By Jonah Mungoshi
Introduction
Egnes Makwabarara’s life is a story of compassion, dedication, and unwavering commitment to public health. Her career, defined by groundbreaking achievements and selfless service, is a testament to the transformative power of leadership. One day in November 2023, this dedication was captured in a heartfelt message from one of her managers, shared with the entire UNICEF Zimbabwe team:
Dear Colleagues,
I would like to share an incredible story of how UNICEF colleagues support the wellbeing of women and children every day. Today that colleague was Egnes Makwabarara.
This morning as Egnes arrived at the office, the health team received an SOS call from the main gate pleading with Carol and Mr Mkandla, Safeguard Office, for someone to come and assist a young mother who was in labour and striving to get to Mbuya Nehanda Maternity Hospital located in the Parirenyatwa grounds to deliver her baby but did not manage.
Egnes went into action. She asked Judith to bring any supplies to aid delivery from the office, and they both ran to the gate. Egnes delivered the baby that had just popped out, she cleaned the baby with bare hands, and the baby boy immediately let out an emotional cry as she finished off the delivery process with the assistance of the ambulance crew that by then had arrived from MARS. Fortunately, the MARS crew had the needed gloves, chord clamps, and a blade, which helped to finish off delivery of the placenta successfully.
The bouncing baby boy was snuggly wrapped in one of our UNICEF linen samples (green from Kingsport), and the mother was made comfortable by changing her soiled clothes and promptly wheeled into the ambulance and taken across the road to Mbuya Nehanda Maternity Hospital for admission.
Egnes will be following up with the hospital to provide the necessary baseline information for the mother and baby. Donations to welcome the baby are most welcome!
Colleagues, please join me in congratulating Egnes and commending her for the wonderful act of helping bring a baby into the world, today. A big thanks also to Carol and Judith for assisting her.
Best wishes,
Zeinab Adam
Deputy Representative, UNICEF Zimbabwe
This extraordinary event captures the essence of Egnes’ career: a leader who does not hesitate to take immediate action, even in the most unexpected situations, to ensure the wellbeing of others. Her story goes far beyond this act of heroism, spanning decades of dedicated service to public health and profound impact on Zimbabwe’s healthcare system.
Roots of Resilience: Early Life and Education
Born in 1961 in Highfield, Harare, Egnes grew up as the second of seven children in a family that exemplified discipline, perseverance, and a powerful sense of community. Her father, a manager with a deep passion for football, played a significant role in shaping the family’s values. He encouraged teamwork, accountability, and commitment to one’s goals – principles that would deeply influence Egnes’ outlook on life. Her mother, a homemaker, was the pillar of emotional support, nurturing her children with unwavering love and instilling in them the importance of compassion and unity. Together, her parents provided a stable, albeit modest, environment that was rich in values and life lessons.
The family’s life took a dramatic turn when her father made the courageous decision to join Zimbabwe’s liberation struggle, a move that reflected his commitment to justice and national independence. This decision uprooted the family, forcing them to leave their urban home in Kambuzuma for the rural landscapes of Mhondoro. The transition from city life to the demanding realities of rural living was a profound shift. In Kambuzuma the family had access to relatively stable infrastructure and community networks, but in Mhondoro, they had to adapt to an entirely different way of life. Subsistence farming, fetching water from distant sources, and limited access to basic services became part of their daily reality.
For Egnes, this period was a defining chapter in her life. The rural setting exposed her to the everyday struggles faced by many Zimbabwean families, particularly the lack of access to education and healthcare. Despite the upheaval and the challenges of adjusting to rural life, Egnes displayed remarkable resilience. She quickly adapted to her new environment, taking on household responsibilities while continuing to nurture her dreams of a better future. The resilience she developed during this time would become a cornerstone of her character and leadership style in later years.
One of the most significant challenges Egnes faced was the disruption to her education. The financial strain on the family meant that her schooling was often intermittent, with periods when she had to stay at home because they could not afford school fees. Yet, Egnes’ determination to excel academically never wavered. Even when formal schooling was out of reach, she remained committed to self-study, often borrowing books from peers and older students to stay ahead. Her resourcefulness and love for learning earned her respect in her community and support from her extended family.
The turning point came when her uncle, a dedicated teacher and advocate for education, stepped in to ensure that Egnes could return to school. His intervention underscored the importance of supportive networks in overcoming adversity. With his encouragement and financial assistance, Egnes resumed her studies, excelling in subjects such as science and mathematics. Her academic achievements during this period were not just a testament to her intellectual capabilities but also a reflection of her tenacity and focus.
