Dr Anita Parbhoo, Leading with Heart

As a child, Dr. Anita Parbhoo waited in the car outside Cape Town’s world-renowned Red Cross War Memorial Children’s Hospital while her father did pre-med ward rounds. Today, she leads that very same hospital as its CEO and her innovative leadership contributions are setting a benchmark for excellence in child health services nationwide.

In this episode of Awakening Doctor, we trace her journey from those early formative moments to becoming a nationally recognised health leader and recipient of the 2024 Jakes Gerwel Award in Public Health.

Dr. Parbhoo reflects candidly on the path from clinician to executive, sharing insights on overcoming imposter syndrome, navigating perfectionism as both a doctor and a mother, and learning to trust her intuition in uncharted terrain. With warmth and humility, she discusses the milestones that shaped her, her passion for mentoring future healthcare leaders, and her deep commitment to advocating for the voiceless.

Her leadership at Red Cross Children’s Hospital exemplifies a powerful evolution in healthcare - one that embraces emotional intelligence, recognises the interdependence of health systems, and remains rooted in compassion, connection, and purpose.

Whether she’s abseiling in a Snow White costume for a cause, championing small but impactful actions, or making time for meaningful connections, Dr. Parbhoo’s story is an inspiring call to lead with heart and to see beyond hospital walls to the communities and environments that shape our children's health outcomes.

Join us for a heartfelt exploration of leadership, legacy, and the dedication it takes to change the system from within.

Chapters

• 0:00 Personal Mastery and Parenting Philosophy
• 9:04 Masters in Public Health as a Catalyst
• 16:14 From Clinician to Hospital Leadership
• 25:34 Leadership Style and Personal Growth
• 36:15 Managing COVID at a Children's Hospital
• 48:48 Motherhood and Career Balance
• 56:24 Karate and Flamenco Dancing Passions
• 1:09:30 Advocacy for Children's Wellbeing
• 1:19:30 Challenges and Future Aspirations
• 1:23:14 Message to Young Doctors

Transcript

Dr Maria Christodoulou: 0:00

I was listening to the talk that you gave when you received the Jake's Gerwel Award last year and one of the stories that stood out for me was your memory of being a child sitting in the car with your sister outside Red Cross Children's Hospital while your father did pre-med ward rounds. So I guess that thing of the parents' job and responsibility to his patients kind of almost taking precedence is a theme that runs in the family.

Dr Anita Parbhoo: 0:27

It does, and also in my husband's family, because his father was a surgeon and he also recalls many childhoods sitting not in Cape Town, in Port Elizabeth, but a similar kind of thing. So, yes, part of it is it shifts from generations because you just come to expect that. But I think the thing is when you are there, when you are with your children, when you are with your family, to try to be emotionally present, and I think that's the thing that kids can pick up. Sometimes it's not just about the time and the hours, it's about the emotional availability, and obviously that changes from time to time depending on where you're at. But just trying to realize that quality over quantity. M ake it count when you do connect and realizing that there is nothing such as a perfect parent, and that was a journey itself.

Dr Anita Parbhoo: 1:15

I can say this easily now, but it's been a journey to get to that space of moving from the perfectionist, putting the perfectionist aside, about appreciating that good enough is okay, and just making it about the connection and not necessarily the time, any other kind of metric.

Dr Maria Christodoulou: 1:34

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 me today is Dr Anita Parbhoo, the Chief Executive Officer of Red Cross War Memorial Children's Hospital in Cape Town and recipient of the 2024 Jakes Gerwel Award in Public Health from the University of the Western Cape. Anita is a dedicated mentor and a passionate advocate for children's health, whose innovative leadership contributions have set a benchmark for excellence in child health services around the country. Welcome, Anita, it's a privilege to have you with us here today.

Dr Anita Parbhoo: 2:27

Thanks so much, Maria. I've actually been wanting to speak to you for a long time, and thank you for giving me this opportunity.

Dr Maria Christodoulou: 2:34

Well, we're excited to learn more about your personal story. And before I say the next thing, just to acknowledge Amy is also in the room with us. Welcome, Amy. Thank you, Maria, happy to be here. Nice to see you again. For those who don't know, Amy is our producer and editor, so it's great to have you in the room, Amy. Anita, I was going to say that so often when you are in a leadership role, and being the CEO of a big hospital in South Africa certainly places you in that category, one tends to focus on your career and your leadership accomplishments and leadership challenges, and obviously we'll talk a little bit about that. But mostly what I'm hoping is that we can learn a little bit more about the woman behind that role and what has shaped you and what has brought you to this position in life and what are some of the things that have motivated you to be in this space of advocating for children's health. Where should we begin? Where's a good place to start telling the story?

Dr Anita Parbhoo: 3:27

I think today I'd like to start talking about me pursuing a Master's in Public Health, and I started this in 2018. And I'd been at Red Cross Hospital as a medical manager since 2008. And somewhere along my journey and after having my second child in 2015, my son is now 10 years old, I got to a space where I thought, I really love what I do. I'm really passionate about child health. I feel like there's something else. I felt at the time that I was in a space where I was looking for answers, looking to pursue new things, still loved my role where I was, but just wanted to expand my breadth of knowledge and felt the energy again after having a baby, of wanting to go out in the world and somebody suggested to me to do a Master's in Public Health and, in particular, to pursue it at the University of the Western Cape.

Dr Anita Parbhoo: 4:25

Having been a UCT graduate, it was a kind of change for me, but it was really the right decision for me and the timing was right. Just exploring and navigating through the Master's in Public Health has been a turning point in my life, really absolutely. So maybe not such a turning point, but more an expansion point and a catalyst for so many things that have just helped to push me on and push me forward in following my passion and connecting me to my purpose. So that, for me, was a really amazing experience.

Dr Maria Christodoulou: 5:02

I can see that this was quite a transformative experience for you.

Dr Anita Parbhoo: 5:06

It was absolutely, and you know, going back to do formal studies again after so many years. I hadn't done anything formal since I graduated as a doctor in 1996. I've obviously done informal things and always looking to learn more knowledge, but to go back as a mature learner, I found it such a wonderful experience at the School of Public Health at UWC. We were, of course, meeting in person for our block weeks and then doing the other work online, but meeting so many people from different walks of life and not only South Africans, and also not being just surrounded by doctors. V arious disciplines and people pursuing public health, also with their different questions in mind. I think the way that they curated the course... Obviously it was before COVID and I set out it was going to be two years of modules with block weeks, 2018, 2019 and 2020 was going to be the year that I just do my research project and obviously all that changed. But there had always been a niggling question that I'd had from being at Red Cross Hospital and I'd love to share that story with you, Maria. So I started at Red Cross in July 2008 as a medical manager. I'd previously worked for a few years in the clothing industry healthcare fund, where I had a fabulous mentor who kind of pushed me and nudged me to take on more senior roles and bigger roles, and soon after I started at Red Cross Hospital, one of the things that I learned was that one of the things that this amazing hospital is internationally renowned for is the separation of conjoint twins. I know because I've just looked into it and when we looked at the stats last year, since the hospital opened in 1956, 57 sets of twins have been assessed here, because not all of them can have surgery. This is an incredibly proud thing as a medical manager of surgical services, and it was around 2010, so not long after I'd started here, there was a set of conjoined twins that came from another country and the twins came in and they required months of investigations and assessments to see if they're appropriate to do surgery and what kind of surgery, and staging of surgery, and then the rehab. A nd they went through that whole process and after many, many months and being in the hospital many, many months, the twins finally went home and I think it was within six months we heard that one of the twins had died, and not from any surgical complications but from simple gastroenteritis. And we were really devastated, I think, as a hospital community, whoever had been part of their journey because the teams really get involved with the mom and the parents and the family. T hat kind of thing just niggled with me. It just stayed with me, this kind of unsettling feeling of what are we doing?

Dr Anita Parbhoo: 8:08

So I'd entered this Department of Health and the government public sector, directly into a tertiary academic hospital, and I then was grappling with this thing of we do all these amazing things, we spend so much money on tertiary services, which is appropriate, but how, after we've poured all that time, energy, resource into a patient, can they die from simple gastroenteritis?

