figure a

“Imagine growing up in apartheid South Africa as a woman of color, wanting to do academic surgery.” This was the world in which Kokila Lakhoo began her surgical journey in pre-Mandela South Africa in the 1980’s during a time when the government was not supportive of the educational ambitions of black and brown communities. Now, as Professor of Pediatric Surgery at Oxford University, Prof Lakhoo remembers her own fight for social justice and remains one of the world’s strongest advocates for children and surgical health care providers in low-and-middle-income-countries (LMICs). She owes her early interest in medicine and social justice to her grandmother who was a community health care advocate in the hamlet (Bethal, South Africa) where there were no affordable facilities for people of color. She inculcated a strong sense of right and wrong in the young Kokila Lakhoo, who would go on to fight for the same rights for billions of people around the world as a global surgery advocate.

She completed medical school at the University of Natal in 1982 and discovered a burgeoning love for surgery as an intern. There was an immediate backlash to her nascent ambitions. She recalls, “Everybody thought I was mad… they would say ‘You have no chance… This is suicide… they won’t let you do it.” Professor Lakhoo remained resolute and pushed her case, without mentors, and with nothing but a quiet determination and her trademark resourcefulness to keep her going. This continued during her move to her first position at one of the segregated “apartheid hospitals.” She continued to face discouraging resistance to her career ambitions and was alone in her surgical aspirations. When against the odds, and contrary to expectations she fulfilled the academic criteria for admission by excelling in the part 1 exams, she again encountered resistance. During her first position as senior house officer in surgery at Baragwanath hospital (tertiary center for black and brown communities) there was a movement to reduce the number of doctors. She found herself in the line of fire. She was the only one in her cohort with the intent of becoming a surgeon and had passed part 1 of the surgical exams. It was then that her trademark tenacity shone through. She defied the insistence that she should give up her dreams and refused to leave the medical director’s office for 6 hours. She proclaimed “I’m not leaving–I want my job, because I have passed the exams and I want to be a surgeon, you have to give me the job.” Her insistence paid off when she was allowed to enter surgical training.

Her perseverance to educate herself did not stop. During her post-graduate studies, she traveled 35 km to attend lectures daily, attended extra surgical lectures at neighboring hospitals and pursued her PhD simultaneously with the grueling residency. “I did my experiments at night and weekends and took call in the morning.” After successfully completing her surgical training and PhD, she completed advanced training in pediatric surgery at Red Cross Children’s Hospital in Cape Town, South Africa, and then in Great Ormond Street in London. She completed her adult surgical training in 1989 and pediatric surgery in 1992. At the time of her completion of pediatric surgery training in 1992, she was the first qualified female pediatric surgeon and the first qualified female pediatric surgeon of color in South Africa.

Professor Lakhoo’s most impactful contribution to global health has been her role in developing pediatric surgery in Tanzania with little to no funding. She used her own funds and annual leave to help set the rudimentary building blocks of what would eventually become a longstanding partnership with Tanzanian surgeons [1]. She worked closely with the surgical team there to develop academic tools such as various aspects of scholarship and leadership. She also fostered clinical advances as well as career development alongside the local team [2, 3].

She is also a co-founder and past President of the Global Initiative in Children’s Surgery (GICS) and has been a strong advocate uplifting the voices of children and providers of surgery in LMICs [4]. She has led global efforts through the British Association of Pediatric Surgeons and provided leadership and support to the Pan-African Association of Pediatric Surgeons (PAPSA) and served as lead pediatric surgery external examiner for the College of Surgeons of East, Central, and Southern Africa (COSECSA) [5]. Professor Lakhoo believes the one of the most significant problems in the surgical community that needs to be addressed are the pervasive inequalities in the field with need for leadership, mentorship, role models, and advocacy.

In her spare time, she finds joy in making miniatures that she often gifts to her trainees.

Throughout her career, Professor Lakhoo has maintained a preserving outlook—“There are no failures in life, there are only setbacks. I hope more women and people from challenging backgrounds can be encouraged to take up surgical careers. Challenges in acknowledgement of the pioneering advances by women, especially those of color, still persist even up to now. The field still lacks sufficient workforce diversity in South Africa. I found I was able to have greater impact and career growth outside the country I trained and that remains the case for many other women globally as well.” She grounds herself in being able to separate her home (her husband and two children) and professional life, and she encourages trainees to strive for their dreams, never accept “no” and not be afraid to make mistakes along the way.