Gefland first practiced medicine in South Africa and the United Kingdom before joining the Southern Rhodesia Medical Service as physician,
pathologist and
radiologist in 1939. After he began government service, he was known as the only doctor to correctly diagnose the illness of the wife of the Head of the Medical Services. In 1955, Gelfand founded the
Central African Journal of Medicine with Joseph Ritchken, and remained its co-editor for many years. In 1962, he joined the
University College of Rhodesia and Nyasaland as founding Professor of African Medicine. From 1970, until his retirement in 1977, he was Professor and Head of Department of Medicine, and thereafter Emeritus Professor and Senior Clinical Research Fellow. His works on rheumatic diseases were used as references for further study as well as in to complications related to
tuberculosis,
HIV, and other diseases. Gelfand wrote a total of 330 articles and monographs in various journals on topics ranging from medicine, ethics, philosophy, history,
Shona custom, religion, and culture, with titles including "Migration of African Labourers in Rhodesia and Nyasaland (1890 - 1914)". He wrote more than 30 books, amongst them
The Sick African and
Livingstone, the Doctor. In a 1979 article "The infrequencey of
homosexuality in traditional
Shona society," for
The Central African Journal of Medicine, Gelfand noted: "The traditional Shona have none of the problems associated with homosexuality [so] obviously they must have a valuable method of bringing up children, especially with regards to normal sex relations, thus avoiding this anomaly so frequent in Western society." Despite strongly
homophobic attitudes existing in Shona society, homosexuality has historically been present. ==Personal life and death==