BOK STAR BEATS THE ODDS

When Springbok forward BONGI MBONAMBI felt a sharp pain in his side the day before a big match, he had no way of knowing that his rugby career – and his life – would soon be in the balance.

Bongi Mbonambi only played 20 minutes of the 2019 Rugby World Cup final. Midway through the first half he took a knee to the head while defending the Springboks’ early lead and had to watch from the sidelines as his teammates beat England to lift the trophy.

Not that Mbonambi was complaining. Barely a year before that historic game, he was lying in a Mediclinic hospital bed wondering if he’d ever play professional rugby again. His year-long journey from operating table to the starting line-up in world rugby’s biggest game took all the warrior mentality he could muster. It wasn’t his first major setback, and it wouldn’t be his last. But it was certainly his most significant.

Mbonambi isn’t the biggest front-row forward you’ll ever meet. At 1.75m, he’s relatively compact compared to many of his Springbok teammates. As the World Cup final camera panned across the team during the national anthems, it had to dip down a few centimetres between Frans Malherbe (1.90 m), Mbonambi, and Lukhanyo Am (1.86 m).

His size counted against him early on, with his coaches telling him outright that he wasn’t big enough to progress beyond age-group level rugby.

“One day, I challenged one of those coaches by asking, ‘Why would you say something like that?’,” he later told SA Rugby magazine. “He told me my size would count against me in professional rugby. It really hurt to hear that, but then I managed to turn it into a positive. When people tell me I can’t do something it makes me try even harder.”

That determination – or stubbornness – saw Mbonambi work his way through South Africa’s Under-20 team into Super Rugby with the Bulls and Stormers, before earning his Springbok call-up in 2016. By 2019 he was a Springbok starter, although – thanks to a flying English knee – not a Rugby World Cup final finisher.

“I was pretty upset,” he told the SA Rugby podcast, reflecting on that experience. “I was actually having an argument with my doctor on the field, telling him I was okay and that I could stay on. But they were looking after my safety and, sadly, I had to leave the field. Still, I got the opportunity to play in a World Cup final, and not a lot of players can say that.”

Certainly not after suffering a life-threatening case of a burst appendix. 

“Appendix surgery is supposed to be a quick thing. They just pull it out, stitch you up, and the next day you’re ready to go.”

Bongi Mbonambi

In mid-February 2018 Mbonambi was preparing for the Stormers’ opening Super Rugby match when he started feeling a sharp pain in his side. “The Friday night before we played the [Argentine club] Jaguares at Newlands, it was about 3am and I woke up, got out of bed, and started telling my wife, ‘Listen, something is wrong’,” he recalled in Bongi Mbonambi: The Documentary. “She asked me what was wrong. I said, ‘There’s a pain in my stomach. I don’t know what’s going on.’ I went to the bathroom, and nothing was happening. It was just getting worse. I told her, ‘We have to go to hospital now.’ In the car I was already cramping up and experiencing pain, and my wife was also starting to panic.”

His appendix was infected. A thin tube that joins to the large intestine, the appendix is a strange quirk of human anatomy. When you’re young it’s an important part of your immune system, helping your body to fight disease. But as you get older, other parts of your body take over the infection-fighting functions and your appendix just sits there, waiting for something to go wrong.

In the early hours of that Friday morning, something went badly wrong for Bongi Mbonambi. When he arrived at the emergency room at Mediclinic Milnerton, he couldn’t get out of the car. “They had to bring a wheelchair,” he says, recalling the agonising wait as the Mediclinic team attended to him.

“I passed out waiting on the benches outside,” he recalls. “Then the doctor came and put me on a bed, did the checks and everything, and I think I passed out again on the bed there. I woke up being told that I’d just come out of surgery.”

Dr Maré du Plessis was the specialist surgeon who performed the appendectomy, the operation to remove Mbonambi’s appendix. “He presented with a burst appendix, and we performed a procedure through a keyhole operation with washout,” he says. “We had to do it laparoscopically, because most of the time – even if the appendix is ruptured – the patient will do very well and won’t have problems with big, open wounds that become septic.”

In that keyhole surgery, Dr Du Plessis made a couple of small cuts in Mbonambi’s side, and – with minimal surgical impact – removed the appendix and cleaned out the area. Unfortunately, Mbonambi didn’t recover as the surgical team was hoping he would.

“Appendix surgery is supposed to be a quick thing,” Mbonambi says. “They just pull it out, stitch you up, and the next day you’re ready to go. But the next day I was still sweating, I had a fever, and now the doctor’s saying, ‘Something is wrong here. We’re going to send you in for another MRI scan.’ He thought that maybe some of the appendix fluids had leaked into my intestines.”

That’s exactly what had happened. A burst appendix can allow stool, mucous and other infections to leak into the system, ultimately causing life-threatening medical emergencies like peritonitis, a swelling of the tissue that lines your abdomen.

“Ideally you would want the patient to present early. Bongi didn’t. He presented late… The diagnosis of appendicitis was only made when he was admitted to hospital.”

Dr Maré du Plessis, specialist surgeon

“The scan showed that Bongi had ongoing intra-abdominal sepsis, so we had to go back and do an open procedure to wash out his abdominal cavity properly and get control of the sepsis,” says Dr Du Plessis. 

Complications can happen when a patient has had an appendectomy – especially if the symptoms are picked up late. “It’s not unusual,” says Dr Du Plessis. “Ideally you would want the patient to present earlier. Bongi didn’t. He presented late. He’d had about three days of symptoms, which were being treated with medication. The diagnosis of appendicitis was only made when he was admitted to hospital.”

The open surgery saved Mbonambi’s life. “They had to cut through my abdomen and my muscles, and just make sure everything was clean on the inside, in my intestines,” he says. A related bladder infection was treated with antibiotics, and before long Mbonambi was discharged from Mediclinic Milnerton.

“It was a positive sign that I could actually walk out of the hospital,” he says “But being at home, I was just thinking, ‘Right, now the journey starts. Now you’re going to show how tough you are and how strong your faith is.’ I think I lost about 10kg in the space of two weeks. Coming back, doing my rehab, slowly but surely, and having my wife backing me all the way… making it through that was a miracle.”  

After initial fears that he’d have to miss the rest of the season, Mbonambi battled back with the same bloody-mindedness that had fuelled his early rugby career. By June 2018 he was back in the Springbok Test side. Fifteen months later he was taking the field in the Rugby World Cup final.

In mid-2018 Mbonambi’s coach at Western Province, John Dobson, spoke about his miracle – and miraculously quick – recovery. “People don’t appreciate how serious the appendicitis matter was,” Dobson told the Sunday Times. “I saw him about four weeks after the operation and he didn’t look like a professional rugby player. He’d lost so much weight because of the nature of what had happened to him. For him to rebuild his body in such a short space of time is a remarkable achievement. It shows what kind of a warrior he is.”

Dr Du Plessis describes Mbonambi as “a lovely guy, and a very nice patient”. Dobson has a different take. “If you know Bongi, he’s quite a scary individual. At training we often tell him to go easy or he’ll hurt himself or break the other players.”

That warrior mentality, combined with expert medical care and strong support at home, was the difference between life and death; and between giving up on a professional rugby career or playing in – and winning – a World Cup final.