Dr Anita Parbhoo: 8:34

It really did shake me and kind of put it at the back of my mind and carried on working and many other things happened and then I realized when I'd started the public health studies, trying to look at the whole health system and trying to look at addressing the social determinants, and it really put it into place for me into what we need to do as a health system, as a whole health system, and also coming to realize that there's actually very little that we do from a health department, or rather, we see often the after effects where other things have gone wrong.

Dr Anita Parbhoo: 9:09

We're grappling now, after COVID, with severe malnutrition in children, poverty in all our vulnerable populations. So it was about giving me a grounding into understanding where the tertiary services part fits in to the whole health system across the whole continuum, and also about how we can possibly use our role in the Department of Health and Wellness to leverage other system levers to impact on children. It has been for me, a place where not to say that I had all my questions answered, but for me to rather place myself into what do I need to do next? What is the next right thing to do? Where do I need to focus my energies? And then, as I took up the role of CEO in July 2021, that journey through my public health studies has helped me to know where to focus my energies and where to lead the hospital team and my team and to really look for opportunities to see what we can do in the arena of child health and well-being.

Dr Maria Christodoulou: 10:18

That story is quite... I'm sitting here thinking, okay, so, having now had this grounding in this master's in public health and having a better understanding of where the tertiary facility is situated within the health system, what does one do differently in such a situation?

Dr Anita Parbhoo: 10:49

think for me, you know, working in an academic hospital, it can be very easy for people to retreat into their silos, because everyone is pursuing excellence, as they should.

Dr Anita Parbhoo: 10:53

But I think it's about providing the opportunity and encouraging the system to work as a whole, so that when research is being done or what work is being done is, how does that contribute in terms of the health system and public health?

Dr Anita Parbhoo: 11:07

I think it's about showing the leadership, about directing the flow and also trying to look for opportunities to connect. So, for instance, where we're sitting in a tertiary hospital, where I'm sitting, I'm actually sitting at the top of the iceberg in terms of child health care. The majority of child health is being done in the rest of the health system. How do I ensure that we all connect with all the other parts in the health system so that we all support each other and we allow the flow of patients to where they should be and actually prevent quite a lot of patients from coming into hospitals? It's not easy, but a big part of it is about the mindset and recognizing that all the different parts are important, but that we are connected and so to not work on our own.

Dr Maria Christodoulou: 11:54

You said that your Masters gave you a greater sense of purpose and clarity about what your purpose is in the world. If you had to describe your purpose or sense of purpose, what would it encompass?

Dr Anita Parbhoo: 12:07

I have a very strong connection to my purpose and that is around advocating for children. Actually, always advocating for any underdog, but in particular advocating for children. I do feel I had a tricky childhood myself, and I would love to be and try to be an advocate for children who can't speak themselves. So trying to look for opportunities where something needs to be done or something needs to be advocated for, and to just bolster and empower those who are already doing work in that field and to support it. Because I am in a position of privilege being the CEO of this fantastic, internationally renowned hospital in our Department of Health and Wellness, which is very well run, and so how do I use that to create a better environment for children, but not only at this particular hospital. It's about what we're doing in the whole of the Western Cape and beyond.

Dr Maria Christodoulou: 13:07

So you mentioned in passing that you had a tricky childhood yourself. Maybe let's go back a little bit. Where were you born? What was your childhood like? What was tricky about it?

Dr Anita Parbhoo: 13:16

I was actually born in Port Elizabeth. That's something we have in common. And I still have lots of family there. A big part of my life has been my husband and although we only connected again in first year varsity, so we both studied medicine together in Cape Town. We were actually both at each other's first birthday parties because we were a small Gujarati community in Malabar, which is a neighborhood in Port Elizabeth. We have photos of each other at that party.

Dr Anita Parbhoo: 13:50

And also attending the nursery school, which is at the temple that we attended in Port Elizabeth. Actually, I just spent sub A in Port Elizabeth. My dad, who was a practicing GP and was doing anaesthetics as a GP, got accepted to do registrar training at Groote Schuur Hospital, s o we moved to Cape Town. So I do consider myself a Capetonian. I remember spending very many happy holidays in Port Elizabeth, but also Uitenhage, which is now Kariega, with cousins, having lots of fun and laughter. The rest of my schooling I did in Cape Town. I studied in Cape Town at UCT and then, when my husband finally realized what was good for him, we both applied to do our internship at Livingston Hospital.

Dr Maria Christodoulou: 14:40

So you went back.

Dr Anita Parbhoo: 14:41

Ja, so we spent some time there, really learned a lot. It was a big culture shock for us, coming from the kind of Groote Schuur/ UCT environment and a certain work ethic and then going to a different province where things were different and having to go from a space where you quite mollycoddled as a sixth-year student at UCT and going to an environment where you are it. A nd started the first rotation in the trauma unit doing surgery and absolutely overwhelmed with things, with little to no supervision at the time. Quite anxiety provoking, but learned such a lot and made such amazing friends, because obviously there was no medical school there at the time, so everyone who was doing the internship was from either UCT or Stellenbosch or other places, and so it would be work hard and then really enjoy the time off at the beach or wherever.

Dr Anita Parbhoo: 15:41

So really lovely time, difficult time, tricky, very anxiety-provoking, especially if you, like me, like to do things the right way. There's just so many things and there don't seem to be anyone to really approach to... Why is there no supervision? Why don't we have consumables? Why are things being done in that way and there is no channel really to deal with that? It was really an eye opener but really stood us in good stead for what came later.

Dr Maria Christodoulou: 16:13

So your father was a doctor. What motivated you to go to medical school? Let's go back a little bit further. Why medical school?

Dr Anita Parbhoo: 16:21

I can't actually give you a solid answer other than to say that is the only thing I've ever thought about doing, and it must be from having seen what my father was doing. And my father could be grumpy at times but he was really passionate about his work and about anaesthesia and he would show us that he would print off colouring pages for the ninja turtles to give to his patients when he was doing pre-meds, just to make them feel really comfortable. And it was a side of him that I really enjoyed seeing. That I didn't necessarily see at home. It must have stemmed from that, from seeing him as a role model.

Dr Anita Parbhoo: 16:59

But actually he did not want me to do medicine and at one stage actually said to me that I should not do medicine because I'm going to work very hard and I need to be also thinking about what kind of family life I'd want to have. And it was only until I think I was in matric and it got to the point where I needed to apply for university that I said I really want to do this and then he conceded. So it wasn't from him saying, oh, I think you should do medicine, but also because he was a doctor, h e had other colleagues and things that were doctors that we would engage with.

Dr Anita Parbhoo: 17:34

So I was kind of in that world. T hat obviously had something to do with it as well, but it was really... I loved when he would speak about how he would engage with his patients and how he always used to tell me about how important it was because he was at Groote Schuur for a while and then he was also in private practice working at various hospitals, and how important it was to build relationships with everyone in the hospital. So he would tell me about porters and the nurses and the clerks and the receptionists, all of them and it seemed like this fascinating world where they clearly seemed to love my father and, as I said, sometimes he could be quite grumpy at home but there was this whole other world of his and I think the connecting with people is something that inspired me.

Dr Maria Christodoulou: 18:24

And when you started medical school, what was your fantasy about what you were going to do or be as a doctor one day?

Dr Anita Parbhoo: 18:31

You know, at that stage I didn't have any thoughts about specializing in anything particular. I think I assumed that I would maybe be a general practitioner, become a GP and have a practice, but there was nothing in particular that I thought about pursuing and I certainly didn't think that I was going to become a health manager or a

Dr Anita Parbhoo: 18:55

I mean, that wasn't even in my paradigm and I think that's part of the reason why I chose to focus on that in my research for my mini thesis for my Master's in Public Health, and I actually chose to focus on... The title of my mini thesis was 'The opportunities and challenges of being a hybrid manager in an academic hospital,' and I did that Groote Schuur Hospital. I couldn't obviously do it at Red Cross Hospital and was privileged to interview some clinicians, not just doctors but across the field. So a hybrid manager is someone who's still a clinician and seeing patients, so doing direct patient care, but also has managerial responsibilities and how they manage those two aspects.