Mhondoro also provided Egnes with life lessons that went beyond the classroom. The sense of community in rural Zimbabwe was deeply ingrained in her upbringing. Neighbours often worked together during planting and harvesting seasons, sharing resources and knowledge. This spirit of collective effort left a lasting impression on Egnes, teaching her the importance of collaboration and empathy—qualities that would later define her approach to public health and leadership.
The political and social climate of the time also played a significant role in shaping Egnes’ worldview. Growing up during the liberation struggle, she witnessed the sacrifices made by her father and others in the fight for independence. This instilled in her a deep sense of responsibility to contribute to the betterment of her country. The challenges her family faced during this turbulent period reinforced her belief in the power of resilience and determination.
As she progressed through her education, Egnes’ potential became increasingly evident. Her teachers often praised her for her sharp mind and ability to grasp complex concepts quickly. She developed a particular interest in biology, which laid the foundation for her future career in healthcare. Her ability to excel academically, despite the odds, became a source of inspiration for her siblings, who looked up to her as a role model.
In hindsight, Egnes’ early years in Kambuzuma and Mhondoro were a crucible in which her character was forged. The blend of urban exposure, rural challenges, and the values instilled by her parents created a unique foundation for her future endeavours. These formative experiences not only prepared her for the rigors of a career in public health but also instilled in her a deep empathy for the underserved and a relentless drive to make a difference.
Egnes’ journey from Kambuzuma to Mhondoro, marked by challenges and triumphs, set the stage for a life dedicated to uplifting others. Her ability to rise above financial hardships and interruptions to her education demonstrated the resilience, adaptability, and determination that would become the hallmarks of her career. From these humble beginnings, she began a journey that would ultimately touch countless lives and leave an indelible mark on Zimbabwe’s healthcare system.
Building a Career in Public Health
Nursing and Community Health
Egnes’ journey into public health began with her training at Harare Hospital from May 1981 to May 1984, one of Zimbabwe’s largest healthcare institutions. This was a transformative period for her, as it marked the transition from a young woman with dreams of serving her community to a trained healthcare professional equipped with the skills to make a tangible difference. The hospital setting introduced her to the realities of Zimbabwe’s healthcare system, where resource constraints often challenged healthcare delivery. Despite these challenges, Egnes thrived in her role, displaying a natural aptitude for patient care and a keen ability to learn quickly.
Her commitment to improving maternal and child health led her to specialise in midwifery, a field where the stakes were high, and the need for skilled professionals was critical – Egnes’ passion for advancing maternal and child health drove her to pursue specialisation in midwifery, a field marked by high stakes and a pressing need for skilled experts. Her academic excellence in this field was remarkable, culminating in a prestigious achievement: Egnes broke records and was awarded the coveted Gold Medal in Theory in 1987 at Harare Central Hospital, a testament to her dedication, hard work, and outstanding academic prowess. Working closely with expecting mothers, Egnes developed a deep understanding of the challenges they faced, particularly in rural and underserved areas. The emotional connections she formed with her patients motivated her to go beyond her duties, often taking the initiative to educate women on prenatal and postnatal care.
Her career trajectory soon expanded into community health, which took her to Karoi District. This shift from hospital-based care to community outreach marked a significant phase in her career. In Karoi, Egnes worked in remote areas where access to healthcare was limited or non-existent. She frequently encountered families who had to walk long distances to receive basic medical services, a situation that underscored the systemic inequities within Zimbabwe’s healthcare system.
Recognising the urgency of these challenges, Egnes developed innovative strategies to bridge the healthcare gaps in these underserved regions. She organised mobile clinics, bringing essential services such as immunisations and antenatal care directly to the communities. These mobile clinics not only reduced the physical barriers to healthcare but also built trust with local populations, many of whom had never interacted with formal healthcare systems. Egnes’ ability to connect with these communities, understanding their unique cultural and social dynamics, played a crucial role in the success of these initiatives.
Her work in Karoi was not without its challenges. Limited resources meant that Egnes often had to improvise, using her creativity to make the most of what was available. Whether it was repurposing vehicles for emergency transport or working with local leaders to mobilise community volunteers, Egnes’ resourcefulness became a hallmark of her approach. This period cemented her reputation as a problem solver and a compassionate healthcare provider who was unafraid to tackle the most pressing issues head-on.
Leadership and Strategic Growth
Egnes’ natural leadership skills became increasingly evident as her career progressed. Her exceptional work in community health and her ability to lead by example earned her promotions to roles such as District Nursing Officer in Kariba and Makonde districts. These positions expanded her influence, allowing her to manage health systems, train staff, and engage directly with stakeholders at multiple levels.
