My first experience driving on the left was in South Africa. Later I have driven on the left in Scotland and Wales. I usually drove a stick shift.
In South Africa I drove in Pretoria and in the countryside of Kwa Zulu Natal. I don’t remember any problems in Pretoria. Except for once, I stopped for gas at a Shell station. After my tank was full I discovered that they would only accept Shell credit cards or cash. I did not have enough cash and only a Visa card. One of the employees rode with me to a ATM to get the cash. This was about 20 years ago.
Driving in the country is much easier than in Wales. The countryside is much like the Southwest USA so the roads are relatively wide with wide shoulders. There is no problem of driving narrow roads with stone walls right on the verge. As mentioned, live stock on the roads can be a problem. The cities are of the same vintage as American cities so the roads are in a grid and wide. Parking lots having wider slots than in the UK.
South Africans are serious about faster traffic having the right away. Do not linger in the passing lane of a multi lane highway. On a two lane road give following traffic the opportunity to pass.
One thing to note is that the highways are numbered. Single digit are primary roads, two digits are secondary roads (generally OK), and three digit roads may be an adventure!
My wife and I always pay to have both of us be drivers. Just in case.
This info is from about 20 years ago.
If you can get an automatic, do so. But if you can drive with a stick, learning to shift with your left hand is not a problem.