Dora Nginza doctor aims to heal unseen scars

Personal loss has led to professional growth for a 29-year-old Dora Nginza hospital psychiatry registrar, who has opted to pour her expertise and experience into healing the unseen scars of mental illness.

Dr Nokwazi Mtshengu’s research — involving the translation  of a globally accredited psychiatric tool to assess post-partum depression into isiXhosa — is expected to make a real difference to patients, whose home language is not English.

Worldwide, post-partum depression affects 15% of  mothers after childbirth.

It is a significant public health problem in SA, where the rate among women in relative poverty is three times that of high-income countries.

Mtshengu and her colleagues at Dora Nginza often assess illiterate patients who only speak isiXhosa.

Through her  work at Walter Sisulu University, the MMed researcher aims to render the English medium Edinburgh Postnatal Depression Scale questionnaire understandable to patients.

Mtshengu said the diagnostic instrument and the more general depression diagnostic tool, the Mini-International Neuropsychiatric Interview, are fraught with difficulties in terms of patients’ understanding and self-reporting.

For this reason, her MMed research aims to translate and render the depression scale questionnaire more understandable for her patients, enabling more accurate diagnoses of depression and prompter referrals.

Her research caught the attention of Discovery, which through  its independent trust — the Discovery Foundation — awarded Mtshengu and 41 other medical specialists grants to the value of R27m last year.

“My team will check responses against the English version for reliability of scores and test-taking behaviour,” Mtshengu said.

“Work in SA has mainly been focused on cross-cultural validation, reliability, specificity and correlation to diagnostic manuals — it’s unclear to me why a translation took so long,” she said.

Perinatal depression (which encompasses prenatal and post-partum depression) often goes undetected.

This gave raise to another passion for Mtshengu — helping to educate families and patients’ support systems.

“Families typically live with the patient, so their inclusion in the management plan is important,” she said.

“They can become an extra set of eyes to notice early warning signs of relapse and minimise the risk to the baby and mother,” she said.

Mtshengu expects her work to help improve identification, referral, proper diagnosis and treatment.

The Flagstaff-born doctor said her ability to persevere in the face of difficulty — an attribute to which she credits her late mother, Sylvia — had stood her in good stead in her career.

“With my mother’s passing, the consultants I was working with at Grey’s [hospital in Pietermaritzburg] were supportive — I could not function optimally and missed several days.

“It probably contributed to me leaning towards psychiatry and a therapeutic direction,” she said.

“This specialisation is a privilege — it’s the ultimate opportunity to help others.

“I love working to improve the mental health care of all people in their most vulnerable times — and addressing the associated stigma.

“People can be overlooked and stigmatised, because the scar is often not physical.”

Since 2006, the Discovery Foundation has invested more than R230m in training and support for more than 400 medical specialists and institutions.

The grants support academic research and clinical science, sub-specialist training, rural medicine as well as programmes to develop public health-care resources.