(A tree of service and endurance – rooted in Africa, shaped by light, standing for)

TSHEMBA, THE NGO THAT TAUGHT ME EVERYTHING WITHOUT KNOWING IT

A memoir of service, rupture and quiet clarity

by Paul Alexander Wolf

I arrived at Tshemba in April 2023 with the uncomplicated aim of serving, learning, and contributing whatever I could during my nine weeks in the Lowveld. I was 68 then, still steady on my feet, still curious, still believing – perhaps naively, perhaps beautifully – that when you give your time freely, you walk into goodwill by default. I had worked in rural South Africa long ago in Venda, and I thought I knew the landscape. But nothing prepares you for the Lowveld until you are standing in it, feeling its heat, its silence, its unspoken rules, and its deep, ancient pulse.

On my second or third evening at the volunteer village, load shedding plunged the entire walkway into complete darkness. My room was the furthest from the lodge, and my night vision, never excellent, became nearly useless. I walked into a Big 5 reserve with nothing but the dim torch of my phone. Earlier that day we had signed a disclaimer acknowledging that Tshemba took no responsibility for any injury or accident, which felt theoretical at the time and very real in that moment. I couldn’t see whether I was heading toward my room or toward the open bush. After nearly giving up, I stopped at the staff block and knocked M’s door, phoned her asking for help. I was told to “follow the lights”. There were no lights. It took me almost forty minutes to find my room by memory, instinct and a slightly elevated pulse. Only later did it strike me as symbolic: a foreshadowing of how small signals in an organisation can be missed even when help would have made all the difference.

Later that evening, still rattled, I messaged what I thought was the correct WhatsApp group to ask about something medically related. It landed in the wrong group. Instead of a simple correction, I received a sharp message from N. It surprised me – not because of what she said, but because of the tone. I responded (Dutch straight forward) too quickly that her message was totally unhelpful, and I apologised soon after. A small misunderstanding, but the kind that organisations under strain interpret far beyond its scale. It was my first glimpse of how brittle communication could be inside a team that otherwise carried a noble mission.

The days, however, were fulfilling. At Tintswalo OPD I saw the full rural South African clinical spectrum: febrile children, chest infections, pregnancy complications, uncontrolled hypertension, diabetic crises, asthma flares, trauma wounds, the never-ending choreography of HIV and TB, and the long, human queue that arrives before sunrise. OPD humbles you. It returns you to the fundamentals – clarity, pace, listening, compassion, stamina.

The outer clinics each had their own cadence. Dwarsloop, steady and warm. Cottondale, chaotic but earnest. And then Hlokomela – the place that felt like home. Hlokomela had cohesion, a rare kind: nurses who trusted one another, a team that worked with rhythm, and leadership that was steady and kind. Sonja Botha led with warmth and grounded competence. The HIV team, including Carissa, worked with precision and heart. Inez coordinated clinics with reliability and grace. Hlokomela embodied the best of grassroots South African primary care – resilient, human, and unpretentious.

One morning at an outer clinic, a nurse came in to assist with translation. She looked exhausted – no breakfast, no sleep, personal difficulties weighing heavily. The queue outside was long. I asked her how we could survive the day. She whispered she had no money for food. I gave her 50 rand to get something – anything – at KFC. She returned revived and smiling, and together we saw the patients efficiently. At the next Thursday meeting, I mentioned this moment. N immediately called it “bribery”. I smiled – not at her, but at the absurdity of the interpretation. Compassion interpreted as corruption is not a moral failure. It is a cultural signal.

Then came the interim evaluation. Present: N and a senior staff member, R. A vague complaint was raised from a nurse – I had “lectured” a patient. I was told I had to prove the complaint wrong. It was the first time in my career that burden of proof was placed on the accused in such an imaginative way. Then the comment: “You stand too close to people.” In truth, I stand closer sometimes because of my hearing, but I did not share that – it felt unnecessary. What struck me was R’s discomfort; she sensed the imbalance in the room. Later, the Hlokomela team leader simply said: “Nonsense.” It confirmed what I already knew: the people who worked with me daily had no issue. The tensions lived elsewhere.

