When Dr Dimitri Erasmus was 12, he lost the second of his two brothers – both of them at the age of 14 in two separate incidents. During the turmoil that followed these tragedies, a local general practitioner supported the family. It was largely as a result of this display of empathy that the youngster decided to pursue a career in medicine when he was in grade 9.

He remained faithful to this commitment and, after matriculating at Paterson High School in Port Elizabeth, he went on to study virology (MSc) and medicine (MBChB) at the University of Cape Town. It was as chief executive officer (CEO) of Tygerberg Hospital that he retired recently, bringing an end to a long and fulfilling career in medicine.

There have been many moments of pride and pleasure along the way. Among these are the 14 years he spent in private practice – from mid-1989 to early 2004 – in Mitchells Plain. “I really learnt a great deal in terms of patient-centredness and caring for people," recalls Erasmus.

During this period, he also represented general practitioners on committees of both regional and national professional bodies, and served as a national councillor and observer on the board of directors of the South African Medical Association (SAMA) in 2001.

Beyond private practice

“That's when I realised I wanted to get out of a solo practice environment and pursue a career in an organisation," Erasmus says. To prepare himself for such a role, he started studying part-time for an MBA at Stellenbosch University's Business School in 2002.

He then applied for a position in the Western Cape Department of Health (DoH) and ended up as medical superintendent at Red Cross War Memorial Children's Hospital in February 2004. Just one and a half years later, he became its CEO.

“The transition from clinical doctor to manager was quite easy," Erasmus observes. His private practice taught him a lot about management principles. And his passion for children made him especially well-suited to Red Cross (he once even considered becoming a paediatrician, and was affectionately known by some patients as the “kinderdokter" in Mitchells Plain).

Red Cross holds many fond memories for Erasmus: “My most memorable experience there was seeing how the hospital grew in terms of its status and infrastructure, and how people really showed an interest in the care of children."

In 2010, an outbreak of measles and diarrhoea in the province presented a major challenge. Erasmus was involved in the DoH's efforts to develop a response. “It was a memorable moment, but also very emotional – to see children become so ill," he recalls. “That made me more determined to ensure doctors had everything they needed to care for patients."

From Red Cross to Tygerberg

His move to Tygerberg Hospital in August 2010 posed new challenges. At Red Cross, for instance, there was a well-established trust that raised funds for infrastructure upgrades. At Tygerberg, on the other hand, he was confronted with crumbling infrastructure. Attending to this became one of his main priorities.

In addition, he set out to build sound relationships, particularly with clinicians and with SU's Faculty of Medicine and Health Sciences (FMHS). “I believe partnership is important to deliver health services in an academic environment," Erasmus explains.

His third priority was to focus on general specialist services and strengthen the academic training platform in the eastern metropole: “In the public sector, resource constraints have always been a major issue."

Erasmus addressed all three tasks with a remarkable degree of success. In 2018, he was a member of the DoH team that secured R1,9 billion over 10 years from the provincial treasury for an infrastructure upgrade at Tygerberg Hospital, which is now under way.

The team also secured a commitment to build two new hospitals: Tygerberg Central Hospital (on the current site) and Tygerberg Regional Hospital (in the Belhar area). “That was quite a huge achievement," says Erasmus. “We are hopeful this will happen in the next 10 to 12 years."

Partnership with FMHS was key

He developed highly effective partnerships as well: “What was most rewarding was the solid, genuine and lasting partnership between the hospital and the FMHS, built on mutual trust. I'll always take that with me.

“The Dean (Prof Jimmy Volmink), his team and I worked well together. Our doors were always open to each other. The Faculty never saw itself as being apart from the Tygerberg team, and the Tygerberg team never saw themselves as being apart from the Faculty. We really worked together as a unified team."

Erasmus adds: “The FMHS has a mandate to do research and to ensure that training occurs; the DoH has to run services and provide learning opportunities for healthcare professionals. Together, as a team, we saw that as a joint mandate. We always placed the patients and the trainees at the centre."

Erasmus points to the recently revised bilateral agreement between the provincial DoH and the FHMS on services and training as an example: “We were quite responsive to the needs of both parties. We had the same vision and outlook. We wanted to do the best we could – not only for patients, but also for the training of healthcare professionals."

Erasmus is particularly pleased with the progress made since 2017 in strengthening the academic training and services platform in the eastern metropole in a range of general specialist services: “That was quite an achievement."

Volmink readily acknowledges the importance of Erasmus's leadership over the past decade: “Tygerberg Hospital is an indispensable platform for providing essential healthcare in the Western Cape and beyond. Dr Erasmus' caring and decisive leadership of this fine institution has had a significant and far-reaching impact on the quality of patient care.

“These attributes were particularly in evidence during the Covid-19 surge in 2020 when he needed to make tough decisions regarding the upscaling of intensive and critical care services and the de-escalation of other services." 

The Dean adds: “We also recognise the important role he played in enabling our Faculty to advance its goal of improving health and health equity through training, research and service. It was an incredible pleasure and privilege to work with him as a partner. I will miss our monthly cappuccino and catch-up sessions!"

Dr Therese Fish, who worked closely with Erasmus in her capacity as Vice Dean: Clinical Services and Social Impact, also looks back at his term as CEO with a great deal of satisfaction.

“Since Dr Erasmus became CEO, the relationship with the Faculty as a whole strengthened significantly," she notes. “We're in a much better space than we were before he came. We've had very tough times in terms of budgetary constraints and issues around discrimination. But, with his leadership calibre, he assisted us to navigate some of those difficult issues. He's fair; he's firm."

Fish adds: “We both have a philosophy around the importance of having good partners, and how you manage the partnership. The partnership (between the Hospital and the University) is based on mutuality. We all have a commitment to ensuring we have good service and good human resources. That is the fundamental principle of the partnership.

“It's like we're in this marriage, and we can never get divorced. Even if we have tough times, we have to work on it. We have to make it work if we want to provide services and health professionals for our population."

It is clear Erasmus' absence will be keenly felt. “We both have the same philosophy about doing good and looking out for the people of this country, and about giving back because of the opportunities we've had," says Fish. “I'll miss him for that, and for the work we've done together."

Caption: Dr Dimitri Erasmus. Photo by Stefan Els.