Maryke Bezuidenhout checks her patient Qhamkile Gumede’s wheelchair during a home-based visit. (Photo: Thom Pierce/Spotlight)
News & Features
5th March 2026 | Sue Segar
Maryke Bezuidenhout is constantly on the road in rural, northern KwaZulu-Natal visiting and helping people with disabilities where they live. As part of Spotlight’s new Rural Health Heroes series, writer Sue Segar and photographer Thom Pierce tagged along with her.
On a sweltering Wednesday morning in Makwakwa in the far north of KwaZulu-Natal, about 20 kms from the southern border of Mozambique, a bakkie drives up to a small home in the middle of the bush.
An unlikely duo makes their way out of the vehicle. One is a tall woman, lithe and tanned, wearing short-sleeved blue scrubs with shorts. She hoists a large wheelchair off the back of the bakkie onto the ground and wheels it towards the passenger seat. The other is a man, who slowly manoeuvres himself into the wheelchair and pushes himself alongside the woman towards the house.
Maryke Bezuidenhout and Moses Mthembu are on an outreach visit to a family with disabled toddler twins who need wheelchairs. One twin has cerebral palsy, and the other has brittle bone disease which leads to regular fractures.
Today, as part of their service, Bezuidenhout, a physiotherapist and head of rehabilitation at Manguzi Hospital, is fine-tuning the twins’ wheelchair seating. “I seated them last November, but they’ve grown,” she says. “I’m also measuring one of the little girls for a standing frame,” she says.
Mthembu, who has paraplegia, is here to talk to the children’s father. Having a person with a disability in a home, he says, has repercussions on many levels, with one common problem being that “many mothers of kids with disabilities are left by the fathers”.
While Bezuidenhout goes into the house with the mother and children, Mthembu stays outside with the twins’ father. The two men talk animatedly. The dad tells Mthembu he’s spent lots of money on his children and loves them dearly.
Bezuidenhout describes Mthembu as “my wheelchair repairer and my support”. Besides helping fix wheelchairs for Manguzi’s rehabilitation department and repairing wheelchairs at the disability care centre next to Manguzi, he runs an NPO offering peer support to other people living with disabilities and their relatives.
“As Manguzi rehab, we collaborate closely with Moses’s NPO to ensure that vital peer support happens in the community,” says Bezuidenhout. “If you break your spine, you want to hear from someone in the same boat.”
A rural hero known to many
Visiting disabled patients at home is a key part of Bezuidenhout’s work at Manguzi Hospital. The 280-bed public hospital is in Kwa-Ngwanase (Kosi Bay), just south of the Mozambique border, and east of eSwatini.
The hospital, Bezuidenhout says, officially serves a population of more than 140 000, but the true number is likely higher due to the many undocumented residents and transient patients who rely on the hospital and its 13 linked clinics.
“There are just under 500 people on our system, who require routine home visits. Among them are 284 wheelchair users, of whom 231 are intermediate or advanced cases requiring our attention at least twice a year. People who require home visits could typically be the elderly, and those with conditions such as cerebral palsy, paraplegia, quadriplegia, strokes, and mental health conditions.”
Bezuidenhout and her team visit patients regularly to do a combination of physical rehabilitation, wheelchair repairs, reseating, or servicing, wheelchair skills training, and peer support.
Long, bumpy road trips through the bush
Bezuidenhout and Mthembu return to the bakkie and head off to their next appointment. These home-based outreach visits involve driving long distances along bumpy dirt roads, to scattered homesteads in the bush, often through the thick red sand which characterises this area. Both point out that it’s bad enough driving a four-wheel-drive vehicle in these parts, let alone a wheelchair.
Their next visit is to see Qhamkile Gumede, a 58-year-old grandmother with paraplegia. “She’s very independent and likes going shopping in her three-wheeler rugged-terrain chair,” says Bezuidenhout. “But we’ve had a lot of rain, and her wheelchair is really rusted.”
On arrival, the pair are greeted warmly by the soft-spoken gogo who chats to Mthembu as he works on her wheelchair. Chickens roam in the yard; there are goats nearby. Mthembu checks the wheelchair’s bearings, changes the footplate, and sorts out the brakes.
