Dr Dakalo Arnold Muavha — one of only four gynaecologists and obstetricians in the country, and the first black South African, to have super-specialised in the field of urogynaecology — has returned home to Limpopo, the province of his birth, determined to assist in tackling the burning health issue of pelvic floor disorders which impact so many women.
Speaking during Women’s Month, Dr Muavha, who grew up in the small village of Nwaxinyamani south east of Louis Trichardt, says that, until now, there has not been an integrated urogynaecology service within Limpopo province and many patients had to be referred to Johannesburg for treatment.
“Pelvic floor disorders can result in a variety of problems including incontinence, which is the loss of bladder and/or bowel control. Although these disorders are not life-threatening, they occur quite commonly and can have a devastating impact on the lives of those affected,” adds Dr Muavha, who has established the province’s first private urogynaecology unit for the treatment of conditions related to pelvic floor disorders at Netcare Pholoso Hospital in Polokwane.
Pic: Dr Dakalo Muavha, who has established Limpopo province’s first private urogynaecology unit for the treatment of conditions related to pelvic floor disorders at Netcare Pholoso Hospital in Polokwane.
“There are numerous older women in particular who live with severe and embarrassing incontinence disorders. Many are unaware that these can be treated, while others are too embarrassed about the condition to seek medical assistance.
“A number of these women live in fear of public humiliation, and consequently stop going to public places and end up living their lives quietly at home. Some are discriminated against, lose their partners and become susceptible to anxiety and depression. These conditions can also impact economically on families, as some women give up their jobs, and spend R1 200 a month or more on adult nappies.”
Dr Muavha, who is not only skilled in the management of pelvic floor disorders, but also in laparoscopic surgery and medical research, says that he considers this situation to be “a great tragedy”, particularly as most of these women can be treated with relative ease today.
In the past, many women would have been referred to a urologist for bladder problems, then sent to a gynaecologist for womb problems, and then later to a colorectal surgeon to treat any bowel disorders, he explains. The urogynaecologist, however, is trained to deal with all issues related to the pelvic floor and organs, including the bladder, uterus or womb, and rectum.
“It is my vision to improve access to care through new urogynaecology units within both the private sector at Netcare Pholoso Hospital, as well as the public sector via Polokwane/Mankweng Hospital complex. I feel blessed to have the opportunity to make a meaningful difference to the lives of women within the province of my birth.”
Dr Muavha says that in addition to incontinence problems, pelvic floor disorders may also cause pelvic organ prolapse, a condition in which the uterus, bladder and bowel may ‘drop’ down within the vaginal canal. “While pelvic floor disorders may have a variety of causes, they occur more commonly in women over the age of 50 who have given birth to a number of children. The older a woman gets, the higher her chance of a pelvic floor disorder of one kind or another, and the risk increases in overweight individuals.”
Netcare Pholoso Hospital general manager, Fabion Bennett, says that Dr Muavha opened his practice at the beginning of August this year.
“This service is now fully operational and includes special technologies such as a new urodynamics system, an investigative tool used in the diagnosis of pelvic floor disorders and in the planning of treatment of urinary incontinence, as well as a facility for performing minimally invasive procedures.”
Asked how he became interested in medicine, Dr Muavha said that he has been blessed with wonderful mentors throughout his life. While growing up, he was particularly inspired by the positive contribution made within the community by the teachers, doctors, nurses, church ministers and other leaders.
“As a child I admired, for example, the legendary local general practitioner, Dr Marivati, who selflessly helped the poor in my community and all the adjacent villages, with a smile, and at a very nominal fee. I felt that if I too became a doctor, I could make a meaningful contribution,” volunteers the specialist, who is married and has two children.
After qualifying as a doctor, Dr Muavha specialised in obstetrics and gynaecology and thereafter did a further two years training through UCT to super-specialise in conditions related to the pelvic floor disorders in women.
“Urogynaecology is a relatively new sub-speciality globally and I was only the third person in the country and the first Black South African to qualify in this field of medicine. I furthered my experience while working at the well-known urogynaecology unit at Netcare Christiaan Barnard Memorial Hospital in Cape Town.
“As a newly elected board member of the South African Urogynaecology Association [SAUGA], an association shaping the future of urogynaecology in South Africa, I have also been provided with the opportunity to play an active role in this regard,” he adds.
Bennet says Dr Muavha is working closely with other specialists and healthcare practitioners at the Netcare Pholoso Hospital, including urologists, colorectal surgeons and physiotherapists, in order to provide a comprehensive urogynaecology treatment service.
“We consider it a great privilege to have a specialist of his calibre practising at our facility, and thank him for setting up urogynaecology service at our hospital to the benefit of our patients,” he concludes.
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