Dr Anita Parbhoo: 19:41

Having been a hybrid manager before, not at Red Cross, but where I worked before, because I was still seeing patients and then started managing the clinic and doing that, and that was fascinating for me, that study, because it made me realize that is really challenging for many clinicians, because none of us at that stage went into medicine thinking we're going to be managing people and we certainly weren't trained in that. And then progressing to a senior role and then suddenly having to manage a department or other people and not being trained in it, not being exposed to it and not understanding the processes. What I found is being in an academic hospital is what I call the double burden of bureaucracy, because the clinician also has two masters now. J oint staff are appointed jointly by the Department of Health as well as the university, and then having to navigate two different organizations where you're not orientated to either of them, who have different administrative processes, different ways of doing things, for instance ordering medical equipment. Nobody sits you down and says this is what you need to do.

Dr Anita Parbhoo: 20:52

If you need to replace something or get something repaired, not knowing who to ask and not having the time because you're burdened with clinical work. But there also were opportunities that I found in that research study, in that other people would generally respect you because you're still a clinician and have your hands on the ground. It's good to stay in touch with others. But really I chose to focus on that in my mini thesis because I was also in that position where I had to kind of make my way, figure it out and, as they say, learn management on the fly. S o, did not ever think, in my wildest dreams, that I would even be a medical manager, let alone a CEO, and to be in this privileged position that I am in now.

Dr Maria Christodoulou: 21:35

So what are some of the things you would reflect on as highlights in your career thus far?

Dr Anita Parbhoo: 21:42

I think, working at this hospital, I've had the opportunity to meet so many people, not only within the hospital but different organizations that we work with, really inspiring people. I've had some amazing mentors. Also had mentors that saw something in me that I did not see at the time, and it's just... I think, also, being in a children's hospital, it can be the most surreal thing. I can wake up in the morning and have five different engagements in my day. One would be some meeting about HR processes. I'd have piles of documents to sign and the next thing I'm expected to go in our therapeutic playground in front of the hospital and sing and dance because, for instance, recently it was World Read Aloud Day and to jump and sing and do that, and all in a day's work.

Dr Anita Parbhoo: 22:38

I remember when I started at Red Cross in 2008. The first Monday, we had a management meeting and I remember sitting there and thinking what is going on? Because a group of clowns joined the management meeting. They were coming to ask if they could come and entertain the children, and every other week would bring something different. So I think what's been really lovely is to be able to maintain that playful aspect, still being able to lead in a way. But also, what's been a highlight for me is being able to, once I'd been appointed as a CEO, is to lead in my flavour, if I can call it that.

Dr Anita Parbhoo: 23:22

And I think there is something special about the leader of a children's hospital being a woman, kind of a motherly figure, and really trying to stay in my femininity, even though I'm very clear on my leadership. But trying to have a kind and warm leadership and, having done lots of self-mastery, feeling comfortable to do that.

Dr Maria Christodoulou: 23:50

Is it challenging to stay in your femininity and be a leader of a big hospital?

Dr Anita Parbhoo: 23:55

I think where I am now, I no longer find it challenging, but it wasn't always like that.

Dr Anita Parbhoo: 24:03

One thing I do want to talk about is in my career I've had some low points and in around 2012, I went through a difficult period where I was off work for a bit and it was a culmination of work stressors and poor leadership in the hospital at the time and also unresolved issues from my childhood that I needed to work through. But it was also then a kind of catalyst for if I can pinpoint the start of my personal mastery journey and I continue to work on that myself, continue to try and reflect. I'm very open about receiving therapeutic support. I really feel that everyone should have a counselor and a coach and to really continue working on myself, to do self-reflection, hold that mirror up and to see what's going on, and as I've gone along that journey and even as being appointed the CEO, there were some challenges during that time but all of those things I've managed to work through and kind of use as an anchor to further concretize why I need to lead in this way, if that makes sense.

Dr Maria Christodoulou: 25:18

So if somebody were to describe the flavour of your leadership style, what would they say?

Dr Anita Parbhoo: 25:34

I think I really value relationship and connection so I will always try to make the time to connect.

Dr Anita Parbhoo: 25:36

It's not always easy.

Dr Anita Parbhoo: 25:37

Being a manager of a complex organization or institution has obviously got challenges and there are some conflicts that are necessary to go into in trying to navigate the way through services and other issues... corporate governance, clinical governance, but I do really enjoy connecting with people and I really believe that it's so worth investing the time in connecting with people, at looking someone in the eye and whether it is a minute or five minutes, a short encounter at the gate, somebody coming to drop off a form, or a longer conversation.

Dr Anita Parbhoo: 26:19

This morning I was walking from my car to the office and one of our drivers came past and we had a five-minute chat and they were just sharing with me about their health journey and advice they were given and just to be able to connect in that way with people from across the hospital but also in other spaces. And it's really remarkable when you look someone in the eye and they can see that you see them, because I think we're all so busy. People are so connected to their devices. I'm also guilty of that s ometimes. I'll be walking and checking messages on my phone, but if you actually take the time to stop and try and connect, it makes a huge difference, and so when the time comes to talk about something, you're kind of not starting at a totally new place, and COVID was an example of that.

Dr Anita Parbhoo: 27:13

If you've invested time over many years of trying to connect with people, trying to take an interest in what they're doing, not only in work but in their personal spaces, in their whole lives and then you're in a crisis. People will tend to come and do their very best because you're all in it together. So I think for me, that's the kind of leadership that I want to show. Obviously, there are often challenges and there are difficult conversations we need to have, but I try and have those difficult conversations whilst trying to be very clear and to try and separate the issue from the person. And I follow... there's so many different frameworks that I've learned about during the years. T he Radical Candor framework, so many others that I try to use, try to do active listening and many, many things that I've kind of absorbed over the years and will try and embody. The other thing that I'm really passionate about... T here are many things that I'm passionate about, but one of them is really about supporting leadership development and so just trying to take that time to mentor people.

Dr Anita Parbhoo: 28:20

I have been doing it for a while, but in the last year it's been absolutely fabulous to really concretize this mentoring that I've done. As I said, I've been doing it informally and I'm also now being part of a program with UCT, University of Toronto, and Kenya University as a mentor on this Women in Global Health Fellowship Program, and last year I was paired with a young doctor in Kenya to mentor and what a fascinating experience it has been, because as much as you mentor and you provide support for someone or share ideas, they're sharing ideas with you and it's fascinating to hear different perspectives and I've learned such a lot from people that I've been mentoring. All of those things I try to bring to bear in the running of a hospital, which is busy and has lots of mundane and transactional requirements, but I also try to look and see where I can make space to have the more transformational and transformative conversations as well.

Dr Maria Christodoulou: 29:25

And I think that's one of the things that stands out about your leadership style is that interest in developing others and supporting others to become leaders in their own right. What's the biggest challenge you've experienced as a leader or as a woman in leadership?

Dr Anita Parbhoo: 29:41

One of the things I've realized as I started to work on my own personal mastery journey.

Dr Anita Parbhoo: 29:49

One of the things I've had to do is take some people off the pedestals that I gave them, and sometimes, the more experienced I've become on my journey and the more I've learned, I've sometimes had to realize that others who are held in such high esteem have actually disappointed me now at that level and that I don't really align with the way that they're doing things anymore. And that's quite an uncomfortable space to be in, that when one has mentors, you might want to take something from one mentor and something else from another mentor. It's okay to not aspire to do everything that a particular mentor does. I think for me it was trying to become comfortable with that notion of we have so many parts. There's some parts that fit, there are other parts that don't really align, and that's okay. But I think one of the biggest life lessons that I've had to learn is how to really go back and work on how to trust my own gut.

Dr Anita Parbhoo: 30:56

And that's something that I try in the mentoring process to just share with others, because I think, particularly as women, there is a tendency to not trust your own gut, or I would find that women may have experienced something in their careers which has made them shy away from trusting their own gut and kind of how to get back to the place of realizing actually that was about the other person, it wasn't about me, and you need to be able to work on it.

