Fears as Durban loses last state cancer specialist – Bhekisisa

Written by: JOAN VAN DYK for Bhekisisa
Only two state cancer specialists remain in the province of more than 10-million people.

Durban loses its last public sector oncologist today as shortages of specialists in the province continue.

The doctor’s departure from Inkosi Albert Luthuli Central Hospital leaves KwaZulu-Natal with just two oncologists, both practising at Grey’s Hospital in Pietermaritzburg.

Chairperson of South Africa Medical Association’s KwaZulu-Natal branch Mvuyisi Mzukwa says these two doctors are swamped and dealing with a backlog of patients, some of whom have been waiting for treatment since 2011.

The closure of cancer services may be the latest symptom of what the South African Medical Association (Sama) and human rights organisation Section27 says are the province’s failing health systems. In May, the duo took to the streets to protest issues such as staff shortages, poor working conditions and deteriorating infrastructure and equipment.

In a five-page memo delivered to KwaZulu-Natal health MEC Sibongiseni Dhlomo, Sama alleged that the provinces had severe shortages of specialists such oncologists but also obstetricians, psychiatrists and orthopaedic and general surgeons. The association also said health facilities operated amid shortfalls of soap, gloves, needles and clean linens. Doctors also complained of rat and insect infestations.

As the province’s shortage of specialists grows, so too will waiting lists for treatments, warns Mzukwa.

But KwaZulu-Natal health department spokesperson Sam Mkhwanazi says the department is already recruiting new oncologists and in the interim, private sector oncologists and radiotherapists will provide cancer treatment at Inkosi Albert Luthuli Central Hospital. These specialists will be overseen by the head of Pietermaritzburg’s oncology unit at Grey’s Hospital.

Meanwhile, the KwaZulu-Natal department of health is running a deficit of more than R1-billion this year, according to information presented at the health budget vote in March. This includes an R500-million shortage for HIV treatment for the 2017/ 18 financial year.

The health systems and policy manager at the Rural Health Advocacy Project, Russell Rensburg says some companies contracted to maintain medical equipment and provide medications have not been paid. He explains that many continue to provide services and credits them with helping keep the health system afloat.

Rensburg told Bhekisisa in January that although provincial health budgets have almost doubled in the past 15 years, they have not kept up with the rising cost of employees.

Employee compensation now accounts for about 65 % of provincial health expenditure, according to a 2016 working paper released by the Rural Health Advocacy Project.

Rensburg warns that the country’s recession and ratings downgrade could topple KwaZulu-Natal’s health system if government fails to adjust current and projected budgets that have largely been based on false assumptions.

He explains: “The current budget is based on a projection that the economy would grow by between 1.2 and 1.5% in the next year. But the country is now in a recession and the ratings downgrade will affect our ability to loan money. The department has its head in the sand.”

The recession is likely to reduce levels of taxable income as companies shy away from investing and creating jobs in the country. Meanwhile, the recent downgrade in South Africa’s credit ratings means there will likely be less money for public expenditure as more cash goes to service debt.

Other provincial health departments will also suffer, he says. In September, South Africa introduced new HIV treatment guidelines that now offer antiretrovirals to anyone who has tested HIV-positive, meaning many more people now qualify to receive the drugs than before. Previously, people would have had to wait until their CD4 counts — a measure of the immune system’s strength — fell to 500.

Rensburg says that government is spending money to increase access to HIV treatment and roll out the National Health Insurance while there may not funds to sustain existing programmes.

He explains: “We are facing a financial crisis in health and it is being ignored.”

Maximising the quality of life this World Cancer Day

Today is World Cancer Day and the Cancer Association of South Africa (CANSA) is emphasising that cancer is “not beyond us” in terms of cancer control and reducing the impact of the disease.


Elize Joubert, CANSA’s Acting CEO says “World Cancer Day is important because the global cancer epidemic is huge and set to rise.  Currently 8.2 million people die from cancer worldwide every year – in South Africa, more than 100 000 are diagnosed annually.  This day helps us spread the word and raise the profile of cancer”.

According to the Centres for Disease Control and Prevent (CDC) more than twice as many people die from cancer than from Aids, malaria, and tuberculosis combined. The WHO projects that without immediate action, the global number of deaths from cancer will increase by nearly 80% by 2030, with most occurring in low- and middle-income countries.

Taking place under the tagline ‘Not beyond us’, World Cancer Day focuses on taking a positive and proactive approach to the fight against cancer, highlighting that solutions do exist regarding cancer care and early detection and that they are within reach.

As part of World Cancer Day, CANSA is hosting Open Days at its 30 CANSA Care Centres countrywide inviting communities, workplaces and the media to visit and find out more about our care and support programmes.

“We want to ensure fewer people develop cancer and that cancer survivors are successfully treated and offered care, support, guidance and advice to all those affected by cancer to ensure a better quality of life. We
know that cancer can have a serious impact on a person’s emotional, physical and mental state – so by understanding and responding to that impact – the quality of life for patients, their loved ones and caregivers can be maximised,” Joubert added.

CANSA provides comprehensive care and support programmes for cancer patients and their families, to help them find the best care solution and advice on managing side effects of treatment, be it physical, emotional and / or spiritual.

Joubert states, “Take part in our Open Days and find out more about how we work towards a cancer-free world. Many of our CANSA Care Centre teams also provide early detection screening programmes to help reduce the cancer risk, while our nine Mobile Health Clinics provide screening and early detection programmes in remote areas.”

She concluded, “For many people facing a cancer diagnosis, it’s the toughest fight of their lives. Maintaining social support networks and talking about cancer is important for both the person living with cancer and their caregiver.  So we encourage cancer survivors to join our ‘iSurvivor’ e-online support programme. It’s a free, e-mail based programme written by a cancer survivor to help other survivors cope better. It’s a manageable guide with all the helpful resources available such as health information, where the nearest CANSA Care Centre is, how to lead a balanced lifestyle, how to reduce the risk of recurrence of cancer and where to find counselling and support.”

For more info visit www.cansa.org.za or contact CANSA toll-free 0800226622 or at [email protected] as email address. Follow CANSA on Twitter: @CANSA (http://www.twitter.com/@CANSA), Instagram (http://instagram.com/cancerassociationofsouthafrica) and join CANSA on Facebook: CANSA The Cancer Association of South Africa.