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.”
According to the South African Medical Journal¹ the overall survival rates for childhood cancer in South Africa remain low when compared to international data. Greater awareness of the warning signs of childhood cancer can encourage earlier diagnosis and lead to improved outcomes for all ethnic groups.
Many childhood cancers are treatable with high treatment success rates between 70% and 80% in well-resourced countries, while approximately 80% of children with cancer in Africa die without access to adequate care. Whilst South Africa has an established oncology healthcare service, the infrastructure is overburdened, the cancer awareness in the primary healthcare service is poor, and widespread service delivery challenges exist. A 2014 research paper carried in Stones, David K., et al. entitled “Childhood cancer survival rates in two South African units”, quotes South African overall survival rates at 52.1%. ¹
CANSA’s CEO, Elize Joubert says: “It’s estimated that currently less than half of the children with cancer in South Africa are diagnosed and many of those who are diagnosed are already in the advanced stages of the illness. Early detection will go a long way in reducing the fatality rate, however this can only be done by creating greater awareness and instilling knowledge in parts of the healthcare system and with the public.”
Cancers in children tend to be different from those found in adults with most of them often occurring in the developing cells such as bone marrow, blood, kidneys and nervous system tissues. According to the recent South African Children’s Cancer Study Group (SACCSG) registry statistics, for 2009 to 2013, the five foremost childhood cancers in South Africa are leukaemia, followed by lymphoma (tumours that begin in the lymph glands), then brain tumours, nephroblastomas, or Wilms tumours – cancer of the kidneys – and then soft tissue sarcomas, which are tumours that begin in the connective tissue. Read more about the types of childhood cancers…
Early Detection is Key
Part of CANSA’s Childhood Cancer Awareness Programme is aimed at educating the public on the early warning signs and in South Africa, the Saint Siluan Warning Signs list is used as per below…
St Siluan Warning Signs Childhood Cancer:
S – Seek medical help early for persistent symptoms
I – White spot in the eye, new squint, sudden blindness or bulging eyeball
L – Lump on the stomach, pelvis, head, arms, legs, testicle or glands
U – Unexplained fever present for over two weeks, weight loss, fatigue, pale appearance, easy bruising & bleeding
A – Aching bones, joints, back and easy fractures
N – Neurological signs, a change in walk, balance or speech, regression, contiguous headaches with/without vomiting & enlarged head
The advice given to parents by CANSA should they have any concerns about their child showing symptoms, they need to seek medical help immediately. Children with cancer need to receive the right treatment, preferably in a paediatric oncology unit.
A young cancer Survivor, Thandi* and her mom Jessica*, were being rejected by their community. Jessica says: “The lack of knowledge and understanding in our village is extreme. The majority still believe that my child is contagious and can harm them.” CANSA’s TLC Staff in Kimberley stepped in to offer support and information to their community. (*Names changed to protect privacy)
CANSA offers a programme called CANSA Tough Living with Cancer (TLC) that supports not only the diagnosed child or teen, but also the family and loved ones affected by cancer, as well as children who have a parent with cancer. #CANSAtlc
CANSA embraces a holistic approach to include all aspects of physical, spiritual, psychological and social well-being.
CANSA TLC Offers:
support groups
prosthetic assistance
skills development
educational school programmes
volunteer training
CANSA TLC Facilities:
Currently, five CANSA TLC facilities for children/teens and parents and families affected by cancer, are available:
Watch video of when CANSA TLC Nicus Lodge was visited by SABC Real Talk with Anele on #MandelaDay 2017:
Do You or Your Child / Teen Need Support?
Parents in need of support are invited to join a TLC Support Group in their area (contact the nearest CANSA Care Centre), or help to establish one if one doesn’t exist. Parents, families, and supporters can also join the ‘CANSA TLC’ Facebook group to connect with others in a similar position.
¹ Stones, David K., et al. “Childhood cancer survival rates in two South African units.” SAMJ: South African Medical Journal 104.7 (2014): 501 – 504.
About CANSA
CANSA offers a unique integrated service to the public and to all people affected by cancer. CANSA is a leading role-player in cancer research (more than R12 million spent annually) and the scientific findings and knowledge gained from our research are used to realign our health programmes, as well as strengthen our watchdog role to the greater benefit of the public.
Our health programmes comprise health and education campaigns; CANSA Care Centres that offer a wide range of care and support services to those affected by cancer; stoma and other clinical support and organisational management; medical equipment hire, as well as a toll-free line to offer information and support.
We also supply patient care and support in the form of 11 CANSA Care Homes in the main metropolitan areas for out-of-town cancer patients; a Wellness Centre based in Polokwane; and CANSA-TLC lodging for parents and guardians of children undergoing cancer treatment.