In Kariba
Egnes’ innovative approach to addressing the unique challenges in Kariba is truly commendable. By chartering planes and boats to coordinate emergency medical responses, she ensured that even the most isolated communities received lifesaving care. Her leadership and strategic thinking saved lives and demonstrated her ability to act decisively under pressure.
The success of the programme was further enhanced through stakeholder involvement and resource mobilisation. The Officer-In-Charge (OIC) of the ZNA Amphibious Squadron, the Zimbabwe Republic Police (ZRP), and local hotels and private companies all contributed to the programme’s success. The ZNA Amphibious Squadron provided logistical support and transportation services, while the ZRP offered security services and assisted in coordinating emergency responses. Local hotels and private companies provided accommodation, support services, and resources, including funding, equipment, and expertise. Additionally, the Rotary Club of Maluba in Kariba played a significant role in supporting the programme through donations, volunteer work, and community outreach.
Egnes worked closely with a vibrant District Health Executive (DHE) team, demonstrating the power of teamwork and collaboration. Together, they leveraged their collective expertise and resources to overcome the unique challenges of Kariba, ultimately achieving remarkable results in improving healthcare outcomes for the local community.
Effective resource mobilisation was also critical to the programme’s success. Local businesses donated funds, goods, and services, while community groups contributed volunteer time, skills, and resources. International partners provided technical assistance, funding, and expertise to support the programme. By engaging stakeholders, mobilizing resources, and fostering a collaborative spirit, Egnes and her team achieved a truly impressive impact in Kariba.
In Chinhoyi
Egnes’ work in Chinhoyi is truly inspiring. By focusing on strengthening health systems and improving the quality of care, she implemented staff training programmes that built capacity among healthcare workers, particularly in maternal and child health.
Her emphasis on mentorship and skill development created a ripple effect, improving the overall performance of healthcare facilities in the district. Egnes also worked closely with local government officials to secure funding and resources, showcasing her ability to advocate effectively for systemic improvements.
The impact of her work was evident in Makonde district, which consistently demonstrated exceptional preparedness and response to outbreaks and campaigns, earning its reputation as a top-performing district in the province. Egnes’ ability to engage stakeholders in programming was instrumental in this success, highlighting the value of collaborative efforts and community involvement in driving meaningful change.
Throughout her tenure in these leadership roles, Egnes maintained a hands-on approach, frequently visiting healthcare facilities and interacting with staff and patients. Her visibility and accessibility made her a respected figure within the healthcare community, earning her the trust and admiration of those she worked with. These experiences laid the groundwork for her later work at UNICEF, where her ability to lead teams and implement large-scale health initiatives would become invaluable.
Joining UNICEF: A Transformative Role
In 2013, Egnes joined UNICEF Zimbabwe as a Health Specialist, marking a significant shift in her career. Moving from government service to an international organisation was both an exciting opportunity and a challenging transition. The role required her to adapt quickly to a new working culture, where the focus shifted from direct implementation to advisory and strategic planning responsibilities. Egnes embraced these changes, leveraging her extensive field experience to inform her work at a national and international level.
Her primary focus at UNICEF was on immunisation, a cornerstone of the organisation’s efforts to improve child health and survival. This role required meticulous planning and coordination, as it involved managing vaccine procurement, logistics, and distribution across Zimbabwe. Egnes’ background in community health proved invaluable, as she brought a practical understanding of the challenges faced by healthcare workers on the ground.
One of the most striking aspects of Egnes’ work at UNICEF was her ability to build partnerships and foster collaboration. She worked closely with the Ministry of Health and Child Care, non-governmental organisations, and community leaders to ensure the success of immunisation campaigns. Her approach was characterised by inclusivity and a commitment to addressing the needs of all stakeholders, from high-level policymakers to frontline healthcare workers.
Immunisation Coverage and Strategic Impact
Egnes’ most notable achievement at UNICEF was ensuring consistently high immunisation coverage across Zimbabwe. Under her leadership, the country achieved over 90% coverage for essential vaccines, a remarkable feat given the logistical and financial challenges involved. This success was not just a statistical milestone but a lifesaving accomplishment, as it significantly reduced the incidence of vaccine-preventable diseases such as measles and polio.
