An NGO has offered Kwazulu-Natal Health free use of its mobile mammography trucks to reduce the present six-month delay for breast cancer checks but the province, whose own oncology services have virtually collapsed, has refused to pay for fuel and accommodation of the staff.
A Sunday Tribune report says that Pink Drive believes that, with KZN already in an oncology treatment crisis, it could alleviate the backlog of breast cancer examinations if the health department supported its efforts. Pink Drive is the only organisation to own mobile mammography trucks in Africa and has offered services free, provided the Health Department paid for the truck’s fuel and accommodation for a few team members. But the, the report says, the department refused to provide assistance.
Pink Drive CEO Noelene Kotschan said it was not the first time it had locked horns with the department over its services. She said, after several years of battling to get approval to bring their trucks into the province, Pink Drive was eventually cleared to do so in August.
The report says the organisation is able to use specially equipped trucks to perform up to 30 mammograms a day. Pap-smears and prostate cancer examinations are the other procedures that can be conducted in its vehicles. It is known that women wait up to six months to have mammograms done in KZN, and Pink Drive had been contacted by many who were in mammography truck owned by Pink Drive being used at a corporate event.
“Now that we have approval to bring trucks into the province, the KZN Health Department won’t pay to get them here. We are offering the free use of our machines, which means we could drive into rural communities and perform mammograms,” said Kotschan.
She said with the issues of KZN’S oncology machines being out of order, their trucks could help to ease the situation. “We have offered the department to use the machines for free because we know there is a serious problem in the province. All we are asking is for it to pay our petrol and accommodation costs and, if it had the capacity, send a nurse who is trained in oncology to assist us. It is a small ask, when one considers we are doing what the government should be doing, which is providing a decent health service for its citizens,” claimed Kotschan.
She is quoted in the report as saying that the trucks cost almost R10m to build and the mammography machines nearly R6m. “We are an NGO that relies on funding for survival. These trucks were bought and built after we raised the money. We also have to make sure that they remain well maintained. Our plan was to help out with the KZN oncology crisis, but if we do not get the support we need, then there is not much we can do.” Kotschan said on the few occasions that they have been into the province, their services were paid for by corporate South Africa.
The DA’s KZN spokesperson on health issues, Dr Imran Keeka, said he welcomed the use of the truck in the province because it was something that the province desperately needed to deal with the oncology crisis. “Breast cancer is the number one killer in KZN among female cancer patients. Prevention is important, and we need this truck in our province due to the ongoing problems of our mammogram machines not working,” said Keeka.
He also said KZN should welcome the health trucks because the South African Human Rights Commission’s oncology report recommended that the KZN health department formed partnerships with private organisations to help with the oncology crisis.
Spokesperson for the KZN Department of Health, Sam Mkhwanazi, is quoted in the report as saying: “Screening for breast cancer and oncology treatment in general are two separate matters. It is thus crucial to understand that mammograms are screening tools and not diagnostic and treatment tools. In dealing with the issue of mammograms, which is a screening tool, there might be a temptation to oversimplify issues and link mammograms with the treatment of cancer, considering the recent public discourse regarding oncology.
“It is now a matter of public record that, working with non-governmental organisations and oncologists from the private sector, the department has put in place plans to mitigate challenges related to oncology. For instance, cancer patients from northern KZN no longer have to travel to Addington Hospital and Inkosi Albert Luthuli Central Hospital for oncology services, thanks to a partnership the department has with a private health services group, which provides such services.
“The department is also working tirelessly to recruit oncologists to the public sector. The government has always been concerned about unidentified breast and cervical cancer and cases in the province. In a bid to bring about awareness of cancer, KZN MEC for Health, Dr Sibongiseni Dhlomo, launched the Phila Ma campaign.
“Owing to the success of the Phila Ma campaign, which is linked to Operation Sukuma Sakhe, more women are coming forward to test for cancer. Working with NGOS, the department continues to show success in cancer awareness campaigns to ensure early detection.
“Over the years, the department has collaborated with and supported Pink Drive in its many endeavours to create cancer awareness. These activities took place at Madadeni (Newcastle), Empangeni, Addington Hospital in Durban and at Grey’s Hospital in Pietermaritzburg. The department recognises and appreciates the work done by Pink Drive for communities in KZN and will engage with it to discuss matters of mutual interest without prejudice, fear or favour.”