Dr Anita Parbhoo: 31:30

But it's a constant practice. It doesn't just come automatically. That's been one thing that I've learned to really to just try and focus in, tune in, what is my gut actually saying and then, if need be, seek counsel from various people that you trust with different things, and then think, okay, right, now, this is a possible solution because I think at this level the kind of things that I'm dealing with, as with others at my level, there's usually no perfect solution, for it's like uncharted territory, so you actually have to try and assimilate what could possibly be out there, try and put it all together and then to come up with okay, I think this is the best possible solution at the moment for the current context. In two weeks time we might've chosen something else, but for now, where we're at what's available this is what

Dr Anita Parbhoo: 32:23

I think we should do, and being okay with it and realizing... and I learned this during COVID, because COVID, things were changing so rapidly and we would make a decision in the morning about how to manage patients and then by the next morning realize no, no, no, this works in some of the wards but doesn't work in others and to change it and to be comfortable to say, it's not that we made a wrong decision yesterday. Yesterday's decision was based on what was happening yesterday and it's okay to adapt and to change and not to castigate yourself for what you did the day before. I think, coming as a doctor, you also have a sense that you've got to always be right and you've got to always know what's going on. And people look at you and think that you should just have all the answers and to say, actually I don't, and to be vulnerable enough to say, oh shucks, I really don't know what to do. I've never experienced this before and I'm not sure what do you think? What do you think?

Dr Anita Parbhoo: 33:24

What do you think, and then again trust your gut as to what is the best way to navigate that thing.

Dr Maria Christodoulou: 33:34

Can you think of a time when you were really in that place of, I have no idea what to do, and how you handled it?.

Dr Anita Parbhoo: 33:38

Well, COVID was a constant, constant space where that feeling came up, and I think what was really challenging for us during COVID is that everyone in the world, even before COVID actually hit South Africa, they were talking about what they're going to do with adults. And then, when COVID hit, they were talking about what they're doing with adults. Okay, but no one's actually talking about what should we do with managing children? And then you're one of two children's hospitals in the country, so who do you actually turn to for advice? We tried to interact with other colleagues. I remember going on a video call with our head of surgery at the time, with surgical colleagues in Italy in a children's hospital, and then telling us that what they did is they put all the COVID patients in one hospital and all the non-COVID patients in another hospital, and then we realized that's not going to work for us. In our context it's really not.

Dr Anita Parbhoo: 34:30

So, what then? And you really had to figure it out. And then you try and get... Okay, s o from an infection prevention control aspect, what is best? From a practical aspect, what's best?

Dr Anita Parbhoo: 34:40

We knew that our main problem at a children's hospital was not going to be the children, it was going to be lack of staff, because the staff were getting COVID. Not from work, should I say, because staff were meticulous in the wearing of their PPE a nd all of that at the bedside. The place where it would come apart is when they went into the tea rooms. So I called it the saga of tea rooms and travel buddies, because in the tea room the masks would come off and then we're showing each other on the cell phone photos, whatever. And that's where it happened. We had one cohort where there was staff traveling together, I think, from two or three different hospitals, and they all got it.

Dr Anita Parbhoo: 35:20

But for us it was how are we going to protect the vulnerable children with chronic diseases? How are we going to protect them from getting COVID from others, either other pediatric patients or the staff? That was really tricky. And the other big issue was that we were told that one of the first policies that came out during COVID in the country was no visiting policy.

Dr Anita Parbhoo: 35:50

Now, for us that was an absolute no-no, because part of our mainstay, of our overall holistic management of our patient is to have the mother or any caregiver at the bedside. And so to try and kind of fight that, not in our province, but to forge forward to say this is really important, this is not a nice to have, this is an absolute necessity. Okay, but now how are we going to manage this? So we will allow one caregiver at the bedside, but now the mom wants to go home and the granny wants to come. So okay, we allow them to switch once a day, but then try to tell them be really careful with what you're doing when you're not here, because we don't want you to come back in with COVID.

Dr Anita Parbhoo: 36:25

So it was challenging, but I think there were certain things that we found was really important to fight for and we tried to advocate for it and in the end there were colleagues in non-public sector hospitals that were asking how are you doing it? Because we're not being allowed to allow caregivers even into the neonatal unit and things. So it's trying to advocate for what you think is right, even in a space where everyone is saying no and also about then... How do you share that and advocate then for other children in other spaces and trying to help other colleagues navigate their difficult spaces. COVID was a period of huge growth for me personally. It was really taxing on me personally, but it was like a massive growth spurt in so many different spaces it was a lot all at once.

Dr Maria Christodoulou: 37:18

I'm sure, and I'm listening to you talk about advocating for childcare and all the things you had to implement in the hospital. And then I'm wondering you're a mom, you're a wife, you had two children at home. How was it to navigate being responsible for the health of all these children in the public sector and then to go home to your own children and your own husband in the midst of lockdown and everything else that was going on? How did you, as a family, cope with all of that?

Dr Anita Parbhoo: 37:47

I think initially... I don't know if you remember, in the beginning we all had to... I remember the Friday or the... It was two days before lockdown it was announced, but it was only going to happen in two days. We had to issue all the staff with permits to be able to be driving around. We kind of went into action mode and so there was no question asked. There was an expectation. I would be going to work, my husband would be going to work.

Dr Anita Parbhoo: 38:10

I'm very thankful to have support at home in terms of a nanny to help with the children. But even within my husband and myself, we had to change the way that we were doing things and he was such a huge support in that he then was doing amazing meals at home because he still had to go in, but they were obviously only seeing really acute patients, so things were quieter on his side. So I wasn't really worried about the children per se because I knew there was someone with them. But it was difficult and I remember asking my children last year, you know, thinking back now to COVID, you know, what did you think? Because I think I'd been reflecting and feeling, to be honest, feeling guilty about what went on in that COVID period, because I didn't want to be a neglectful mother, and I asked them you know, how did you experience COVID? And one of them said to me, well, Mom, it was difficult because everybody else got to stay at home with their families, but you and dad had to go to work, and so it was a loss because they could see what their friends were doing.

Dr Anita Parbhoo: 39:21

I remember that my son was very young at the time, so in 2020, he'd just turned five, but he had just started to go to school and the school then shifted to an app for them to use from home. But I think after the first week, I had to phone the school teacher and say there is none of that happening in my house. He's not interested in using that app and doing your work on that app and, to be honest, neither my husband or I have the energy. Obviously, we're doing other things to stimulate him, but there's none of that app happening. And they were like no, no, we totally understand. Just try and keep him stimulated.

Dr Anita Parbhoo: 39:58

And then, within a few days of COVID hitting, my son was playing outside and fell off the jungle gym that we have in the garden and fractured his wrist. So this is what children do. Children play and children do these things and these things happen, and so life carries on. The things that children do don't stop because there's a pandemic. It was a very, very difficult period. You feel the mother guilt of not being there all the time, but between my husband and myself we do make a very good team and I say to him now, it will actually be our anniversary soon and we will be married for 23 years and we've been together for six more years, so it's 29 years. We do make a formidable team, and so between us we saw to it that everything was sorted, but it wasn't without difficulty, challenges and really emotional, because I think the thing about that time is also, by the time you do get home, you feel emotionally depleted, besides being exhausted and how to still engage with your children, your families, and some days it's just not really possible.

Dr Anita Parbhoo: 41:07

But it is what it is, and that's the calling.

Dr Maria Christodoulou: 41:10

Yeah, I was listening to the talk that you gave when you received the Jakes Gerwel Award last year and one of the stories that stood out for me was your memory of being a child sitting in the car with your sister outside Red Cross Children's Hospital while your father did pre-med ward rounds. So I guess that thing of the parents' job and responsibility to his patients kind of almost taking precedence is a theme that runs in the family.

Dr Anita Parbhoo: 41:37

It does, and also in my husband's family, because his father was a surgeon and he also recalls many childhoods sitting, not in Cape Town, in Port Elizabeth, but a similar kind of thing. So, yes, part of it is it shifts from generations because you just come to expect that. But I think the thing is when you are there, when you are with your children, when you are with your family, to try to be emotionally present, and I think that's the thing that kids can pick up. Sometimes it's not just about the time and the hours, it's about the emotional availability, and obviously that changes from time to time, depending on where you're at. But just trying to realize that quality over quantity, make it count when you do connect, and realizing that there is nothing such as a perfect parent, and that was a journey itself.

