Inside her office at the tertiary hospital Groote Schuur, Maswime laughs to deflect from the gravity of a point she is bringing across. In a field that's predominantly white and male, she is often the only black woman in a room and at 40, often the youngest. In addition, she feels the eyes of many, many hopeful young black women on her, looking up at her success for inspiration. Being a pioneer brings pressure, says Maswime, as you are not only succeeding for yourself.
In her talk, she noted that while caesarean sections are the most widely performed surgery in the world, African women are fifty times more likely to die from the procedure or resultant infections than women in high-income countries. This was the finding of research she conducted along with colleagues, involving 3 792 patients at 183 hospitals across 22 countries.
"The first patient had an anaesthetic complication during her caesarean section. And it's quite a common complication, so immediately all the doctors are called into the theatre and they did what they could. But then the patient had to be ventilated and sent to the next level of care, which was in Pietermaritzburg 72 kilometres away. And so the decision was made. Because of the distance, let's get her airlifted to the hospital rather than putting her in an ambulance.
In the following years, while treating individual patients at the Chris Hani Baragwanath Academic Hospital in Soweto, inside Maswime, a yearning grew to bring healing on a larger, systemic level; to continue her education into the underlying causes of negative outcomes for mothers and neonates in childbirth.
"There are so many worlds within health systems; internationally, across countries, and provinces," says Maswime."Some are weak, some are good, some are strong. For example, South Africa does have centres of excellence, but then there are the rural hospitals with very few doctors, access to specialists, travel time, and distance to your referral hospitals... We always say that diseases don't have borders, but health systems do...