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Dr Fundile Nyati reveals some of the greatest leadership lessons we can learn from the life of the late Professor Mochichi Samuel Mokgokong (13 August 1952–24 January 2024)

I was faced with a heart-breaking realisation back in 2021, in the middle of the COVID-19 pandemic and almost a year into the massive loss of life that was experienced locally and globally due to the complications of that zoonotic (SARS-Cov-2 germ) driven pandemic, which began in China, and soon engulfed the whole world. It was then that I was faced with the heart-breaking realisation that many South Africans had passed on without their inspirational success stories being recorded in their own words, for future generations to know about the positive impact and rich legacy they had bequeathed to humanity. I was thinking specifically about the many individuals who had achieved great things in our field of medicine and, indeed, in healthcare in general, some of whom were pioneers in their respective professional fields.

The above realisation prompted me to identify some of those #HealthIcons who were still alive and either already in retirement, or about to retire. I drew up a list and decided to approach them one by one. I subsequently began to conduct two-hour-long #LegacyInterviews with these individuals in an attempt to preserve their powerful, inspirational stories, ensuring that they were narrated from the horses’ mouths. The interviewees were ultimately faced with the question of “how would you want to be remembered, once your Creator recalls you from Mother Earth?”

One of the first #HealthIcons I approached granted me a two-and-a-half-hour interview #LegacyInterview: this was Professor Sam Mokgokong of the ‘Mpho and Mphonyana’ Craniopagus Conjoint (head joined) twins marathon pioneering surgical operation fame from back in May 1988. Prof Sam Mokgokong was part of the Johannesburg Baragwanath Hospital’s (now named the Chris Hani Baragwanath Academic Hospital) high-powered pioneering team of top SA neurosurgeons led by Dr Robert Lipschitz, collaborating with another top team of neurosurgeons across the Atlantic pond in the United States of America, which was based at the world-famous John’s Hopkins Hospital, and led by Dr Ben Carsons.

When the sad news of the passing of Prof Sam Mokgokong was announced on the morning of 25 January 2024, there was a massive outpouring of grief here in South Africa, across the African continent, and indeed across the world. During his 71 years and seven months of life—and as the first black African neurosurgeon in South Africa and Africa—he had left a huge legacy through the positive pioneering impact he made by serving humanity, in addition to replicating himself by producing more than 20 black neurosurgeons as well as many more across all race groups in South Africa. Of this impressive number of young neurosurgeon proteges, Prof Mokgokong was most proud of the fact that he had nurtured into full bloom the first, third and fourth black African female neurosurgeons.

As a person who was privileged to sit down with him to capture his reflections on his life for over two hours in the comfort of his home in Wapadrand in Pretoria East, I feel compelled to share a bit about leadership and the character lessons that his rich, inspirational life has bequeathed to current and future generations of South Africans, Africans and people all across the world. I will attempt to select a few of his greatest leadership lessons that I recognised from the #LegacyInterview, with the hope that we can appreciate the hurdles he had to navigate along his life journey as he rose to the top as a pioneering black neurosurgeon, and this as a time during the height of the “total onslaught” Apartheid era in South Africa under then-President PW Botha.

#SpiritualIntelligence

In the 1950s, Prof Sam Mokgokong grew up within a highly educated and staunch religious, spiritual Mokgokong dynasty in the Lutheran Church, Christians-only rural village of Makotopong in the Northern Transvaal (now Limpopo), just north of Pietersburg (now Polokwane). His grandfather the Lutheran Rev Ephraim Thibedi Mokgokong was a former teacher turned reverend and a commercial farmer, and together with his wife they ensured that the young Samuel and their other grandchildren read the Bible everyday before bedtime… and at the local school, the first lesson of the day was religious instruction.

So it was that the young Samuel imbibed the biblical lessons from his very strict grandfather and grandmother, and the spiritual and religious values he learnt from that early stage of life would heavily influence his approach to life in general, and indeed his professional leadership in particular. He was acutely aware that he had a life purpose he was destined to fulfil, and hopefully within the biblical 70 years of life, as a minimum (Psalm 90:10).

He was a man of strong faith and conviction, with a high Spiritual IQ, something that nowadays is seen as being very important among leaders, and beyond the intellectual/rational intelligence (IQ) and Emotional Intelligence (EI/EQ), the latter as espoused by Daniel Goleman in his best-selling book titled “Emotional Intelligence: Why It Can Matter More Than IQ”.

