Dr Tlaleng Mofokeng: 'Images of Gaza gave me PTSD of apartheid'

Read the full transcript of our interview with medical doctor, author and United Nations' Special Rapporteur on the Right to Health

In the second episode of our podcast The Debrief, I spoke to the incredible powerhouse Dr Tlaleng Mofokeng who has been known worldwide for her advocacy on the right to health.

She has used every platform available to her to advocate for the people of Gaza and she explains why it is so personal to her. Spoiler: images of Gaza has invoked the trauma she experienced growing up in apartheid South Africa.

The conversation starts with how she got into medicine, takes a detour into her views on the what is happening in the world and ends with what gives her hope.

Dr Tlaleng shares why she won’t stop supporting the Palestinian cause for liberation and also how she refuels. Our favourite word of the interview: unreasonableness!

Watch the full episode on Youtube and read an edited transcript of the conversation below. If you enjoy The Debrief, don’t forget to share it to as many people as possible and make sure you are subscribed. We can only do this with your support!

Q: I'm joined today by Dr. Tlaleng Mafokeng, who I like to refer to as South Africa’s big sister. And when I was telling a friend yesterday that I was going to be chatting to- She said, Oh, it's the sex doctor that likes to talk about Gaza

T: Oh, well, yes, I'll take that fabulous title. 

Q: Thank you for joining us, your journey has been extraordinary to watch.

You find yourself now in a very, very influential and powerful position at the United Nations, advocating for universal health and access to healthcare.Why is that so important to you?

T: So I knew very early on in life that a lot of what happens to our bodies, and, you know, how well we feel, and what we can accomplish in life is very much tied to how well we are, both physically and mentally. And I think it's because I used to listen to a lot of older women,my mom and my aunt, just talk and share between themselves as women, you know, the kind of challenges that they were facing and I was just always acutely aware of what happens in the health sector [and this] often,intertwines very much with what happens socially in other spaces.

But I think of those early stories and the narration of how women were just struggling, you know, with their lives and their bodies and fertility, and all of those things. And [ it was] partly why I wanted to become a doctor. Uhm, you know, comes from the experience of having listened and heard those different challenges.

Q: The transition between kind of consulting and the practice of a doctor to becoming  a public advocate for reproductive rights, for sexual health pleasure, and then,now for this big issue, that the world has not been able to solve, which is equal access to healthcare.So how does that transition happen?

T: So then I apply of course to Nelson Mandela Medical School, in Durban, and it was a political- institution for me, and a decision that I took because- of the politics of the institution, and I knew though, that the content in the curriculum was still not preparing me 100% for the kind of society that I would be entering and the kinds of demands that that society would have on me as a doctor. So I knew that I would have to unlearn certain ways, but also learn new things, and human rights became that central core of my work and- and it became, of course, being an intern,  being a young doctor.

Q: Where did you intern?

T: At Charlotte Maxeke in Johannesburg, and then I became a community service doctor in the West Rand.  And so I was in many clinics every single day, a different clinic in the West Rand. and that was really important for me to see what community health can look like. 

Q: Did health care feature in your family? Was anyone doctors  or were you the first in your immediate circle? 

T: I was the first doctor, but I had aunts that were nurses but in terms of- medical doctor, I was the first in my family, but I think we've always had a social justice, um, commitment. My mom used to help my grandfather after he had his stroke, he had  become mute and later on cared for my grandmother who had also suffered from a stroke and for many years was bed ridden, post stroke. So I've always been exposed, you know, even knowing, about the[ health care] system's lack terms of rehabilitation and how people's lives are valued and devalued depending on physical disability versus, you know, people who are fully abled . So, I think I've always just had an inclination towards social justice, but through medicine and through understanding how powerful the  practice of medicine can be in restoring people's dignity, because, again, knowing how much indignity happens to our bodies.

Q: Did you see anyone who's- image that you wanted to replicate in your own life, or is it something you kind of traversed blind?

T:You know, in medicine, there wasn't a specialty in the traditonal sense that I could just go into, nothing was going to fulfill this deep seated desire I had to be an activist. On the one hand I still wanted to be a doctor and use that magnificent science that  is medicine, but still keep me connected and rooted within a particular community With all of my feminist principles, with all of my  unreasonableness, and I didn't find anything that was in the mainstream so I had to forge my own part and make it what it is now. This recognizable thing.and I’ve been blessed to have young people and young doctors say “ let us come in and see what you're doing. We also want more of that and we also want to lean more into that”.