Dr Anita Parbhoo: 42:28

I can say this easily now, but it's been a journey to get to that space of moving from the perfectionist, putting the perfectionist aside but appreciating that good enough is okay and just making it about the connection and not necessarily the time, any other kind of metric.

Dr Maria Christodoulou: 42:47

You also shared with me when we met recently that the journey of becoming a mother was quite a challenging one for you. Would you be willing to tell us a bit more about that?

Dr Anita Parbhoo: 42:56

It's so much more common nowadays and I see so many young women going through this now, but we really... N ow, I've been with my husband longer than we've been without each other. We're actually just two weeks apart, we're both Geminis. So I always say we get the one side or the other side. I either love you or I hate you. So when we got married and decided to start a family, we had quite a tricky journey, true to form, for being a doctor, there's always dramatics. I had to be rushed to theatre for an emergency laparoscopy, not realising that I had an erupted ectopic pregnancy, and then I had some early miscarriages after that. But I have a wonderful gynaecologist who is very supportive, who then did the right thing and referred me to the appropriate place, and we needed support at the fertility unit. I have a wonderful daughter who is now 17 years old, and I mentioned that I had a difficult time around 2012. And it was after I started working through so many things that I realized and said to my husband I think we should have another one. So everyone assumes that the second one is a 'laat lammetjie' because there's seven years difference, but it absolutely wasn't like that at all. It was by design, because I really went through a period of extreme anxiety and, once I started working through all of that, realized that there's space in my life and also work is not everything, and that is a lesson for me to learn. A big journey. Ag ain, it comes so easily, but it was many years of trying to work through that and deciding to have a second child. So I have a 17-year-old daughter and a 10-year-old son who are both equally delightful in different phases of their lives.

Dr Anita Parbhoo: 44:36

I think one of the things about being a medical manager, or actually at this hospital, or actually, I'm sure a lot of the clinicians will say that as well is, I think, being at a children's hospital. It's incredible, it's wonderful, it's so rewarding, but it also has a way of really sucking you in that you feel so responsible. A nd there are times, I can tell you, I had to work on just separating myself or my identity from my job purpose and that was a big thing that I had to work through. A nd I'm sure it's not just me, that there are many people who feel like they're carrying the burden of the Western Cape children on their shoulders, and I think it's both a blessing and a curse, because it really pushes you to want to do the best for the most, but as an individual it's just not sustainable to be having that and it's really something, and that's why also I think, having been through difficulties like that in my own personal life, I think that when I'm mentoring others and more junior managers or other staff in the system, is to try and get them to realize earlier on in their career about how important it is to make that distinction and that it doesn't mean you're any less committed, but that you make space for yourself and your own wellness and your family, because if you don't do that, somewhere along the the line it's going to show up. That's also part of my journey.

Dr Anita Parbhoo: 46:08

I often say to people I have a few superpowers. So one of them is I cannot navigate myself anywhere geographically. I will get lost, even when following the GPS s ometimes. I'm not very good at spatial awareness. One of my other superpowers is really being able to tune into what people need and hear and to try and make that connection. I think it is a gift.

Dr Anita Parbhoo: 46:37

But even in that I've had to regulate myself that I don't launch into serving everyone else and forgetting about my own needs, and I've had to try and balance that very well.

Dr Maria Christodoulou: 46:52

I imagine, as a mother especially, there's something about in my fantasy of working in a children's hospital and the little bit of time I spent in paediatrics at Tygerberg, the overwhelm and the distress and the feeling of responsibility when children are really suffering or really struggling and serious illnesses and terminal illnesses, and then going home to your own healthy children. How do you carry that? What helps you to not take that home and or project some of those fears or anxieties onto your own children?

Dr Anita Parbhoo: 47:23

I don't think you can totally protect yourself from that. It's just... I still, often, I'm caught up in meetings and I'm in my office and when I do walk through the hospital and walk through the wards, I still... If I walk through oncology ward, I will come out in tears. If I walk through the burns ward, I will come out in tears. It's just that human reaction. And actually when I became the CEO, I actually changed the office where the previous CEO was. I've moved offices in the same section because it's out of the building, out of the main hospital, but I've moved to the office that's directly opposite an enclosed garden attached to our oncology unit.

Dr Anita Parbhoo: 48:05

And I always say to the team, I sit here and I look out of the window. Firstly, staff can see me when they walk past and realize there is someone at home but secondly, that I look out and I see parents walking with young children who are on chemo and remind myself of why I'm here. B ecause obviously, I deal with lots of other issues and corporate issues besides the clinical governance, and that reminds me of my purpose and why we need to keep fighting for the right thing, and I think it's not just about working at Children's Hospital. I think if you are a doctor or a medical person, you vacillate between thinking the worst or thinking it's nothing. Either the two Panados or it's like oh my god, I think you need a CT-scan.

Dr Anita Parbhoo: 48:51

What we do is, if one of our children's sick, we actually take them to someone else. I mean, obviously, if it's not just a minor thing but to be assessed, because both of us vacillate between one and the other and it is tricky because you do see the most awful things.

Dr Anita Parbhoo: 49:06

I will say something to my daughter and she will say, M om, I know you're just paranoid about this because you see it in the hospital, and I say, yes, I am. So you can't unstrap your seat belt and you can't do that, and you can't do that, and I know you think I'm being anxious. And I am anxious because I see this, we see this at the hospital. So you do become cautious and you do sometimes think that some minor symptom could be something else. And also, I think, because I still have young children, I still feel emotionally connected to what we are doing at the hospital, b ecause it's all very real.

Dr Anita Parbhoo: 49:48

As I look out into the oncology garden, I'm very mindful that that could be my child. T hat could be me walking with my child and it's hard.

Dr Maria Christodoulou: 49:56

Ja. You spoke about some superpowers, and I want to highlight one or two other things that I learned about you when I was preparing for today. The one is that you have a blue belt in karate, and the other is that you are a flamenco dancer.

Dr Anita Parbhoo: 50:12

Yes, true. So I'm a dancer.

Dr Anita Parbhoo: 50:16

I've done dancing since school. The flamenco dancing has been since school. I am not a combat fighter, by any means, but my whole life revolves around this place where I work. October 2018, I was at the hospital and I was at the launch of a partnership with an organization called Kids Kicking Cancer at the hospital.

Dr Anita Parbhoo: 50:44

And they're an international organization started in America by a rabbi who was a paediatrician, but he and his wife lost their child and he was a black belt in karate and he decided to teach the children in the ward that he was looking after and also oncology patients... To teach them some breathing and to try and give them some purpose and autonomy back. So a child with a chronic illness is lying there, is being poked, prodded, procedures being done, and they started this movement to try and empower them. They actually give them a white gi, which is the white karate outfit, and they teach them breathing and so it helps with the procedural pain but also it gives them that sense of autonomy. So their motto is power, peace and purpose. And so I go along to this launch, and the sensei that's there that's been working with our children, Ilse, she has some children and they do a demonstration and the breathing, and I'm so taken aback by this. It's just so wonderful, overcome with emotion, and I go and speak to her and I say, wow, they're just really lovely. I'm just so inspired by what you're doing with the children because they come and do classes twice a week and I can actually see it from the oncology garden where I'm at now.

Dr Anita Parbhoo: 51:59

But do you do classes for adults? Because my husband and I had been doing ballroom dancing. He's not a dancer, I am, and we learned a lot more than ballroom dancing, can I say, because I had to learn to follow him. The company had closed down and we actually had a space and we'd actually enjoyed that time together during the week. One class a week to do something besides looking after the children. And I said to Ilze, I said, do you perhaps run classes for adults? She's Afrikaans speaking so I expected her to say it'd be somewhere in the northern suburbs. I stay in the southern suburbs. She said yes, we do. It's on a Wednesday evening, which is exactly when we used to do the ballroom classes, and it's around the corner from the hospital.

