A website and app dedicated to C-section training? Dr Liesl de Waard's goal

However, in a country with high numbers of necessary C-sections, hospitals have little or no option but to let junior doctors conduct them, too often with little supervision.

Dr De Waard says maternal mortality associated with C-sections has improved over the last decade but remains unacceptably high at three times that of vaginal deliveries.

She agrees that a blended learning approach is the most pragmatic and is fervent about teaching medical interns the best evidence-based C-section techniques, including how to handle emergencies, as early as possible in their careers.

"The procedure itself is pretty simple, as long as nothing goes wrong, but we have big volumes to work with. We don't have an option but to let juniors do it, but I think we can improve things. In my career I've often thought, if only I'd known this from the start!"

Her Discovery Foundation Academic Fellowship Award will cover two years of developing and implementing a caesarean section training programme at Tygerberg Hospital, using researched educational strategies, online learning, simulation, and hands-on procedures.

Grant allows dedicated research

"This grant will give me more time, and I can use it to pay someone to cover some of my clinical responsibilities, so I can get on with software development. I hope to create a website and mobile application dedicated to C-section teaching," she enthuses.

Dr De Waard qualified as a specialist in 2015. One of the most energising pit stops on her journey so far was a three-month sojourn in Amsterdam as a registrar in obstetrics and gynaecology during an exchange programme with Stellenbosch University.

"A Dutch trainee and I swapped homes and jobs. It wasn't easy adjusting to a different health system and language, but it turned into a great experience. I had a consultant on hand whenever I did a C-section, something fairly unfamiliar here," she says.

She was first attracted to obstetrics and gynaecology as an intern. A registrar who guided her at the time, Dr Marlena du Toit, was passionate about teaching C-sections and modelled how a dedicated individual can influence learning.

"I actually did my first C-section as an intern, which she facilitated. It's amazing to be part of the miracle of new life. When it's indicated and you can save the life of a baby or even the mother's, it's a privilege to be entrusted with such a task," she says.

The real tragedy? When a mother dies

"I think the worst part of this work is dealing with the loss of a mother's life. Any loss of life is sad, but when a pregnant woman or somebody who's just had a baby dies, it touches everybody and impacts communities. For me that's the real tragedy. One of my patients had twins and died five years ago. The dad had to go home with two babies. It's stayed with me ever since," she confides.

What gives her the most pleasure is the variety of tasks she can perform at Tygerberg: teaching, research and challenging clinical work. What inspires her most and gives her hope is the resilience of the people she works with who never stop caring for women who entrust them with their lives and those of their unborn children.

Bringing global knowledge home

Born in Johannesburg, she grew up in Barberton to primary school teacher parents who taught her that teaching was a calling. Dr De Waard graduated at Pretoria University in 2005, did her internship at Tygerberg Hospital in Cape Town and completed her community service at Oudtshoorn Hospital. She returned to Tygerberg Hospital as a medical officer. In 2009 she worked for a year in Navan, near Dublin in Ireland, gaining more invaluable experience.

She's married to Dr Chris Muller, a statistics lecturer at Stellenbosch University, whose continued support and encouragement, she says, keeps her and their family going.

This article was created for the 2021 Discovery Foundation Awards and has been edited for the Discovery Magazine.