[This] has led me just beyond informal mentoring to actual formalizing the mentorship and doing, you know, transformational leaders retreats all over the country, but also now on the African continent because we understand that intersection between medicine and humanities. and why it's important as doctors and healthcare workers to continue to advocate for our patients rights because our patients rights are also our rights I also am all right, and I always say to people that- there's no need to be combative with patients when they demand clean linen ,nutritious healthy food and well-built facilities because it's our healthy working environment. And so we need to work together to build and demand a health system that's good for both of us. As opposed to being combative. There are people in these positions of power and authority making decisions that are bad for both of us but we are the human face, unfortunately, we see the failures of the system- but I think for me, it's always about institutional reform rather than looking at individuals. And not the  punishment of individual doctors. 

Q: So this basically makes it hard for anyone to box you.

T: Yes! 

Q: How would you describe yourself, in one word?

T: I like to see myself as a movement builder.Because whether I’m talking about sex and decriminalization, whether I’m talking about, you know, sexual pleasure the rights of LGBTQ persons or intersex persons ,or talking about the rights of women all over the world to self determine.There is always something central about building movements, and I may not be there to sustain them, you know,but to find them and keep it moving. So I think that for me  I'm very happy with that kind of title, movement builder. And ultimately it is about dignity, it's about understanding that at the center of that we are all worthy of dignity, as a bare minimum, you know, and that for me is really important.

Q: You use the word unreasonableness.

T: I love that word. It's a beautiful word. 

Q: I love it. I love it.I  mean, is it unreasonable to fight for the causes? I don't think so.

T: And I think what's unreasonable is perhaps staying positive, right?

Q: Because the world then, very quickly, boxes you into this angry black woman narrative or  this, you know, raging feminist narrative .And so, how do you own that? The unreasonableness. 

T: It's also because I don't know how else to be. I genuinely I don't know how else to be, you know.I've had teachers ask me all throughout  high school, “ There's so many other things, but you wanted to be a doctor from the moment you worked in.Surey, you can be study other things “ and i’d say “ I'm not- No, I really still just want to be a doctor”, so I think there is that level of unreasonableness that is, of course imposed on me.

Like, people see me and  they say, “oh, you're still unreasonable after all this time.” or they're like, “oh, there you go again,”  you know? And I absolutely own it, I think it's necessary. Because, these kinds of issues we're dealing with are about Relations of people's human rights. They're about violations of people's access to education, to food, to health care, that erodes their dignity of course I'm going to be unreasonable in fighting to correct that.

Q: When people tell you, you are a lot, how do you respond?

T: Of course I’m going to be a lot. Are you kidding me? Of course I must be a lot.

Do you know how many people sacrificed? How many women walked this journey? So that I can sit here  and be a lot? That's a fabulous thing to be, that's the opportunity to be in a space where I can be all of me, I can't say what needs to be said and that's it.

Q: So you show up on this international stage, in the United Nations as a special adviser on the Right to Health and it comes with a lot of responsibility.  How is it that you show up? Are you intimidated? Are you ready, you know, getting onto that stage, what was it like?

T: So I feel like I was prepared for that moment. People don't know that I used to cause a lot of trouble in the U.N. as an activist civil society person at the time and I'd been to the general assembly In New York many times to the counsel in geneva many times as well. And I actually delivered the first statement  ever in the council on access to safer abortions on behalf of 264 organizations at the time and that was way before I became a S.R. So I was familiar with the U.N systems and how they worked. So not too intimidated, but very aware of the responsibility of the role. And so I did apply and at the time I was like “I wonder if the U.N. will you know, hire someone who's about sexual decriminalization, I am an abortion provider. I talked about sexual rights and all  of these things. And like you were saying, I'm not ashamed of it all.

I’m not shy to talk about them. And they did appoint me. And I was very clear to them even in my interviews that I would be using anti-racist, anti-colonial analysis to the job.

Q: There's a part of you that's, that's now, you know, quite glaring, which is your repentant stance on the genocide of Palestine. What is it that frames your position in the way that you want? Is it being a medical doctor? Is it your role at the U.N. What is it that led you to be so outspoken on the issue of Gaza?

T: I think this particular escalation, because it's an escalation within the chronic injustice that has been happening all along for 76 years. And there's been moments, you know, of violence, but this particular October 7th moment has really catapulted us into a world that I don't think any of us have yet quantified what it really means.

and when this happened, of course, I was in New York in mid October. And when I was doing my interactive dialogue with member states, I opened my statement with- the fact that we need to recognize that we are really in a- in a terrible- time, space and that the destruction of health care and the infrastructure Has never been seen before to that extent  and that it opens up a brand new area of the human rights violations.

Q: Which is just, sort of a cover

T: And if people cannot get to healthcare and get immediate support and services they need for injuries they will die. So part of the extermination plan initially was  to break down civil infrastructure and one of the  strongest ones  In Gaza had been health infrastructure. And the health workers themselves became the targets as individuals for that. Why I was so clear early on, people forget that some of us survived apartheid, which is exactly what's happening in Gaza. I was a child during apartheid and an adult now who lives in the democratic South Africa.