Her work in immunisation extended beyond maintaining coverage rates. Egnes played a pivotal role in the introduction of new vaccines, such as the rotavirus and HPV vaccines, which addressed critical gaps in child and adolescent health. The rollout of these vaccines required careful planning, from conducting feasibility studies to training healthcare workers and educating communities about their benefits. Egnes’ ability to manage these complex processes ensured their successful implementation, further solidifying Zimbabwe’s reputation as a leader in immunisation efforts.
These achievements earned Zimbabwe multiple awards from Gavi (Bonus), the Vaccine Alliance, recognising the country’s commitment to immunisation excellence. Egnes’ contributions were instrumental in these successes, and her work contributed to UNICEF Zimbabwe being recognised as a model for other countries facing similar challenges.
Beyond the technical aspects of her role, Egnes’ commitment to equity remained a central theme. She prioritised reaching underserved populations, particularly in rural and peri-urban areas where healthcare access was limited. Through facility-based outreach programmes and community engagement initiatives, she ensured that even the most marginalised groups benefited from immunisation services in collaboration with other programmes in the health section.
Egnes’ tenure at UNICEF marked a transformative phase in her career, showcasing her ability to operate at the intersection of strategy and implementation. Her achievements in immunisation and her dedication to improving health outcomes for Zimbabwe’s children have left a lasting legacy, one that continues to inspire healthcare professionals across the country and beyond.
Milestones in Public Health Leadership
1. Development of the National Immunisation Strategy
Egnes played a pivotal role in the development of Zimbabwe’s National Immunisation Strategy, which became a cornerstone of the country’s public health achievements. This comprehensive framework aimed to improve vaccine delivery and uptake nationwide, addressing disparities in immunisation coverage. Egnes ensured that the strategy was grounded in data-driven insights by conducting detailed gender and zero-dose analyses. These studies illuminated the barriers preventing certain populations, particularly women and children, from accessing vaccines.
In urban centres like Harare and Bulawayo, where population density and mobility posed unique challenges, Egnes implemented tailored interventions to bridge these gaps. Her approach considered the sociocultural factors influencing vaccine hesitancy, such as misconceptions about vaccine safety and accessibility. Working closely with local governments, community leaders, and healthcare providers, she developed targeted campaigns to build trust and encourage participation.
One of Egnes’ most pioneering achievements was the integration of immunisation services with other essential community health programmes, including nutrition interventions and maternal healthcare services. This holistic approach enabled healthcare workers to provide comprehensive care, addressing multiple health needs of individuals and communities in a single visit. This holistic approach not only improved vaccine uptake but also strengthened the overall health-seeking behaviour of communities. The strategy’s success was evident in Zimbabwe’s consistently high immunisation rates, with the country frequently exceeding global benchmarks. Egnes’ leadership ensured that the framework was not only effective but also sustainable, laying the groundwork for future public health advancements.
2. Community Engagement Innovations
Egnes’ commitment to community-centred healthcare was most evident in her implementation of the Human-Centred Design approach in Manicaland. This method emphasised the active involvement of local communities in the planning and execution of health interventions, fostering a sense of ownership and trust. Egnes recognised that traditional top-down approaches often alienated communities, leading to resistance or apathy. By contrast, her inclusive model empowered communities to co-create solutions that addressed their specific needs and challenges.
A standout initiative under this approach in the urban setting was the introduction of “Super Saturdays,” a programme designed to bring vaccination services directly to the heart of communities. These events transformed market days and other community gatherings into opportunities for healthcare outreach. Vaccination booths were set up in easily accessible locations, accompanied by educational sessions to dispel myths and provide accurate information about vaccines. The festive atmosphere of these events encouraged participation, significantly boosting vaccination rates among previously underserved populations.
The success of “Super Saturdays” went beyond numbers. It showcased the power of community engagement in overcoming systemic barriers and highlighted the importance of listening to the voices of those most affected. Egnes’ ability to bridge the gap between healthcare providers and the communities they served not only enhanced service delivery but also strengthened trust in the healthcare system.
3. Emergency Responses
Egnes’ leadership during health crises was a testament to her ability to manage complex challenges with efficiency and compassion. Over the years, she played a critical role in responding to outbreaks of cholera, typhoid, and, more recently, COVID-19. These crises tested the resilience of Zimbabwe’s healthcare system, but Egnes’ strategic approach ensured that essential services were maintained even under the most difficult circumstances.
During the cholera and typhoid outbreaks, she participated in the rapid response teams, mobilising resources through proposal writing and deploying healthcare workers to affected areas for vaccinations.
By advocating for community-based surveillance systems, she empowered local volunteers to identify and report cases early, enabling quicker containment of outbreaks.