Dr Anita Parbhoo: 52:38

What? A nyway, I go home, I tell my husband, I said, shouldn't we try this? He will do anything physical, he's game for anything new and any activity. And he says, you realize that karate is not all deep breathing? I know, I know, let's go to a class. She said we can come to a class next week and let's try it out. And I went and I tried it out and the next thing, you know, I'm progressing through all the levels and up to the blue belt, but then I did start struggling because it was starting to be quite physical and it's not really something in my comfort zone. I got right up to blue level. My husband carried on a bit. After that he had to stop because of a slipped disc.

Dr Anita Parbhoo: 53:19

But we really enjoyed it and I think that the thing that I loved about the karate, besides being inspired to do it in the first place with Ilze who was doing this with our children, it's just the kind of discipline, the time that we'd have together. And also it wasn't a very strict dojo. And I was just looking back at some of my messages because I was trying to figure out when I'd actually started and I see that the first thing I'd ask Ilse is, but the one problem I have is, if we do start, is I'm a medical manager, I'm on call every second week, I would need to keep my phone on. Is that a problem? Because I'd heard that dojos are very strict and you can't do that. She says, no problem. We totally understand because you're on call. I said my husband's also on call. No problem. But that was the first thing I had to navigate, just like can I actually go in there and do the classes with the phone on? So yes, I did up to blue belt and then realized, I think I need a different kind of energy because I also didn't have time to do the flamenco and the karate. And I'm very proud of myself because it's not something in my comfort zone that I would have done, and proud for having achieved the blue belt. But it was really a combination of the people involved and doing it with my husband and also proving to myself I can do something that no one would expect me to do, and also that's something that's quite physical i n that way. I t was really a proud thing. If it was now, I don't think I would restart it now.

Dr Anita Parbhoo: 54:39

Flamenco is a totally different thing. Flamenco is a soul thing for me and I really feel a deep connection to that. But also, as many things in my life, fell into it by accident. W e were at school, I think standard nine. One of my school friends had been doing ballet for years and then was doing flamenco dancing, and she said to two of us, why don't you come and try it out? Just come and see. So we went, tried it out.

Dr Anita Parbhoo: 55:09

I think the other friends stopped after a while and I continued and I actually did exams and everything up until elementary level. I had to stop because I was doing medicine and I just couldn't manage all of that. And then when we moved to PE, I kind of stopped doing syllabus classes because I couldn't really find someone and also being on call so many times it didn't work. But I still do flamenco dancing. I try to go once a week. It's very much, even when I'm not going to classes, i t's very much part of me. I think in a past life I must have been Spanish.

Dr Maria Christodoulou: 55:41

Beautiful. It kind of feels almost in some way connected to the work that you do, this interesting mix of this very passionate dance that is the flamenco, very grounded and rooted dance, but then also the discipline and the focus of the martial arts, and I'm sure that that has been quite central to your leadership style too.

Dr Anita Parbhoo: 56:03

Absolutely. This is something that I've realized that I actually need to purposefully do in my life, and so when I was studying, when I was doing the master's, it was hard, it was not easy. I had to do work in the evening. So once the kids went to bed, so maybe from eight till ten, and then weekends, and so that intense kind of academic work, and I realized that I needed to do something creative to kind of offset this intense thinking work, and so at that time I would do lots of art and craft things when I had time, or baking, or cooking, creating new dishes, to try and balance that. And I realized that that is what I need. And when things are getting too intense at work or very heavy, I realized I need to go and do something else just to offset that energy.

Dr Maria Christodoulou: 56:54

You spoke earlier about meeting clowns at a meeting at work, and I know you also told me that you've had opportunity to meet some famous people, whether they're singers or members of the royal family, and do I remember correctly that you abseiled off the building at some point?

Dr Anita Parbhoo: 57:10

Yes, yes, I did that crazy thing and really, if I think about it, it's about relationship. One of my previous colleagues does rescue and every year the rescue personnel come and do this abseiling off the building in superhero costumes for the children, and it's actually a practice that's done at many children's hospitals and so they've been doing it for a while. It was about two weeks before our end of year Christmas parade, because we have City of Cape Town coming with the fire brigades and police and they make a whole fanfare and Father Christmas normally arrives. I can't tell you how, but in different ways. Then they do the abseiling on the same day.

Dr Anita Parbhoo: 57:48

About two weeks before I just popped out of my office and he said are you going to do it this year? Some of the staff have done it previous years. You know me, I don't do that. He's like, why I'll be there. I'm going to do it with you, I'll relay you down and you'll be fine, you'll absolutely manage and I really trust him. I trust what he does, but I also trust him as a person and I looked at my PA and I said to her, what do you think about this? She says I think you should do it. I went back in my office and five months later I came out and thought maybe I will, but I would also like a superhero costume, please and I don't want to be a pirate or something like that.

Dr Anita Parbhoo: 58:33

I want to be maybe Wonder Woman or something like that. T he day came around and I was feeling anxious, because it also entails going up to the F floor, which is our top floor of the hospital, climbing out of a window and then walking on a narrow ledge on the outside of the building.

Dr Anita Parbhoo: 58:51

I did say to them I'm not going to tell many people because I fear that when I have to climb out of the window I might lose my nerve. There's a lady that has a company that hires our costumes and she does it pro bono. So she brings a whole bag of different costumes and people just see what they want. It was a Snow White costume for me and I went out and this colleague was there and he's like I've got you. I'm like okay, and I was quite anxious. And then Anna was going down. I thought all right, because you actually have to bounce off the side of the building to get down and there's a clicky thing that you have to manoeuvre, a little switch thing. And as I'm going down, my comms officer, who's on the ground now, there's a whole lot of staff and patients and everyone on the ground, and she's on the loudspeaker, she says, Dr Parbhoo, give us a wave and I like, oh my goodness, I'm trying to hold it all together, but I turn and I wave and smile and wave and I go down.

Dr Anita Parbhoo: 59:46

My husband was there with the children. It was really amazing and the staff were so happy to see it. And then my son said, next time, I want you to do it off a taller building please. So it was delightful. I did think. Wouldn't it be cool if the CEO of the children's hospital abseiled down there?

Dr Anita Parbhoo: 1:00:06

But I think if it wasn't have been for that colleague who I knew was going to be there, if I was going to do it with a stranger, I wouldn't have done it. But it's again about that connection with someone and trusting them, and also then rationalizing... N o one's ever died before. There've been no other incidents, you'll be fine. It was a wonderful experience and lovely to have been able to do that for the staff and the patients and for myself.

Dr Maria Christodoulou: 1:00:30

I'm struck by the image of you in a Snow White costume.

Dr Maria Christodoulou: 1:00:33

It's somehow... I'm not sure how I feel about that.

Dr Anita Parbhoo: 1:00:38

The things we do for this hospital and the patients and the staff.

Dr Maria Christodoulou: 1:00:43

I guess what the image of the Snow White costume evokes for me is also that here you are, an Indian woman in South Africa, in this leadership role and position. What has that meant for you? Has there been any challenge around that? What's it been like to be a woman of colour in the system?

Dr Anita Parbhoo: 1:01:00

I think before I go there I must just tell you about the Snow White. So why the Snow White is actually so fitting for me, m y husband and I worked in the UK for a while after we were in Port Elizabeth. I loved the Disney store and I actually went every time when I had a chance, and I bought each of the dwarfs and I have the whole set of dwarfs in my bedroom. So, for me, Snow White meant something else. It was really so delightful because I've always had seven dwarfs and I have that connection.

Dr Anita Parbhoo: 1:01:32

So there was not the other connection.

Dr Anita Parbhoo: 1:01:34

But I think, being an Indian woman, I think I personally I don't view the world through that lens and it's not something that I'm fixated on.

Dr Anita Parbhoo: 1:01:44

I think where it has come to bear is rather actually being in the senior role and having to take on some challenging disciplinary processes, where then it is brought to the fore because then when excuses are made or things are deflected to you, it can be turned into a racism thing because I'm different to the person that we're trying to deal with or manage and, to be honest, that's the only context that I've really experienced where it has been an issue.

