For Dr Dulcy Rakumakoe, building a successful healthcare business has never been just about profit. It has been about expanding access to care for people who are often overlooked – and finding the resilience to keep going when the journey becomes difficult.
In her new book, The Fire Within, the medical doctor, entrepreneur and queer advocate shares the personal experiences behind her professional achievements, including the setbacks, self-doubt and moments of vulnerability that shaped her.
Rakumakoe hopes that the book, launched at Henley Business School in Johannesburg on 30 September 2026, will inspire readers to pursue their ambitions despite the obstacles they encounter.
Finding strength in vulnerability
Rakumakoe reveals to MambaOnline that the book began as a form of therapy. She was navigating a difficult period in her business, which was close to liquidation, while leading a team of around 30 people. She was also dealing with challenges in her personal life.
“I felt like I was falling apart, and I needed to see someone,” she recalls.
Her therapist encouraged her to explore vulnerability and begin journalling. The process became an opportunity to reflect on her upbringing, relationships, business decisions and entrepreneurial journey.
“I felt like I needed to be the person in charge, the person running things, the person solving problems for everyone, while inside, I was feeling like a weak little girl who is struggling to cope with everything,” she says.
Writing honestly about her experiences helped her recognise that vulnerability was not a weakness.
“I really learned that it is the strength in vulnerability,” she says. “People can show up for me better when they know that I need them.”
Allowing others into the challenges she faced also helped her team step up and contribute more meaningfully.
A fire ignited by purpose
The book’s title refers to a sense of purpose Rakumakoe traces back to her childhood. When she was six, her grandmother encouraged her to become a doctor so she would not have to endure long queues for healthcare.
That early motivation grew into a broader ambition: building her Quadcare healthcare business that could improve access for poor and vulnerable communities, including LGBTIQ+ people and people with disabilities.
Her experience as a queer woman also shaped this vision. While studying, Rakumakoe encountered a healthcare practitioner whose response to her lesbian identity made her question how other marginalised patients might be treated.
“What happens to a gay guy? What happens to an intersex person… or a transgender individual?” she remembers asking herself.
These experiences helped inform Quadcare’s commitment to providing a safe and inclusive environment. Its clinics display LGBTIQ+ flags, and Rakumakoe says staff are screened for homophobic, transphobic or interphobic attitudes.
Keeping the dream alive
Her entrepreneurial journey has not been without setbacks.
Rakumakoe recalls discovering that an accountant she had trusted for years had defrauded her, leaving her with a substantial tax liability she believed she had already paid to SARS.
She also describes the loss of a business partner with whom she had built the company, a period that left her feeling abandoned as she faced new investors.
“I thought, what is the point to all of this? You know, I cannot do this,” she recalls.
These setbacks, she says, became part of the journey that brought her to where she is today.
Building a business with social impact
As a self-described social entrepreneur, Rakumakoe does not see a contradiction between running a profitable business and creating social impact.
“For a business to have the impact that it is intended to make, it needs to be profitable, it needs to be sustainable,” she explains.
Quadcare has grown to 14 clinics, with a target of 100. She believes financial sustainability is essential to expanding its reach and maintaining the quality of its services.
Her experiences, she says, have changed how she understands leadership and success.
Rather than measuring achievement solely through business milestones, she is proud of the person she has become and the scale of the dreams she now allows herself to pursue.
Responding to the LGBTQ+ healthcare funding crisis
Rakumakoe’s commitment to accessible healthcare has also shaped how Quadcare has responded to funding cuts affecting LGBTQ+ health services. She says the loss of funding left many people struggling to access HIV care, hormones and other essential services.
Rather than raising prices in response to increased demand, she approached the company’s board and investors with a different proposal: reduce prices to help people, especially members of the transgender community, who had lost access to funded services.
Rakumakoe says her investors supported the decision because they had invested not only in the business but also in its vision.
While the changes helped the organisation reach more patients, she warns that the crisis remains severe.
“Even if we have dropped the prices, for as long as the funding cuts continue, there’s still a large number of people who cannot access medicines,” she says.
A deeply personal story
One of the most difficult parts of the book was writing about her mother’s illness and death. Rakumakoe describes the experience of navigating her mother’s cancer treatment and the challenges of receiving compassionate care.
The grief was compounded by moments when she felt she had to arrive in her medical scrubs to ensure her mother was treated properly.
It was a chapter she struggled to write. “I had to stop a few times, to cry and continue writing,” she says.
By including such personal experiences, Rakumakoe says she hopes to challenge the polished narratives often associated with entrepreneurship – stories in which success appears effortless and setbacks are barely acknowledged.
She wants readers to understand that ambition and difficulty can coexist, and that struggles do not necessarily mean someone is failing.
Igniting the fire in others
Rakumakoe believes her book speaks to queer people, women, young entrepreneurs and township youth who may not see themselves represented in conventional success stories.
Ultimately, she hopes it will encourage people to reconnect with their own ambitions.
“The impact that I want The Fire Within to make is to ignite fires in people or reignite fires that have died,” she says.
For Rakumakoe, resilience is not about avoiding difficult experiences or pretending to have everything under control. It is about allowing those experiences to shape you without extinguishing the ambition that first set you on your path.
And sometimes, she suggests, keeping that fire burning begins with allowing yourself to be vulnerable.
The Fire Within is available through Dr Rakumakoe’s website or email, with copies also expected to be available at the Rainbow Store in Cape Town. The author is planning further book-signing events and opportunities to reach readers across South Africa.