During the cholera and typhoid outbreaks, Egnes played a pivotal role in coordinating rapid response teams, mobilizing resources through effective proposal writing, and deploying healthcare workers to affected areas for targeted vaccinations. Furthermore, Egnes ensured the timely and effective distribution of vaccines by spearheading vaccine quantification, ordering, and distribution efforts. She worked tirelessly to ensure that vaccines reached hotspots and high-risk areas, thereby protecting vulnerable populations.
By advocating for community-based surveillance systems, Egnes empowered local volunteers to identify and report cases early, enabling quicker containment of outbreaks. Working closely with the Immunisation Technical Team, she provided technical support to these community-based systems, building capacity and ensuring their sustainability. Her leadership and expertise were critical in saving lives and mitigating the impact of these outbreaks.
The COVID-19 pandemic presented unprecedented challenges, including supply chain disruptions, staff shortages, and vaccine hesitancy. Egnes tackled these issues head-on, advocating for policies that supported frontline healthcare workers. One of her most impactful contributions was advocating and securing allowances for static-site nurses in the urban facilities, a move that not only boosted morale but also ensured the continuity of critical services for the vaccination process. Her ability to adapt to rapidly changing circumstances and prioritise the wellbeing of both healthcare workers and communities underscored her exceptional leadership during crises.
Overcoming Challenges
Egnes’ career has been defined by her ability to navigate systemic challenges with resilience and creativity. Zimbabwe’s healthcare system faced chronic issues such as resource constraints, bureaucratic inefficiencies, and cultural resistance to health initiatives. Egnes approached these hurdles as opportunities for innovation, consistently finding ways to deliver impactful solutions.
During the COVID-19 pandemic, one of the most pressing challenges was retaining healthcare workers amid economic hardships and high stress levels. Egnes recognised that burnout and dissatisfaction among staff threatened the delivery of essential services. She advocated for inclusive budget allocations that ensured allowances for static-site nurses, a policy change that had a ripple effect across the healthcare system. This intervention not only stabilised staffing levels but also sent a strong message of appreciation to frontline workers, fostering a renewed sense of purpose and commitment.
Her ability to navigate bureaucratic complexities was another hallmark of her approach. Egnes developed strong relationships with policymakers and stakeholders, using her influence to advocate for systemic reforms. Her persistence in addressing resource shortages often resulted in innovative solutions, such as leveraging public-private partnerships to secure funding and supplies for health programmes. Through effective coordination with the EPI technical team, Egnes ensured that these efforts were targeted, efficient, and impactful, ultimately leading to improved access to essential healthcare services, enhanced programme sustainability, strengthened public-private partnerships, and increased healthcare system resilience. These efforts demonstrated her strategic acumen, unwavering dedication to improving healthcare access, and ability to drive meaningful change through collaborative and innovative approaches.
Legacy of Empowerment
Beyond her professional achievements, Egnes’ commitment to mentorship and education has left an enduring legacy. She passionately believes in the transformative power of education and has devoted significant time and resources to supporting disadvantaged individuals. Over the years, she has funded the education of a number of orphans and vulnerable children, many of whom have gone on to pursue successful careers in various fields.
Her mentorship extends beyond financial support. Egnes takes a hands-on approach, providing guidance and encouragement to those she supports. Her mentees often describe her as a source of inspiration, citing her resilience and determination as qualities they strive to emulate. She has also fostered a culture of mentorship within her professional circles, encouraging colleagues to invest in the development of the next generation of healthcare leaders.
Egnes’ daughter, Tafadzwa, is a shining example of her mother’s influence. A successful professional in climate change and international relations, Tafadzwa credits her achievements to the values instilled in her by Egnes. The emphasis on resilience, compassion, and service that Egnes embodies has not only shaped her daughter’s path but also inspired countless others who have had the privilege of learning from her.
Egnes’ legacy is a testament to the impact that one dedicated individual can have, not only on a healthcare system but also on the lives of countless individuals. Her work continues to inspire and pave the way for a more equitable and compassionate world.
Conclusion
Egnes Makwabarara’s story is a testament to the extraordinary impact of public health leadership. From her early days in nursing to her transformative role at UNICEF Zimbabwe, Egnes has dedicated her life to improving the health and wellbeing of others. Her heroism, as captured in the story of the emergency delivery, is but one example of her unwavering commitment to humanity.
Her legacy, built on resilience, innovation, and compassion, will inspire future generations of public health professionals. Egnes’ life serves as a powerful reminder that even in the face of challenges, one individual’s dedication can create lasting change.
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