For more information contact CANSA:
Visit www.cansa.org.za or contact CANSA toll-free on 0800 22 66 22 or email [email protected] – follow CANSA on Facebook | Twitter | Instagram. CANSA offers multi-lingual support on WhatsApp: 0721979305 for English and Afrikaans, and 0718673530 for Xhosa, Zulu, Sotho and Siswati.
The most serious type of skin cancer is melanoma, with South Africa having the highest incidence in the world.
In a bid to reduce the scourge of this disease, CANSA is partnering with the Skin Cancer Foundation of South Africa, on National Skin Cancer Screening Day, on 1 September 2017, by offering free FotoFinder mole examinations at all their main metro CANSA Care Centres, as well as at participating dermatologists nationwide. #MelanomaAwareness
“As a proud partner of the Skin Cancer Foundation of South Africa, CANSA is looking forward to taking part. We have FotoFinder devices at most CANSA Care Centres in South Africa, allowing us to examine moles and spots to help lower the risk of skin cancer,” says Gerda Strauss, CANSA Head: Service Delivery.
FotoFinder Assists with Early Detection
The FotoFinder is a mole mapping and dermascope device used in skin cancer screening and is neither invasive nor painful.
Early detection, minimises the severity of the disease, as well as reduces and prevents severe disfigurement. #LowerCancerRisk
According to CANSA, skin cancer is on the rise and diagnosis continues to be seen in much younger individuals. However, the good news is that the risk of skin cancer can be reduced, by simply being more SunSmart and properly protecting bodies in order to lower the risk. #SunSmart
Free Screening 1st September
Free FotoFinder screenings will be on offer on 1 September 2017 at the following CANSA Care Centres:
· Eastern Cape – CANSA East London Care Centre: 043-727 0120
· Free State – CANSA Bloemfontein Care Centre: 051-444 2580
· Gauteng – CANSA Pretoria Care Centre: 012-329 3036
· KZN – CANSA Pietermaritzburg Care Centre: 033 342 9837
· Mpumalanga – CANSA Nelspruit Care Centre: 013-741 5441
· Northern Cape – at the Kimberley Gariep Festival (2 September 2017): 053-831 2968
· Western Cape – Cape Metro Care Centre: 021-689 5347
What is Skin Cancer?
Skin cancer is the uncontrolled growth of abnormal skin cells. It occurs when unrepaired DNA damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations, or genetic defects, that lead the skin cells to multiply rapidly and form malignant tumours. Many dermatologists believe that increased UV exposure resulting from the hole in the ozone layer, has contributed greatly to the rise in melanoma rates over the past two decades.
The Minister of Health Dr Aaron Motsoaledi will this week launch two critical cancer policies namely, Cervical and Breast Cancer policies aimed at addressing high mortality caused by these cancers, management of the condition as well as improve the quality of life of women in South Africa.
Breast and Cervical cancers have been identified amongst the leading cause of deaths among South African women, especially women aged 30 years and older.
While the Cervical cancer prevention and control policy will assist to prevent the disease by promoting healthy lifestyle and provide Human papillomavirus (HPV) vaccination, the Breast cancer control policy will focus on breast cancer awareness, early detection, treatment and care. The implementation of both policies will provide clinical support for women, who are both at risk of developing the disease later in life and currently undergoing treatment to survive and live healthy lives.
The Department of Health is working on a 10-year plan to equip hospitals with the necessary facilities to care and support patients with cancer in an effort to address the Hospital Service Equity and accessibility for women.
The Cervical Cancer prevention and control Policy will enable the introduction of new screening technique called liquid-based cytology which is an improvement from papsmear technique and is more comfortable and produce reliable results.
The Breast cancer control policy will allow women who are diagnosed early to have access to treatment such as Trutusumab which will prolong life if treatment is completed and minimise the recurrence of the disease women.
The Minister of Health Dr Aaron Motsoaledi will this week launch two critical cancer policies namely, Cervical and Breast Cancer policies aimed at addressing high mortality caused by these cancers, management of the condition as well as improve the quality of life of women in South Africa.
Breast and Cervical cancers have been identified amongst the leading cause of deaths among South African women, especially women aged 30 years and older.
While the Cervical cancer prevention and control policy will assist to prevent the disease by promoting healthy lifestyle and provide Human papillomavirus (HPV) vaccination, the Breast cancer control policy will focus on breast cancer awareness, early detection, treatment and care. The implementation of both policies will provide clinical support for women, who are both at risk of developing the disease later in life and currently undergoing treatment to survive and live healthy lives.
The Department of Health is working on a 10-year plan to equip hospitals with the necessary facilities to care and support patients with cancer in an effort to address the Hospital Service Equity and accessibility for women.
The Cervical Cancer prevention and control Policy will enable the introduction of new screening technique called liquid-based cytology which is an improvement from papsmear technique and is more comfortable and produce reliable results.
The Breast cancer control policy will allow women who are diagnosed early to have access to treatment such as Trutusumab which will prolong life if treatment is completed and minimise the recurrence of the disease women.
