Woman surgeon making impact in Tanzania

We are at Muhimbili National Hospital (MNH) paediatric theatre waiting area eager to meet a doctor who has become a household name in Tanzania for participating in separation of conjoined twins.

After few minutes, the theatre door opens and a woman dressed in scrub suit complete with face mask beckons us, she later on removes the mask and smiles as she leads us in a nearby room where we sit for a chat about her life and career.

Meet Dr Zaitun Bokhary, 45, who is the Head Paediatric surgical unit at MNH, who wants Tanzania to be the centre of excellence in paediatric surgeries and roots for adoption of less invasive surgeries using technology.

She believes in the old adage that .”you must have a lion’s heart and the hands of a female to be a surgeon” since women are so keen because they are mostly mothers. “You imagine that the baby you are operating on is your child so that you do an excellent job..If something goes wrong, I can even cry. So am always happy when am successful.”

Dr Bokhary has managed to make a mark in the seemingly male dominated field of medicine, particularly in surgery.

Female surgeons are a paltry number compared to their male counterparts especially in African countries like Tanzania. According to a survey done by Lancet Laboratories in 2017 female surgeons in Africa were at just 9% of all practicing surgeons. Being a paediatric surgeon takes a lot of dedication and is a very demanding profession.

Despite the odds, Dr Bokhary has become a household name in Tanzania when it comes to paediatric surgeries. Being the head of the Paediatric surgical unit at MNH sees her together with her team doing an average of 10 to 12 surgeries per day since they have two paediatric theatres. In 2007, they would initially do three to four.

Some of the notable cases she has handled include conducting the first rare surgery on a 10-year-old child in 2017 from Zanzibar where his lower oesophageal sphincter failed to open during swallowing a condition known as Achalasia. Such a complex surgery had only been done in a few countries such as India and Saudi Arabia. Dr Bokhary did the first such surgery in Tanzania. The separation of conjoined twins is no easy feat and it takes great specialized skill. in 2018 conjoined twins were presented to Dr Bokhary after being referred from Missenyi District where the mother had given birth at St Thereza Omukajunguti health care centre. Maryness and Anisia were first assessed by Dr Bokhary who noted that the twins shared vital organs. Because of this complexity and lack of other specialists needed for the operation the twins had to be flown to Saudi Arabia for the separation operation to be done there. Dr Bokhary had to accompany the twins and was also part of the 35 member team that operated on the girls. “ Being part of the team of surgeons that operated on the girls was a feat I feel great to have been part of. It was a very complex surgery that had to be done in stages. I derive my happiness from seeing the execution of a successful surgery,” remarks Dr Bokhary.

“I have handled some unique cases in my career, and I feel that it’s my calling to save lives, no child should have to endure life but rather every child should enjoy life” says the ever smiling surgeon.

“I remember in 2016 a pair of twin boys who were having difficulties in passing urine because their urinary openings were not well located very far from the head of the penis. I felt the boys had also have a chance to lead normal lives” chronicles Dr Bokhary.

The twin boys had previously been conjoined and were successfully separated in India three years back. “ I was presented with another chance to perform a complex surgery on the boys so that they would be able to pass urine without problems, I am happy to say that the boys are now living healthy and normal lives,” she explains. There are also cases where children are born without anal opening (imperforate anus) which we correct through surgery so that they lead normal lives.

There have also been cases of babies with double buttocks - a distorted anatomy of the back, we correct this until the normal anatomy comes back.

She has also handled cases of orchidopexy - a surgery to move a testicle that has not descended or moved down to its proper place in the scrotum.

MNH being the only referral centre with a paediatric surgical unit in the country sees many patients flocking for assistance. Life of a surgeon is not a walk in the park especially for a married woman like Dr Bokhary. “ I handle an average of between three or four surgeries a day, and at the end of the day I still have to go home and attend to my three children and husband” Dr Bokhary says she values family life very much and she tries by all means to ensure that she gives time to her children despite her busy schedule which most of the time sees her getting home at midnight.

“I am so blessed to have a husband who is so unique, understanding and supportive, over the years we have ensured that we are both available for the children. We often times synchronise our off days so that we spend time as a family” says Dr Bokhary adding that he now speaks like a doctor using medical terms after living with her for years.

She is married to Engineer Laynas Sanya who she met in Russia and the couple is blessed with three children, Ayshat (18), Laura (13) and Mary-Ann (8).

The opening up of the first ever laparoscopy centre for children at the hospital last year once again presented an opportunity for the surgeons at MNH headed by Dr Bokhary to showcase their prowess.

“Since 2018 to date we have managed to conduct 57 successful ambiguous genitalia operations at the hospital. “My team and I are striving to make this a centre of excellence in the region and even beyond. I believe we have what it takes to put Tanzania on the list of countries best ranked for doing paediatric surgeries,” remarks Dr Bokhary.

Dr Bokhary is the only doctor in her family and says being a doctor has always been her passion from a tender age. “I remember growing up I used to dream of being a doctor and I would call myself Dr Tuni” she says with a twinkle in her eye.

After completing her primary and secondary education in Tanzania she left for Emirates before proceeding to Moscow State University for her first degree in medicine. She then studied masters of general surgery at Tumaini University (KCMCo) Moshi 2007 then went to Alexandria University in Cairo for paediatric surgery.

While at Tumaini, there was a visiting paediatric surgeon from UK known as Prof Kokila Lakhoor from Oxford University who made her fall in love with paediatric surgery . After her internship from 2003 to 2004 she then worked as registrar at MNH then left for Cairo for studies then back to MNH.

In 2007 we use to do three to four surgeries in day but has since increased from 10 to 12 since we have two paediatric theatres.

“What I can tell other females is that we can and we are more than able, we have proved them wrong, women have all it takes to be good surgeons,” comments Dr Bokhary .

She is encouraging female doctors to upgrade to be surgeons as there is a very low number, low ratio of surgeons per population being at 0.4:1000.

She says women should not listen to hearsay because everything is possible if they work with determination.

She is trying her best to mentor junior surgeons to fit her shoes in the future. She says the main challenge in the health sector is staffing issue for instance there are only three paediatric surgeons and one general surgeon interested in paediatric at MNH.

They say all work and no play is not good for anyone, so in her leisure time Dr Bokhary likes to unwind by playing volley ball, going to the gym and of course spending quality time with her family and watching soccer being an ardent supporter of Yanga and Chelsea teams.

Dr Bokhary is also passionate about educating and empowering other women and participated in screening of Breast and Cervical cancer. She says The Health Minister Ummy Mwalimu is one woman she admires as she gets things done and is very confident. She also showers praises on MNH director for supporting their work.

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