Dr Anita Parbhoo: 1:02:18

You know, other people have noted that department there's so many of this colour and so many of this colour, and I don't view the world through that lens. I do have my ear to the ground and I do know who's working, who's not working, who's taking a chance, those kinds of things, because that's what matters to me in being efficient and getting the work done, because this is for the children and the communities we serve and the public, and I think just also going through my own experience of trying to find what the right or the happy medium is, for me, being an Indian woman and not being over religious but rather spiritual, but also really enjoying certain cultural aspects in terms of food and flavour and colours and music. That is who I am. I come to work as who I am, not overly Indian, not overly female. I come to work as who I am and I've gotten to be more free in being able to pull in whatever I need in order to deal with the matter at hand.

Dr Maria Christodoulou: 1:03:28

Right. Did you

Dr Anita Parbhoo: 1:03:31

Yes, they do. They do. S o my family and my husband's family as well. So all over Cape Town you can name some of the shoe shops, which I won't go into now, with master shoemakers and crafters, and they will either be related to my husband or to myself, or be married into the family, and it was really funny...

Dr Anita Parbhoo: 1:03:52

After my son was born we had a party, I think a month later, and invited quite a few people, friends and colleagues from both of our sides. I think it was one of my husband's colleagues who said, oh my goodness, all my shoemakers are here in one venue.

Dr Maria Christodoulou: 1:04:10

I guess there's also something quite symbolic about being from a family that makes shoes for people to walk in the world. Absolutely. So you've spoken a little bit about the shift you had to make from being a clinician to being a medical manager and the world that opened up for you when you did your master's in public health, and I know that you're involved in quite an interesting and innovative initiative in government in Cape Town to look at children's health issues in a more multi-sectoral way. Do you want to tell us a little bit about that initiative and that project?

Dr Anita Parbhoo: 1:04:45

So I think, as passionate as I am about child health, there are many individuals in this province who are really passionate about child health as well, and I'm really privileged to be working with some of those people and I think in 2023, Keith Cloete, who's our HOD, and I had a conversation and he'd been chatting to a few different people. We've got an amazing head of paediatrics here, Professor Rudzani Muloiwa, as well as an amazing head at Tygerberg Hospital, Prof Regan Solomons, and we started to talk about with other colleagues, about realizing, after COVID, how COVID really exposed so many cracks when it came to children. I n terms of how children were living and in what conditions they were living in. B asic things like access to water, nutrition, safety, all of these things. Keith started having these conversations about, w hat can we do together to try and improve not only child health,

Dr Anita Parbhoo: 1:05:46

because as I said earlier, our health department only impacts on a small part of what happens in a child's life, but how can we really work together to impact child well-being? Keith, having worked in this field for many years and really been passionate about it himself, we started to gather like-minded people who'd been working in this field, and not only from government, but also from other sectors, and so we've gathered together a group of people and we've now called it the Movement for Child Wellbeing, but it's really a group of people who are across different government departments, civil society, academia to try and come together to say what needs to happen. How can we leverage our position to improve things for child well-being. We actually just had our sixth engagement yesterday. We had started in December 2023, and for yesterday's meeting, I did a timeline of where we've got to now and quite a lot of interesting things have come up.

Dr Anita Parbhoo: 1:06:49

In Keith's position, he's able to leverage it and take it to cabinet etc. And he's also been engaging with other heads of department who've mandated people to be part of it and we're trying to see what are the next steps. One of the big issues around children at the moment is the lack of nutrition. It's really astounding. So we're trying to see if there are levers we can pull with civil society and others to see how we can put something into place. But there are a lot of different things that we are trying to address, but trying to get everyone together to move together. So it is really exciting. There are a few things that have been put on the table already, but I think the great thing is to also just get that network together and to see is this something where we can all move in the same direction, which is quite a feat in itself, but to move in the same direction drawing on everybody's strengths for child wellbeing-being and not just child health.

Dr Maria Christodoulou: 1:07:47

What's the dream? What's going to make you look back on your career one day when you're 95 and go, w e did it, I made a difference, I've left a legacy?

Dr Anita Parbhoo: 1:07:57

I think, for me, what brings me joy is if I reflect on a weekend and think about what's happened over the week or what's happened over the year, and I look back and I see the younger managers or younger people we've managed to touch in some way, to inspire them, to help them on their leadership journey.

Dr Anita Parbhoo: 1:08:20

That is something that really inspires me and brings me joy, because they are going to be the ones forging a new way of working in the health system and taking things forward. So, on the one hand, it's definitely about that, about empowering others, teaching them that there is a different way in a system that's been quite traditional and quite hierarchical. On the other hand, in terms of the child well-being, I think the dream would be to look back and to see that I have used my position in the best possible way to leverage change and just move the dial forward in terms of child well-being. And it's not about here, where we're situated in southern suburbs, it's really about the children in the country and beyond, and to see how we can spur others in other provinces to also start doing something to make impactful change for children.

Dr Maria Christodoulou: 1:09:15

Beautiful. I love that. May it be so. We started talking about your story at the place where you began your Master's in Public Health and you described what a powerful and transformative journey it's been, and I guess in some ways there's been some recognition of that journey in receiving the Jakes Gerwel Award last year. What did that mean for you?

Dr Anita Parbhoo: 1:09:40

It was really such a humbling moment and such an honour and really also such a surprise, because I have, along my journey, suffered from imposter syndrome and although I've done such a lot of work to realize my own self-worth, when I was presented with being nominated for this, I still said, I'm sure there are other people that could be nominated who are making much more impact and just trying to go through that process and actually accept it, and then to be told that you are the recipient.

Dr Anita Parbhoo: 1:10:14

I think it was a crowning moment in my life. I t also gave me, because I had to do a public presentation and knew I was going to receive a citation... It was quite a surreal moment sitting there and listening to my supervisor for my MPH thesis giving me a citation. But in the time leading up to the actual award event, I had time to then really do a deep reflective process and think about where I've come from, what are my hopes and dreams, what do I hope still to achieve, b ecause I had to put it into a presentation and I found just that process was a fantastic process. A nother growth spurt that forced me to sit back and reflect and think about right, what am I going to share with the world? What am I going to put in here, what's important and what's been my journey? And so for me, I really enjoyed that opportunity to go through that process. But it's been wonderful and I think we have such amazing people.

Dr Anita Parbhoo: 1:11:16

I have amazing people working in my hospital. I have such wonderful colleagues across the department. I've learned such a lot from people, not only from UWC, where I did it, but because of the way they structured the masters. There are lecturers from Stellenbosch University, from UCT, and that also showed me the way to collaborate. So I learned from so many people, and for me, receiving the award was also about the space that I've been given in the Department of Health and Wellness, where I find myself in this hospital, to be able to go forth and do what I think I need to be doing to try and improve child well-being.

Dr Anita Parbhoo: 1:11:55

There's no script, there's no set of rules. It's actually liberating to think, right, I can sit here and think about where do I want to go next? What do I want to do? Where's the opportunity? Or, opportunities arise, to take it and really go forward with that. I feel really privileged to be working in this space, to be not only the CEO of this amazing hospital, but also to be part of our broader Department of Health and Wellness and part of the top management of the department, where I can, with my colleagues, try and figure out what the next right step is. I appreciate the freedom that I've been given from this position to be able to think about what we should do next.

Dr Maria Christodoulou: 1:12:40

That's amazing. I feel like we're all very privileged to have someone like you in that position. So what is the hope and dream? What are you hoping is the next right step for you?

Dr Anita Parbhoo: 1:12:55

Sometimes when I speak to family and they've heard about the Jakes Gerwel Award, they say oh, where to next?

Dr Anita Parbhoo: 1:13:02

I honestly feel that I don't need to go anywhere. I feel fulfilled in where I am and from where I am, I'm able to lean into the different aspects of what I feel needs to be done. So, whether it is the leadership development, the mentoring, whether it's the practical stuff on the ground about managing child health issues or delving into how do we engage with our colleagues to do this intersectoral work about child well-being, I feel like I'm well-placed to explore all of those things from where I'm sat at the moment. And that's great, because I do realize that many people who don't feel that they're in such a position. But I appreciate being in this position to be able to do that kind of work that needs to be done, that I feel needs to be done, but also to explore different avenues. And so, when something else comes along to see, does it fit, is it something that would add value, can it benefit the department, is it good for public health? Do I have the time to pursue this, can I add value? And to explore those things.

