Deeply saddened as we in the South African health community were by the loss of Professor Jerry Hoosen Coovadia on 4 October 2023, I reflected on what he had come to mean in my medical career and in my life.
“Prof Jerry”, as we called him, was an internationally renowned South African paediatrician, public health and justice activist and clinician scientist. He made a lasting impact on child health, the response to HIV in South Africa and the region. He died, aged 83, at his home in KwaZulu-Natal, leaving his wife, Dr Zubeida “Zubie” Hamed.
What stands out for me is his principled, pragmatic and compassionate approach to paediatrics and child health. And then how these principles were brought to bear in response to the HIV epidemic.
In 1988 I found myself working to repay a government bursary at the quaint but very busy Eshowe Provincial Hospital in northern KwaZulu-Natal. There were three of us fresh new medical officers who, guided by a few key and wonderfully committed specialists, worked day and night in the emergency unit, outpatients and wards of this bustling public sector hospital serving rural communities.
Those “bush doctoring” days were some of my most fulfilling and exciting. It was satisfying to be carrying out emergency medicine or administering anaesthetics on two out of three nights. At the same time it was terrifying to put the mostly theoretical information we had gained in the last seven years to urgent and critical, practical use.
Paediatrics was no less terrifying than surgery or obstetrics. But we had the wonderful duo of Jenny Chapman guiding us in paediatrics and John Larson in obstetrics and gynaecology, and a library of important manuals and textbooks in the hospital boardroom.
Jenny, who was one of the most dedicated and caring paediatricians I have ever met, simply swore by Prof Jerry, his books and his teaching. I had not yet met Professor Coovadia in person, but I certainly came to intimately know his textbook (as I recall mine was a green version, much dog-eared and underlined) and his teachings not only at medical school but then under Jenny’s tutelage.
What set this book, Paediatrics and Child Health, apart was how it so practically but compassionately spoke to our setting and the African child. It dealt with the dilemmas and quandaries we faced daily in getting the best care to every child with our constrained resources. Jenny also taught me that it was wise to call and consult when the dilemma needed more than one opinion. And no opinion was more important than Prof Jerry’s.
When I later had the great good fortune to meet Prof Jerry in the 1990s as the HIV epidemic was taking off in KwaZulu-Natal, I was thrilled to discover the author was just as I had imagined him from his book: principled, passionate and pragmatic.
Throughout the next decade, our paths crossed frequently as we all took up the business of getting lifesaving HIV treatment to Africa. This meant building clinical evidence, writing guidelines and taking to the streets and courtrooms as activists. His resolute and strong stance against AIDS denialism was critical and inspiring.
Jerry Coovadia: the South African doctor who led the fight against HIV in children
With the end of the denialist era, from 2008 onwards, Prof Jerry’s wisdom continued to be greatly valued. I always enjoyed hearing his opinion or proposed solution to a challenge. True to his nature, the proposal first and foremost had the child, the patient, their family and their community at the heart.
Thereafter, it was carefully considered with the known current evidence available and finally it was pragmatic and feasible in our setting and considerate of the primary health system.
That opinion was always delivered with a quiet but firm voice and his active eyebrows and ready smile providing the right amount of emphasis and exclamation. A recent interview that captured Prof Jerry so wonderfully quoted him as saying “be true to science and kind to patients”, an instruction that should be given to every healthcare professional as they embark on their careers.
Prof Jerry was, and remains, an inspiring model.