Watching what happened in Gaza, I have visceral, literal reactions that I thought were post trauma, I thought I was over the trauma and it reminded me, it took me straight back to where I grew up in QwaQwa with nyangas, those military helicopters, and It took me right there. And so I didn't need to have an academic discussion or be convinced for the next three months that what was happening , in that apartheid regime that Israel is doing, is an injustice. And this escalation was always going to give us outcomes that we've been speaking about today because it's been cautious…

Q: Or  it's too complicated. 

T: and it's not that, The apartheid, and the segregation and everything that has been done in Gaza, and remember Gaza is not a natural geographic unit

Now, where I was born in QwaQwa is also not a natural geographic unit. My people were dumped there ,so there's so many correlations between us.

Q: and given bantustans

T: And then just had to make life happen,and then when they make life happen people think, oh, well, that's fine, they can be strong. 

But it's not about  being strong or will power. It's about violence, systemic, imperialist violence, that has been allowed to continue with impunity for many years. So, the genocide was always in the making.South Africa didnt get there at this extent But that is what apartheid is. It's inherently violent- It inherently creates conditions for genocide.

And also, remember I grew up in a time where my Mandela's name was banned. You couldn’t speak about him, you couldn't sing about him, but the kind of political education that I received included part- of the fact that Palestine is also oppressed, right?And back then, the apartheid  South African defense force was sharing notes and, and practicing their weaponry and all of that with Israel.

Q: which is ironic because they had supported the Nazi’s side of the war in World War II.

T: And so the connections between the Palestinian fight for freedom for me as a black child living in apartheid South Africa can't be more intertwined. Because I couldn't say Mandela’s name but I could learn about imperialism and apartheid and violence to the Palestinians so when Mandela did become president and one of the first places he went to visit was Gaza, and I knew and understood very well, and deeply internalized very well that our freedom is not fully It’s not something I learned as an adult in the U.N. I grew up as a child watching the U.N. who even then,has dedicated this decade to the Mandela Decade of Peace. So there's a lot weaving into this present moment. 

Q: So when you go out, or to dinner parties and people say to you, South Africa has so much of its own problems with inequality, barely can keep the lights on, et cetera. Why are you picking a fight at the International Court of Justice for a country that has nothing to do with you?How do you react?

T: It has everything to do with us, The people who fought like hell fought for us, during apartheid, so that we can even sit and have this like we can this conversation, you and me.

Q: Yeah. So the fact that you are in the United Nations and I was covering the International Court of Justice at the beginning of last year at the Hague, the fact that  three black women were the leading authoritative journalists in the matter was not possible 30 years ago?

T: It was not possible. And for that it was not just a walk in the park for a few people. It was generations of people, it took so much determination from people, people that you’ll never even know by name. And so because people fought like hell for me in QwaQwa and they didn’t even know me,I have a responsibility to also fight like hell for Gaza.They may never know me, it doesn't matter.

It’s that injustice is injustice. And when you know about it, you have a responsibility to do something about it. And of course, there's a lot going on in the world,and people say we could have taken a stance on many things but we took a stance on this one. And so when others see others, it's up to them to take a stance as well but  it's important for many reasons. It's important for my own history, important as a country, and for us, as the global community.

It’s also important for the future of the world that we know we deserve. We may not be there yet- But we know we deserve and that hope, that sense of what if there is something better.

That's what makes us then take the stand. And we must take this stand.

Q: So I want to get to hope in a second, when you look at all of these developments in the world, around how there's no attempt to hide the injustice anymore.does it scare you?

T: It does and that then speaks to power and how people in powerful positions, and I mean political power, social, capital, economic power- will misuse it when they know that there is no consequence.Or when they know that the people they are abusing, there's no one who's going to stand up for them and because  everyone will just  look away and be too busy with their own lives. And that's why the ICJ is very important, it's a signal. It's a first step to correct the impunity and injustices of the past. It's for others to also put on the next step And the next step, until the whole road is paved, but we have to start with the Laying of the first brick.

And so that's what all of these moments are.

Q: Does it not feel sometimes that the brick is so small in comparison to the size of the house that needs to be built?

T: That is true but then for me what's the alternative? you know and so you move

Q: Does the world scare you?

T:The world is full of promise and bountiful and it's never going to be enough for all of us, but I think what scares me are the people who are in these institutions making decisions on behalf of all of usThat’s what scares me.

Q: What keeps you up at night?

T: I think sometimes the feeling that we are and I am an individual taking on entire systems and there is a sense, and a truth, that things don’t move fast enough. We didn't stop the bombs in Gaza for more than 450 days, you know and that for me really keeps me up.So that really is something that I have to remind myself that  I'm just a person, you know, trying to take you on all of these systems.And I think that reminder is important, because it can get a bit suffocating a little bit, you know, and overwhelming to be like there is all of this that needs to be done. 