He says he learnt how to fix wheelchairs through having to fix his own. “Maryke organised training for me in Cape Town where I learnt a lot,” he says. As Mthembu sits with the grandmother, he’s quietly checking in on her and her family. “I ask them how they’re coping financially. I talk to them about hygiene. It takes time to build trust,” he says.
Mthembu’s story
Mthembu, 45, was born in Manguzi and moved to Durban for work as a young man. At the age of 23, he became paraplegic after being shot during a robbery at home in Duzuma township in 2003. “The doctor told me I’d never walk again,” he says.
He recalls his shock and helplessness when he was discharged from hospital, unable to walk, and without a wheelchair, and told the hospital could no longer keep him there. “From being a strong young man, working in a Coca-Cola warehouse, I was spending my days alone. The people I lived with went out to work. I thought my life was dead,” Mthembu says.
He moved home to Manguzi, and was treated in Manguzi Hospital’s rehabilitation unit, where he learnt how to live as a paraplegic. There, he started helping fellow disabled people. “I would share what I’d learnt about how to look after myself as a disabled person, and I’d support them on how to just be a person again.”
When he started working for Manguzi Hospital, Bezuidenhout noticed his ability to support his peers and later arranged for him to attend an Africa Spinal Cord Injury Network conference in 2018. The conference inspired him to start his NPO Siletha Ithemba – isiZulu for Bringing Hope. It now includes four parent facilitators who support mothers of children with cerebral palsy, as well as four peer supporters who work with families of people with disabilities.
Mthembu’s experience of disability is central to how he helps others.
“At first, they say to me: ‘It’s better that I die’, but I say: ‘no, life can carry on’,” he says. “They see me sitting in my wheelchair, strong and working and coping. Then their hearts become soft, and they’re open to learn.”
Looking out for moms of cerebral palsy kids
Phumlile Malaza, a member of Mthembu’s parent support team, assists the mothers of children with cerebral palsy, often during home visits.
Today, she’s also in the car to participate in a monthly support group for these moms at a local clinic. She’s brought along her 11-year-old son, Thamsanqa Ngwane, who has cerebral palsy, since he has a clinic appointment. A group of moms, sitting under a tree outside the clinic with their children let out a cheer when they see her coming.
The next visit is to an elderly woman who uses a three-wheeler wheelchair. She’s now a bit larger, says Mthembu, who will change her into a larger wheelchair. He’ll teach her some wheelchair skills and check that her environment is wheelchair friendly.
Next up is a visit to a severely disabled child with hydrocephalus – a buildup of cerebrospinal fluid in the brain – who needs to be reseated in his wheelchair. “We are also going to tweak his standing frame because he has grown,” says Bezuidenhout.
“This is a challenging case because the little boy bounces between two homesteads, and whenever I try to do this, I either can’t find him, or I can’t find his device, so he’s long overdue,” she adds.
We are greeted by the child’s grandmother who is looking after him today. She brings the standing frame to Bezuidenhout, who pulls the cover off. A cobra emerges from underneath the cover and quickly slithers away, as the women recoil. Snakes are common visitors in these parts, says Bezuidenhout, and gets to work.
23 years and going strong
A day on the road with Bezuidenhout is a day of watching her intense gaze whilst hoisting, heaving, fixing, and fine-tuning the hefty wheelchairs she works with all the time. It’s a day of watching her engage gently with her rural clients, in the local language, and on their terms. She’s prone to loud outbursts of laughter, tinged sometimes with sadness and frustration. Needs are enormous in these parts, distances are vast, and money is scarce.
Born in Pretoria, Bezuidenhout, the daughter of a diplomat, spent her childhood in Europe. The family returned to South Africa in 1994. She attended Pretoria Girls High before studying physiotherapy at the University of Pretoria.
She was just 22 when she started working as the only physiotherapist at Manguzi Hospital in 2002. “It was a small, very dedicated [rehabilitation] department,” she recalls. Twenty-three years later, she’s still there.
Bezuidenhout said that when she arrived, she was blown away by the close collaboration between the rehabilitation department and community stakeholders involved in disability care. “That was my first exposure to a collaborative approach to disability. I’d never dealt with any community health workers or traditional authority structures, and I learnt fast that there has to be lots of thinking out of the box when working rurally.”