One moment revealed this culture more than any other. In the small office one afternoon I overheard N and another staff member speaking dismissively about a previous long-term volunteer. “We don’t want him back.” They were referring to Dr Carl Fatti, the Cape Town ophthalmologist and skilled mountaineer who died tragically while climbing Muizenberg Crag. He had served generously and humbly. When I looked him up, my dismay grew. This was a man widely respected – yet reduced to office gossip in thirty seconds. It was then I understood: Gestalt theory operates strongly in small NGOs. If you pick the wrong details, you create the wrong picture. Culture is shaped not by truth but by perception – and perception can be astonishingly malleable inside a small room.

What steadied me later was realising that this pattern is not unique. Many of South Africa’s most respected rural clinicians – Professor John Gear, Dr Evert Helms at Siloam, Dr Pierre Jacques at Elim, and more recently Dr Ben Gaunt at Zithulele – also did not leave their posts in harmony. Not that I have any reason to compare myself with any of them, but I did know both Helms and Jacques during my time at Siloam, and even then it was clear how much weight they carried for their systems. These were giants of rural medicine, yet their departures were marked by tension, strain or quiet misalignment – not because they failed the system, but because they had carried it for too long. In South African rural healthcare, endings rarely match contributions. Cultures shift, ecosystems tighten, and even the icons eventually step away in silence. Seeing this lineage made my own experience feel less personal and more structural – part of a long, recurring rhythm in rural service.

Despite these dynamics, 2023 ended warmly. I was unanimously welcomed to return to Hlokomela later that year. Sonja supported it. Christine supported it. Inez prepared for it. John approved it after a team meeting. He also confided, almost as an aside, that the internal culture was “unhealthy” – a reflection he linked to his own history at Wits, where he eventually resigned after dynamics became untenable. I held that comment quietly; it carried weight.

Then came 2024-2025: the year everything changed. Sonja resigned – removing my strongest advocate. USAID funding collapsed in 2025 – Hlokomela lost around fifty staff. Burnout rose. A defensive organisational posture emerged. The management triad tightened. N’s influence grew. The psychological safety shrank. The board became more passive. Saying no to volunteers became the easiest path to avoiding conflict.

And so, after thirty-one months of complete absence, and a new application to serve Hlokomela under the umbrella of Tshemba, the new verdict arrived: “chemistry”, “misunderstanding”, “loss of trust”. Yet I had not been there. No interactions. No conflict. No behaviour to interpret. Their new perception had grown internally, without me. Chemistry without contact is projection. Trust lost without interaction is culture. And culture that shrinks becomes its own confinement.

I accepted the decision with dignity because I recognised what it meant. If chemistry deteriorates during absence, the story belongs to the organisation, not the individual. A culture can grow as large as its compassion or shrink as small as its insecurities. In 2023, everything aligned. In 2025, the ecosystem had changed. I was no longer a fit – not for clinical reasons, not for ethical reasons, but because internal narratives had shifted in my absence. And when a culture contracts, volunteering becomes an emotional donation larger than the clinical one.

My final email to John and Christine was warm, respectful and steady ( they are really remarkable people), I thanked them for the opportunity, wished them well, and expressed gratitude for what I had learned. Later, I sent a strategic reflection – modest, constructive, and external – on leadership continuity, organisational cohesion, primary care strengthening and partnership resilience. Why did I do this? Well, Tshemba and Hlokomela are vital entities and need to continue its purpose with a different context down the line perhaps. Christine replied with a brief “Appreciate.” It was professional. It was all she could say inside the constraints she carried. Organisations often become prisoners of the very structures they built.

I leave Tshemba without bitterness. Only clarity. I learned what I needed to learn. They will one day see what they need to see – or not. It is no longer my concern. Some experiences refine us not through harmony but through contrast. And some systems, despite their brilliance at the frontline, struggle internally in ways no volunteer can fix.

I step away with gratitude for the patients, the nurses, the laughter in the clinics, the beautiful team at Hlokomela, the quiet encouragements, the moments of compassion that asked for nothing in return, and the lessons that revealed themselves only after the dust settled. Rural clinics still wake early. Patients still queue before sunrise. Elephants still wander past the chalets. The path still disappears in the dark. But I walk forward now with my own light, steady and sufficient.

I close this chapter the same way I lived it – steady, honest and without resentment. Because some endings do not need applause or explanation – they just need clarity. Thanks, John, your legacy will stay forever with Tshemba.