Q: Someone said something interesting to me the other day, they said you have to separate your fight for justice to the outcome of justice and this is  because you have no control over that. So whether that justice happens today or tomorrow or next year. You, you have to stay committed and see it through. 

T: I mean, there've been many people who are committed, you know, I am, exceptionally committed to mental health In case of journalism and what cyber misogyny and online harassment has done to effectively threaten media freedom. But there's a point in which you- you have to kind of recoil =, and this happened to me last year where, I was completely and utterly burnt out and my Commitment to journalism or my commitment to the industry and how i could relate to my colleagues was superseded by the fact that I was completely burnt out. So how do you navigate  around this monstrous task versus what your needs are?

T: So I'm always very aware that the work mustn't make me so jaded.

That I'm unable to receive or even experience joy. So I'm intentional about creating moments of joy in my life. I schedule joy in my life.

Q: And how do you do that?

T: By spending time with my family and my kids and creating very specific moments with specific friends for specific activities, you know, but I don’t schedule hikes because I don't have land so why would I hike?

Q: It's tough. you get to that point where burnout is not cute anymore and then you actually don't even know where to start in the future In getting help. And so that's what makes me consider the trope of being that, you know, like an angry black woman, or that raging feminist, how much of it is just giving of yourself and where do you find safe spaces?

T: I think for me with those labels, It's part of patriarchal and misogynistic. I think it's lashing back, right? And so I don't spend too much time engaging with those labels because genuinely there is a lot to be actually very angry about.so the fact that When I speak about the issues I speak about you think I'm an angry black woman?

Well, how else will I be in this world, but as a black woman, how else will I be except angry, Except dissatisfied, absolutely enraged with fury. And so people used to think in the U.N.that when you show  emotion it  means you are not diplomatic enough or maybe you’re not used to this. So when we do the press release  and we hear of how women and children are being slaughtered. Doctors are doing x-rays and they're finding bullet fragments in children's brains. If you don't think my press statements should be literally full of rage and fury then what am I doing here? These are people's lives. So for me we have to be honest with the fact that a lot of what we do is weaponized against us and those same people will demand activism from you when now it's them experiencing something. And I always say to people, don't wait until something you are affected by  individually.I don't know go through the  things I advocate for. Or that I fight fiercely for it to have affected me personally. 

And so we have a lot to be angry about, there is a lot to do, and so we must be aware of that at the same time of the silencing, the shaming, all of the name calling is for the purpose to distract you from taking on the misogyny, taking on the patriarchy and the racist tropes of what it means to be a black woman who's in the position of proximal power and to remind those who are in power to do the right thing because I am not the one in power as a black woman i only have proximal power, im just close enough to it to demand the things that I know need to be demanded.

And so reading myself, I had to get rid of the crown and it was so liberating because I demand humanness from myself. I humanize myself so when I'm tired, when I'm thirsty, when I'm hungry, when I'm nervous, I allow myself to say that, and tell people next to me, Actually, I am very  nervous for this speech today. And they go “really?” And then I go “ yeah” because they need to see me as human.

Not as a machine, you know. So i say I'm actually very exhausted today and this call has to be t- minutes shorter because I'm really exhausted and people just have to accept that we are not machines just because we're committed to a cause, that doesn't mean that we must dehumanize ourselves but also allow us to do that. So I am very intentional about reminding people that I'm also human. 

Q: If you could give advice to a young South African woman who wants to walk in your footsteps particularly, maybe not exactly your path, but in the path of marrying purpose to advocacy and activism. What would you tell her? Say it was a younger version of you, what would you tell that person? 

T:I'd say read as widely as you can, and immerse yourself In poetry and arts and music, because those things are important, they tap into a different part of your brain as well.

And when you feel you are whole- enough, then come out and give. But I think don't rush. Take the time and I would say find your tribe. Sometimes you have to make, you know, your tribe.

Q: And finally, what gives you hope? What is the thing that keeps you keep on?

T: I think it's not in fact that no matter how difficult it is- times may seem and often feel- that they will get better. Like, there isn't a thing that doesn't have an end point, whether it’s joy, or  sadness has an end point and I think. that keeps me going. Knowing that even if I did nothing, the world would resolve itself. But now that I am here and I am able to do something I hope that we can get to justice quicker, that we can get to a sweet spot quicker.And that's just what gives me hope.

Q: Thank you so much for what you do and the work that you do is absolutely important, absolutely inspiring but it’s more than that. Thank you so much for being you, I really mean it. I'm not trying to be facetious here. I appreciate it. I think that so many people in the world appreciate it.So many in South Africa appreciate it and I'm leaving this chat with one thing- unreasonableness. Thank you so much for being here with me and for all that you do.