Dr Maria Christodoulou: 1:14:12

Nice. Is there anything that we haven't spoken about that you would like to share?

Dr Anita Parbhoo: 1:14:19

I just... I think it's important to mention that it really is worth taking the time to connect with people. Often we're so busy and we're all going about our busy lives and we may not realize it at the time. But just taking that time to stop and have that five-minute conversation with someone, or even a three-minute conversation. You never know what impact that has on that person or how they may just need to connect with you that day. S omething that you spark in them, that sparks them to do something else. But also usually, when these chance connections happen, when I'm walking or walking through the hospital, I usually walk away feeling so enriched because of that connection and hearing what they have to say, which has got nothing to do with work but has everything to do with humanity. For me, that's really important.

Dr Maria Christodoulou: 1:15:16

I think that I agree. That's a very important message and in part, it's the aim of this podcast is to actually show that doctors have other sides to them and that there is a humanity that is at play even in the professional domain, and that we bring our human selves to the workplace and that so often our aspirations and ambitions and dreams are motivated by those human stories that we've endured and encountered. What keeps you awake at night?

Dr Anita Parbhoo: 1:15:46

I feel a lot more settled this year. Last time this year I did not feel so settled. What keeps me awake is really trying to figure out how to manage budgets in a time of austerity, when you know that so much more service is needed and realizing that I get it. This is the budget envelope that we have and this is what we've got to use. But you know that what's going to happen and I'm not only talking about for my hospital, I'm talking about our department of health as a whole is that it means we've got to stop something somewhere, and some part of the population is going to be impacted, and I think that was a really, really difficult time to navigate.

Dr Anita Parbhoo: 1:16:29

In my hospital as well, we had to deactivate posts. It was really challenging to do, especially when you know that that service is needed and those are things that are bigger than all of us. I think it's the things that you don't have control over but yet are impacting on the service directly. And also when you know that it's impacting and usually, as always happens, as with recent events around funding, the most vulnerable in the population. The other thing that really keeps me up at night is when I hear about a particular child and we see the violence against children and gender-based violence and just thinking about how it's possible that we are in a world where so little thought is given to children, often. Again the most vulnerable, often without a voice. How do we actually go about stopping that kind of senseless violence? And that's hard. You see the patients coming in and the ones that don't come and speaking to the families. That's really heartbreaking.

Dr Maria Christodoulou: 1:17:47

So what keeps you going, what keeps you motivated and hopeful in the midst of all of that?

Dr Anita Parbhoo: 1:17:54

I think I feel that I'm a resilient person. I've overcome many challenges in my own life and I feel that there's always something that can be done. We may not be able to correct everything in the world, but I think there's always something that we can try and do together to try and make a change. Sometimes it feels like it's only a small change we're making. Other times we're able to impact in a bigger way, but I feel there's always something that we can do.

Dr Maria Christodoulou: 1:18:31

And maybe the last or second last question from my side, what advice would you have for a young colleague who's starting out in their medical career and might be thinking gosh, I hadn't thought about medical management and our training does place such emphasis on the clinical training. What advice would you have? What would be helpful for them to think about or consider as they navigate their career?

Dr Anita Parbhoo: 1:18:54

I've chatted to quite a few younger colleagues recently. I've chatted to a few who are kind of at the point in their life where they've finished their comm service and they've done the internship and taking on a job but not quite sure what's next. And the one thing I do try and say is that, try not to panic, because you don't need to decide now what you want to do definitively. I think medicine is wonderful from the point of view that there's so many different aspects that you could lean into, and part of it is about your personality and what you like doing and try to get them to understand what part of medicine they really enjoy. Is it the connecting with people? Is it the diagnosing of things? Is it the laying hands on and doing physical things and being able to do procedures? And to try and just give themselves time to explore different things.

Dr Anita Parbhoo: 1:19:51

And sometimes just take a job because the job's available and not for that anything's necessarily going to come out of it, but there's always... Often what happens is taking a job and seeing that some opportunity arises, either by meeting someone, getting yourself known. I was saying to a young doctor the other day, even if you take a medical officer job and you're interested in going into management. Often there is an opportunity for you to find something or some process to manage while you're in a medical officer job, so see what you can take out of it, see who you can meet, see what you can learn and somewhere in that might be the next stepping stone to where you're going to go, but to give yourself time to figure it out, because medicine is such a vast discipline.

Dr Anita Parbhoo: 1:20:40

And don't decide too quickly. You want to give yourself the opportunity to explore different things and unless you're absolutely clear that this is exactly what I want to do. B ut most medical people that I've come across don't have that clarity and it's fine to just explore for a while and take three or four years to just do different things and then see what really sits well with you and where you feel you are going to be fulfilled and also practically what's going to suit your lifestyle. If you're planning to be a mother or a father and have children and what's also going to suit your lifestyle, because I think those practical things are equally important to consider.

Dr Maria Christodoulou: 1:21:21

And I think it's such an important reminder and also such good advice to give themselves time. I think so often I'm speaking to young people who are feeling the pressure of you've got to choose your specialty, you've got to immediately get a registrar post and you've got to get there as quickly as possible and not giving themselves enough space and time to really explore and get clearer about what matters to them and what the possibilities are before they finalize those decisions. But I'm also seeing, and Amy and I were chatting about this the other day, a new generation of younger colleagues who are actually stepping outside of that box and allowing themselves to make very different decisions about the direction they want to take their careers in, which is quite exciting.

Dr Anita Parbhoo: 1:22:06

You speak to younger doctors and younger people from other clinical disciplines and see how excited they are and what ideas they have. I think sometimes they get frustrated because they find like they don't have a platform to go there yet. But then to say, just be patient with yourself and it might not be the exact place you want it to be, but see then if that can be a springboard for what you actually want to do.

Dr Maria Christodoulou: 1:22:26

Right.

Dr Maria Christodoulou: 1:22:29

Amy, is there anything you'd like to say or ask Anita?

Amy Kaye: 1:22:35

It's so lovely to know that the children are being managed and taken care of by a real-life superhero who's absa iling down the building and dealing with clowns and readathons and doing the flamenco and kicking ass and kicking cancer. You fit so wonderfully. It makes me really happy and I'm sure it makes the children happy, and I'm sure it really makes the parents of the children happy that you're there, that you're the matriarch overseeing all of this stuff and taking care of everyone, and I'm sorry for the things that you went through in your life when you were younger, but it makes complete sense that you can now be there for those families and those children that really need somebody who understands and who really cares and has a real feeling and a passion for this. Just keep doing what you're doing and anybody who can abseil down a building gets k udos from me. I think it's flipping amazing. I could never do that. I have an incredibly hectic fear of heights. So, what are you going to do next?

Dr Anita Parbhoo: 1:23:30

I don't know. I will see what opportunity presents itself next and see what I'm feeling like at the time. But thank you very much Amy.

Amy Kaye: 1:23:38

Keep going. It's amazing.

Dr Anita Parbhoo: 1:23:40

Thank you.

Dr Maria Christodoulou: 1:23:42

As a way of closing, Anita, just to ask you, having had this opportunity to reflect on some of your story and some of the things you've been through in your life and in your career, what stays with you at the end of this conversation? What are you going to take away?

Dr Anita Parbhoo: 1:23:57

It's been an interesting experience to do this. I can speak about the hospital, I can speak about the services for hours. It's a very different thing when the spotlight's turned to you. It was a bit challenging at first thinking about it, but it's been wonderful and you've made it very easy. Thank you.

Dr Maria Christodoulou: 1:24:16

Thank you, and thank you for not only being willing to come and share some of your story, but also for the work that you do in the world. As Amy says, this idea that there's a superhero out there who's scaling buildings and doing superhero antics to protect the children of our country, there's hope and there's inspiration from that. And I also think you bring a beautiful, playful, joie de vivre, in a way, that is really important. I'm grateful for you and I'm grateful for the work you do in the world. Thank you Anita.

Dr Maria Christodoulou: 1:24:36

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.