Let's say, you'll have a nursing assistant who's not necessarily contributing but is the one who might be assisting with the whatever. But that part of it, yoh, I will never be able to survive without you, Mamu Jane. It will be difficult. So Mamu Jane feels so good that, oh, do you know that without me you guys will never be able to...? Yes, of course, we need you. Without you we are nothing. That part of it, make people feel good about themselves, that they are valuable.

Dr Maria Christodoulou: 1:40:01

Probably what makes you a good politician. What I was going to say is that the entire time we've been speaking, I've had such a sense of, on the one hand, the part of you that has been through some difficult things and that we've only scratched the surface of those, but, on the other, this sense of... Amy spoke about your energy being quite contagious. There's this sense of like an aliveness, like the fighting spirit, like there's a vitality that moves through you that almost feels like, whew, got to watch out, because this energy is very powerful, and I find myself wanting to ask you about the lineage. W hat do you know about your ancestry and what do you know about your heritage? Because it feels like there's a life force that moves through you that is bigger than you and me and Amy, and very, very powerful.

Prof Nomafrench Mbombo: 1:40:45

I'm the first... called the 'mafungwashe', so I'm the first daughter. When I was growing up, I was blessed in the sense that specifically from the father's side, partly from the maternal side, there was a sense of being like a princess. I'm not sure because everyone felt like I was blessed in the sense that I was nerdish, so there was this kind of... N ot necessarily to be treated like a princess per se. But I used to joke during the time when I was a young girl among the boys that, especially with the boyfriends, what I've said, you need to understand that if you don't take care of me, that my family treats me like a princess.

Prof Nomafrench Mbombo: 1:41:25

However, I've got this thing about, I've got a purpose. Why am I on earth? Perhaps youll find that I don't have that space where I'll say, I'll relax, I've arrived. I've never felt I've arrived, I've achieved. There's always this sense that I think God says that, thank you, my daughter, you have done good. Now what is next? So that's why part of when I was saying that when I left the executive it was about...

Prof Nomafrench Mbombo: 1:42:06

I reflected, I said I think there's something that I'm set to do. What I know, when God wants to use you further and gives you another command, he has to isolate you so that you could have a space and moment with him, because when you're too busy, you don't see the light. So that's why, for me, it was about, t his is a platform where I've been busy for 10 years. What else do you want to achieve there? Yes, probably, if you could be maybe the next national health minister. As I'm saying that, I'm still in the discernment. I don't know as yet, but what I know, there's a spiritual significance of whatever that is happening. At this stage, I don't know exactly what.

Prof Nomafrench Mbombo: 1:42:51

So when I say, oh, you might see me doing jumping after 90 years or whatever. It's about just me talking, but there'll be time where I have to discern and listen. There is that thing that says I'm here for a reason, but I don't know exactly what.

Dr Maria Christodoulou: 1:43:06

I think it takes humility to admit that you don't know what, but to follow that impulse each time and to make meaning of what happens to you in a way that allows you to keep going with whatever it is that's calling you. And when I asked about your ancestry, I was less interested in whether there was any royal blood or any fancy blood or anything like that. It was more.... It feels ancient and it feels rooted in something very powerful, and it feels like there's a life force and a vitality that has survived and endured, and I'm not surprised you're an activist and a fighter. It feels like that moves through you and some of that is your spiritual power. There's no doubt in my mind about that, and I also think that when you talk about purpose, one of the things I read, that really helped me make sense of purpose, was that your job can change many times, but your purpose remains the A same., and there's a thread that runs through your life of activism, maternal and child health, equity, t hat feels like no matter what you're going to be doing, it's going to be about that. So, Prof, thank you for giving us this time, thank you for sharing your story, thank you for the work that you do in the world and your commitment to not leaving anyone behind. [Prof Nomafrench Mbombo: Thank you. All the best.] Thank you so much.

Dr Maria Christodoulou: 1:44:21

I'm Dr Maria Christodoulou and you've been listening to the Awakening Doctor podcast. If you enjoyed this conversation, please share it with your friends, follow Awakening Doctor on Instagram, Facebook and Spotify, and go to Apple podcasts to subscribe, rate and give us a good review. Thank you so much for listening.