Meanwhile, in Gauteng, the dread and fear that can come with a cancer diagnosis is now being compounded by patients being forced to wait two months before accessing any form of treatment. This is according to a Daily Maverick report which said that the number of cancer patients who are waiting for radiation treatment at Steve Biko Academic Hospital in Pretoria has gone up, with at least 934 cancer patients on the waiting list. In a written reply, Gauteng Department of Health MEC Gwen Ramokgopa stated that the numbers on the waiting list are not static but are dependent on medical services provided daily. The report quotes Jack Bloom, DA shadow minister of health as saying that the delays in cancer treatment are due to broken machinery earlier in 2017 and a shortage of radiographers.
Lauren Pretorius, CEO of Campaigning for Cancer, said radiotherapy is a vital part of treatment protocols to halt the growth of cancer cells or provide relief from symptoms for the patient. “Any delays in treatment can be a death sentence for some patients. By not addressing the current breakdown of machines at Steve Biko Academic hospital the Department of Health is in direct violation of these patient’s constitutional rights,” she said.
The report says this has been a recurring issue for the past 10 years where Campaigning for Cancer has had to deal with patient backlogs, medicine stock-outs and machinery breakdowns. The most affected institutions were: Steve Biko Academic Hospital, Charlotte Maxeke Academic Hospital and Grey’s and Albert Luthuli Academic Hospitals in KwaZulu-Natal.
Pretorius explained that the problems appear to be administrative in nature and that lack of budget planning was the reason that these hospitals do not have operating machinery. “They haven’t budgeted for maintenance. Without maintenance, even when these machines work there is the possibility of them being ineffective,” Pretorius said.
She said Campaigning for Cancer has been reaching out to the department on a case by case basis. “We have, with other civil society, pushed for the (health) minister to develop and publish a national cancer control plan, and some progress has been made, but it will be a long time before these policies filter down to the patient. Cancer care in South Africa is in crisis,” said Pretorius.
“I think we have about 25 cases, but these are the patients who were willing to complain; it is very rare that some patients go against the state, and many of them die before we finish the extended process of complaint. The cases are mostly from Steve Biko, Charlotte Maxeke, Frere, Albert Luthuli and George Mukhari Hospital (childhood cancer),” said Pretorius.
The report says patients currently wait about one month to see a doctor, and will receive radiation treatment two months after being scanned. This three-month delay decreases the survival chances of cancer patients.
In February and March this year two of the four radiation machines could not be used because broken air-conditioning led to dangerous over-heating. “We were assured that the air-conditioning has been fixed and all the radiation machines can now be used, but a backlog has developed because of the down time,” said Bloom, who further explained that another problem Steve Biko hospital is facing is that there are only 20 radiographers but 31 are ideally required to make best use of the machines. Ten radiographers have left in the last year, and only eight have been recruited to replace them.
The report says in June, South Africa saw a similar incident at the KwaZulu-Natal Health Department where the department was going through the same dilemma Steve Biko hospital is going through. “Although the situation is not bad as the one in KZN, the numbers have gone up. The increase is also caused by referrals; their referrals are not good because they are only done at a later stage where the patient will also experience a delay in treatment,” said Bloom.
“I am concerned that there is a large backlog of cancer cases which is being worsened by the shortage of radiographers. More radiographers should be recruited urgently and private hospitals should be contracted to cut the backlog,” said Bloom.
Good news for patients in the Eastern Cape, however, is that a new cancer unit is to be opened soon in Mthatha. Health-e News reports that, according to the MEC of Health, Dr Phumza Dyantyi, while there is currently a cancer unit in Mthatha, it offered only medical oncology services.
But plans were now in place to launch a campaign that would see the Eastern Cape government help extend the services and bring them closer to the people by offering both medical and radiation oncology services.
As the Health Department, we are planning to open a unit offering medical and radiation oncology services to treat a variety of cancers using state-of-the-art equipment. The process is currently in the design stage, and we are hoping that by the end of 2018/19 financial year phase one will be operating,” Dyantyi said.
Margarete Nontuthuzelo Ndarane (68), a cancer survivor, said having to travel far from home had made things much worse for her when she was ill and said that she was happy to hear the news of the new cancer unit in Mthatha. “It is a great initiative which needs to be applauded. It may happen that for those who don’t win the battle with cancer, being away from their family could be a contributing factor (in their deaths) due to the lack of their support system,” Ndarane said.Sunday Tribune report (subscription needed) Daily Maverick report Health-e News report