#ServantLeadership

As the first black African to qualify as a neurosurgeon in South Africa back in 1987, Prof Sam Mokgokong was acutely aware of the burden of being a pioneer who had to represent the aspirations of the countless people who looked upon him to ensure the opening of doors that had previously been deliberately closed to black people (Africans, Indians and Coloureds) based on a warped mindset that was convinced that these groups did not have the mental capacity to qualify as medical doctors, let alone have the potential to aspire to the lofty heights to be trained towards qualification to operate on the human brain (and spinal cord!). Such delicate organs of the human body were believed to only be within the medical capacity and prowess of medical experts of European or Caucasian descent, as only they were uniquely gifted with the mental prowess to qualify and practice in such “fine arts”.

From Day 1 after qualification as the first black African neurosurgeon, Prof Mokgokong committed himself to ensuring that he worked exclusively in the public health service, serving the majority of South Africans and Africans who could not afford the professional fees he could have charged his patients if he had worked in the Private Health Sector, thereby serving only those privileged individuals who could afford to be members—or dependants of members—of medical aid schemes.

He was a man on a mission when he took over the reins as Head of the Department of Neurosurgery at Medunsa (Medical University of Southern Africa, now named the Sefako Makgatho Health Sciences University) in Ga-Rankuwa, north of Pretoria, and later at the University of Pretoria at Steve Biko Academic Hospital. His mission was to systematically disprove the notion that the field of neurosurgery which previously had been closed to blacks was, in fact, not the sole preserve of white medicine men (and some white medicine women!). He set himself a target of producing as many black neurosurgeons as possible in order to prove that it was not a fluke when a black person qualified as a neurosurgeon but, rather, was something that was attainable for intellectually gifted black people who were motivated and committed to working hard towards the realisation of their professional dreams.

During the time he was Head of Neurosurgery at the University of Pretoria, working at the Steve Biko Academic hospital, he came up with a novel idea to decentralise access to neurosurgical professional skills by identifying the Tembisa Hospital and Kalafong Hospital as feeder hospitals that needed to be empowered to perform some of the neurosurgical operations that previously could only be performed at tertiary level at Steve Biko Hospital. That decentralisation programme is still in place today, providing improved access to these highly technical neurosurgical operations at secondary hospital care level.

At the ripe old age of 68—post-retirement age!—he was approached by the Limpopo Provincial Health Department and the University of Limpopo to accept a short-term contract to provide his leadership and professional skills to the Limpopo Provincial Polokwane/Mankweng Hospital Complex (PMHC)… and for two years he served people from the community that gave birth to him as a form of giving back through his specialised skills. Serving the people of Limpopo (previously Northern Transvaal) fulfilled him greatly, despite the physically challenging toll on his body of driving from Pretoria on a Monday and coming back to his home in Gauteng that Friday.

Prof Samuel Mokgokong was acutely aware that being a leader—especially a pioneering leader—placed him in the almighty position of serving others, and through recognising and taking on that life purpose it was a role he executed brilliantly. He received multiple recognition awards for his servant leadership role, for example from Medunsa/SMU, the University of Pretoria (his Alma Mater), the University of Natal (now the University of KwaZulu-Natal), and the Health Professions Council of South Africa (HPCSA), an organisation which he led with distinction as its President, and in so doing leading the profession and protecting the public.

#BuildingNextGeneration

In the leadership books, various writers have opined on the task of creating the next cohort of leaders. Gwen Ifill once said “we can’t expect the world to get better by itself. We have to create something we can leave the next generation”. Another writer, Daniel Lubetzky, said that “we all have a responsibility to try and make this world better, whether it’s through work, the causes we champion, the way that we treat people, or the values we impart to the next generation.”

A relevant quote on gender transformative leadership comes from the late Ruth Bader Ginsburg, who once said that “women will only have true equality when men share with them the responsibility of bringing up the next generation”. Janelle Monae also opined about the leadership burden towards the next generation as follows: “I always think about the next generation and creating a different blueprint for them. That’s my goal: to let them know there’s another way”.

I have carefully selected and referenced the above quotes to highlight the fact that, in leadership, there is a huge weight of expectation to create the next layer of leadership that can replace one, and go on to achieve even greater achievements than oneself. Prof Sam Mokgokong clearly understood that automatic transformative mandate, and in our interview he was mindful of that mandate, not to mention very happy that he had executed it to the best of his ability.

#RisingAboveRacialPrejudices

Prof Mokgokong grew up, succeeded and made breakthroughs on numerous professional fronts at the height of Apartheid, which was how he experienced first-hand the ways in which that system was successfully designed to squash the realisation of the potential of black people in the field of neurosurgery, as well as across most disciplines of medicine.

