Cancer treatment in KwaZulu-Natal Health facilities has all but ground to a halt as a result of a severe shortage of staff, numerous resignations, and equipment that is no longer functioning, reports The Citizen. In addition, about half of the department’s cancer radiotherapy machines are not in working order.
The report says while exact details are hard to determine, it can be confirmed that at least three of the department’s specialist oncologists in Durban have quit and another one is set to leave by the end of February.
The provincial department has two oncology centres – Durban and Pietermaritzburg. In Durban prior to October there were only five oncologists under whom a number of registrars (doctors training to be oncologists) worked to treat the bulk of the province’s cancer patients, who would be referred to Inkosi Albert Luthuli Hospital (IALH) or Addington Hospital for treatment, be it surgery, chemotherapy, or radiotherapy.
The report said many of the staff – doctors, radiographers, and others – were reluctant to be identified for fear of being suspended or victimised. Also, questions on how many oncologists the department should have went unanswered by the department. Several sources said the resignations were attributable to the dire situation with more and more treatment being palliative rather than curative.
The report says the lack of oncologists is only one of the problems the department is facing. Another shortage is that of radiographers. Exactly what the full complement of radiographers should be is unknown, but in 2013 there were 15 radiographers working at Addington Hospital alone. “The machines cannot run at capacity even if there are more consultants,” said one source. The two Elektra machines and one Siemens should each be receiving 45 patents daily, but by the end of October the capacity had reportedly dropped to 26 patients for each machine.
But, the report says, while the staff shortage is critical the department appears to be stuck when it comes to repairing or maintaining the machines used for cancer treatment. The two state of the art R120m Varian Rapid Arc Linear Accelerator machines at Durban’s Addington Hospital have not been fully functional since the end of 2012. The department has been in a dispute with the authorised South African agents – Techmed Africa – and refused to pay them for the maintenance, with Health MEC Sibongiseni Dhlomo accusing them of corruption. A seven-year corruption investigation by the Hawks has to date not seen the light of day or seen anyone being prosecuted.
Last year, the department broke literally every rule governing the way departments are meant to procure services and appointed another company to repair and maintain the machines.
The report says ever since the contract to appoint KZN Oncology Inc was signed by Health Department head Dr Sifiso Mtshali on 17 December, only one of the machines has ever worked – and intermittently at that. Staff were told by government that KZN Oncology had been paid but they were told by KZN Oncology Inc that they had not been paid. Comment was not immediately available from KZN Oncology Inc CEO Dr Nkhanyiso Zwane.
It is also understood that the single working cancer radiotherapy machine at Greys Hospital in Pietermaritzburg is also not functioning and the department had yet to issue an order for that machine to be repaired.
The report says the oncologists, radiologists, and six cancer radiotherapy machines at Greys, IALH, and Addington are the only cancer treatment available to about 85% of the province’s population of 11m who do not have access to private medical care. It is understood that even if a patient does get an appointment to see a specialist consultant, for patients at Addington, who have to be transferred to the already backlogged IALH, the first chance they will have for access to a cancer radiation therapy machine is August 2017.
“Due to the long waiting period patients are dying and staff have indicated that in the event of them being treated timeously, this could have been avoided,” a union representative reported to his head office earlier this week. Exactly what the waiting times at IALH and Grey’s Hospital are is currently unknown.
It is medically accepted that early detection leads to higher rates of successful treatment. However, the report says, even though MEC Dhlomo urged women during Breast Cancer Awareness Month recently to get screened, this was in fact not always possible.
The Ngwelezana Provincial Hospital in Empangeni has been without a mammography machine since early July. At the end of October it was known that as many as 900 women had to have their appointments rescheduled. That mammography machine is used for the entire northern areas of the province.
Only Durban’s King Edward VIII Hospital, Addington Hospital, and IALH, as well as Grey’s Hospital in Pietermaritzburg, have functioning mammography machines. The machines in Prince Mshiyeni Hospital and RK Khan Hospital are no longer working.
The report says a list of questions submitted to the department on 28 November about the machines at Addington Hospital, staffing levels, and patient waiting times remain unanswered, despite a reminder.The Citizen report