She spent the first ten years of her career learning “the musculoskeletal stuff”, before becoming increasingly involved in policy issues. She’s done a range of courses on the practical skills of repairing wheelchairs as well as a master’s in public health, a diploma in health economics, and then courses in advanced wheelchair seating and repairs.
It’s not uncommon for Bezuidenhout to drive home from the bush at 20:00. “I’m always busy,” she says. She manages a team of more than 16 people, including therapists, occupational therapists, speech and audio therapists, as well as community service students, general assistants and wheelchair repairers.
Hustling for resources
Bezuidenhout spends a lot of her spare time at the Phumelele Mntwana Disability Care Centre, a residential care facility run by mothers of children with disabilities. She has, through the years, worked hard to help renovate the centre and is constantly hustling for resources to keep it going. She clearly loves the inhabitants. There are eight people living in the centre, each with their own story of why they cannot live at home with their families in this rural setting.
Inside the centre, Spotlight meets 18-year-old Sizwe Nxumalo, who is paralysed in all four limbs because of a severe neck-spinal injury. Bezuidenhout sits herself down next to the bed in which he is lying. She asks him about his music.
Nxumalo is in a drama group, and loves making music, particularly singing. He uses his tongue to scroll and type on his cell phone. Delighted to meet a fellow muso in Spotlight’s photographer, Thom Pierce, he plays some of his songs, sung over background music. Nxumalo is part of a disability performing arts group which organised a drama and music festival last year for performing arts groups across the Manguzi health catchment area.
Bezuidenhout starts telling Nxumalo some of the adventures of her day, including the snake that curled out of the standing frame. She and Nxumalo cackle with laughter at all the anecdotes.
Nxumalo arrived at Manguzi Hospital after spending more than a year at another hospital in the area. “They were basically treating him as a palliative patient. We decided to keep Sizwe. Within a week, we rebuilt a twelve-inch adult motorised wheelchair from bits and pieces we found lying around,” says Bezuidenhout. “That was the last I had to do for Sizwe because then he took off.” After Nxumalo returned home, he kept in touch with Bezuidenhout. “We realised that living in such a deep rural community was not conducive to his condition, and we convinced his granny to send him back to the centre.”
Standing up for the underdog
Asked what drives her, Bezuidenhout responds: “I like standing up for the underdog. I like the challenge of beating an unfair system. I like the outcomes of the work I do, like seeing somebody slowly mastering their wheelchair skills to the point where they can get into a taxi, start a business and get a family. I like seeing a mother becoming proud of her child with a disability and taking him out with everybody else.”
Outside of work, Bezuidenhout is involved in various rehabilitation driven work. This spans supporting the NGO Rural Rehab SA, to organising Manguzi Gijima, an annual disability sports and advocacy event, to her most recent project of running a campaign to provide an adapted Segway chair for a girl with paraplegia who is struggling to get to school.
She says she finds it particularly fulfilling getting kids with physical disabilities into mainstream schools and challenging the negative attitudes that keep them out.
“Although our country has a policy of inclusive education, it’s not very inclusive… A lot of children with disabilities are simply excluded from mainstream schooling and told to go to special schools,” Bezuidenhout says.
She believes that many teachers and principals lack experience with disability and then cite concerns about school infrastructure for not being able to cater to all learners. Yet, this year she managed to get a child with quadriplegia accepted into a school on condition that she comes up with a plan to have ramps built. “I’ve found the donor funding so we will start building the ramps”.
For her, the healthcare system is unfair for many reasons. “There is inefficiency everywhere in the system, with parallel processes happening all the time, and planning and implementation happening in silos. The service delivery platform is designed around what works for healthcare workers, rather than what works for the patients,” she reckons.
When she’s not working, there’s the beautiful outdoors, up near Kosi Bay, which Bezuidenhout loves to explore. She lives on the side of a lake and loves to kayak, or cycle along the dusty roads on her mountain bike. In spite of regularly feeling “burnt out” by the many rural health challenges she faces every day, she is clearly here to stay.
Note: In Spotlight’s Rural Heroes series, we tell the stories of people working at the coalface of rural health. Besides platforming these remarkable individuals, the series also aims to increase understanding of the unique challenges of offering healthcare services in rural areas.
