This autum graduation season, Gwaha Madwatte has two achievements to celebrate: obtaining a master’s in Anthropology from the University of Pretoria’s (UP) Faculty of Humanities and becoming the first UP recipient of the Wenner-Gren Wadsworth African Fellowship.

The $20 000 (about R373 000) fellowship provides funding for African students pursuing a PhD; the students also receive international-level training in anthropology.

“I am still in shock,” says Madwatte, who hails from Nigeria’s Adamawa State. “I am still processing the fact that I have been awarded this prestigious scholarship, and being the first at UP makes it even more mind-blowing. It is such an honour and privilege to walk the path of many great anthropologists who have been recipients of this stellar award.”

Madwatte adds that the award has opened up “a world of unimaginable possibilities”.

His academic journey is not a conventional one. Madwatte started off as a scientist, having completed a Bachelor of Science in Natural and Environmental Sciences at the American University of Nigeria. Afterwards, while working as a research assistant, he met a medical anthropologist who inspired him to look at public health and health systems research from a social science perspective.

“Social science research produces rich contextual data, especially anthropological research,” he explains. “This led to my decision to do an honours in Anthropology at the University of Western Cape in Cape Town, in 2020. I was sponsored by the Mandela Rhodes Foundation. My honours research explored the extent to which capitalism influenced the experiences of healthcare workers during the COVID-19 pandemic. I took it a step further during my master’s, which was funded by the Mastercard Foundation Scholars Programme at UP; my research explored healthcare workers’ duty to care and the praxis of ethics.”

In his thesis (titled ‘A praxis of policy: Negotiating the ethics of a duty to care among healthcare workers in Gauteng, South Africa’), which was supervised by Professor Fraser McNeill, Madwatte explored the self-image that biomedical and nursing practices have portrayed over the years, which is one of strict adherence to protocol and ethics. He argues that these professions pride themselves on rigid ethical codes that inform their practice yet that fail to provide a habitat for those codes to be enacted in reality.

“My work focused on healthcare workers’ praxis of biomedical ethics in a healthcare system that has been ravaged by structural challenges evidenced by poor management, and shortages of biomedical supplies, staff and equipment,” Madwatte says.

Within the context of these challenges, his research explored the practical rationalities of everyday decision-making to ensure that care is achieved.

“My findings showed the contextual and ever-changing nature of ethics,” Madwatte explains. “It became clear to me that for care to be achieved, certain practices that involve improvisation and negotiation are inevitable, given the working conditions of healthcare workers.”

According to his findings, healthcare workers often have to localise ethical codes as they improvise and negotiate in order to get patients to a healthy state.

“I found that while the actions of healthcare professionals may appear unethical from the bioethical fundamentalist’s viewpoint, healthcare workers mostly perceive such situations less as a deviation from pedagogical bioethics but as a praxis of them.”

He adds that interestingly, despite the rigid ethical code, no two healthcare workers practise ethics in one way. Yet despite this multiplicity, the practice of ethics is not fragmented, but hangs together through the outcome it produces: healthy patients.

“My work amplified the voices of the many superheroes in hospitals who continue to strive to provide care regardless of working conditions,” Madwatte says. “It emphasised the need for the fundamental bioethicist and health policymaker  to consider the local worlds in which patients and practitioners live, worlds that involve inadequate distributions of resources, as this impacts the praxis of ethics.”

Madwatte is now focusing on making progress on his PhD thesis on hospital process, patient autonomy and the logic of care. He looks forward to immersing himself in intellectual spaces that will create opportunities for growth as a young academic.

“We’ll see what the future holds,” he says. “I believe there are boundless possibilities that will come my way. While I wait, I plan to take it one day at a time, making today matter.”