He had applied and was admitted to do a medical degree at both Wits University and the University of Natal, but he chose to go to the relatively newly established medical school for ‘natives’ in Natal because he couldn’t bear to be part of a medical training system through which black medical students would be barred from training in wards that had white patients.

During his post-graduate training and participation in the Colleges of Medicines of South Africa (CMSA) examinations as a neurosurgeon in training (registrar), he believed he was deliberately failed twice in his first part examinations, and once in his second part exams, largely to frustrate him as an ambitious black person who wanted to break barriers into a world that had been preserved for white people.

Despite the bad racially motivated experiences he encountered during his march to qualifying as a neurosurgeon, he understood that not all white people espoused such racist agendas. After all, he owed admission for his training in neurosurgery at Medunsa to one Professor Joubert who, when Mokgokong approached him requesting a posting as a registrar, Joubert admitted him on the spot to undergo the lengthy training.

Another example was when he qualified as the first black neurosurgeon in 1987, it was Prof van Rensburg (Head of Neurosurgery at the University of Pretoria) who recruited him, only for the Hospital Superintendent to thwart Joubert’s effort at creating a diversity within the department. Based on the strong belief that Prof van Rensburg had in the newly qualified black neurosurgeon, he subsequently canvassed his colleague, Prof Ronald Lipschitz, who was head of neurosurgery at Wits University based at Baragwanath Hospital, to argue Mokgokong’s case for admission. Prof Lipschitz welcomed Mokgokong in as a junior neurosurgery consultant in his own department and, a year later in 1988, Prof Sam Mokgokong was part of that groundbreaking marathon neurosurgical operation to separate Mpho and

Prof Sam Mokgokong went on to successfully lead the Neurosurgery Department at the Medunsa/Ga-Rankuwa Hospital, and later would head up the Neurosurgery Department at the University of Pretoria’s Steve Biko Academic Hospital, in so doing completing a full circle considering that he had been rejected there based on the colour of his skin decades earlier.

While Prof Sam suffered many hurdles due to the then-prevalent racial prejudice policies of Apartheid in South Africa, the biggest breakthroughs in his professional career were achieved thanks to the efforts of some enlightened white colleagues, who had the courage and conviction to stand up against the reigning conventional “wisdom” that claimed that only white people had the capacity to perform higher medical functions… and in so doing the previously closed doors started to open for people of colour.

As such, during his long career as a leading black neurosurgeon, Prof Sam Mokgokong chose to emulate the leadership qualities of our founding President, Nelson Rolihlahla Mandela, who helped to build a new South Africa by bearing no grudges against people from the white community: instead, he fostered unity and reconciliation, despite having personally experienced enormous past injustices.

#LeavingALegacy

Being a staunch Christian, Prof Sam Mokgokong tried to live his life as close as possible to biblical teachings, and he truly believed that a human being’s average lifespan should be at least 70 years (anything above that was an unexpected bonus!). He was also on a professional mission to leave a positive legacy when his time came, and he indeed was able to work professionally until 70 years of age.

During his #HealthIcon legacy interview I asked him what contribution to humanity he might be remembered for, he proudly answered with the epitaph:

“He had a great sense of pride about the following achievements:

He taught and produced more neurosurgeons of all races than any of his contemporaries.

The discipline of neurosurgery was no longer unattainable to black South Africans, thanks to his pioneering lifetime work, during which he broke many artificial barriers, having chosen to ‘stay and train’ others in the public health sector, linked to academia. He influenced other academic institutions in South Africa to produce more neurosurgeons, than before.”

To quote Vitor Belfort, “legacy is not what I did for myself, it’s what I’m doing for the next generation”, so this was Prof Sam Mokgokong’s motto as he set about executing his pioneering work.

“From a gender transformative perspective, he produced the first, third and fourth black women neurosurgeons in South Africa, diversifying a previously white, male-dominated discipline of medicine”.

In conclusion, based on the two-and-a-half-hour-long #HealthIcons legacy interview that I conducted with Prof Sam Mokgokong, I could have written many more pages about him, highlighting more leadership and character lessons from his professional life. Perhaps a book will be a better platform through which to honour his life, his work and his legacy, but for now an article in an esteemed magazine is a small way to honour this giant of a man.

Follow Dr Fundile Nyati on ”Dr Fundi’s Health Matters Podcast

By Editor