No treatment for KZN cancer victims
Shortage of staff and broken equipment put patients in peril
CANCER treatment in KwaZulu-Natal’s health department has virtually ground to a halt as a result of a shortage of staff, numerous resignations, and equipment that is no longer functioning. In addition, half of the department’s cancer radiotherapy machines don’t work.
Twelve-year veteran and the department’s head of oncology in Durban, Dr Pooven Govender, left at the end of October and Dr S’thembile Ngidi left at the end of November.
Ngidi made history in 2015 when she graduated from the Colleges of Medicine of South Africa as KZN’s first black female oncologist – and the country’s second.
The provincial department has two oncology centres – in 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 Central Hospital (IALCH) or Addington Hospital for treatment, be it surgery, chemotherapy, or radiotherapy.
Many of the staff – doctors, radiographers and others – were reluctant to be identified for fear of being suspended or victimised. According to one official, who spoke on condition of anonymity, patients are diagnosed at the various provincial hospitals, either from a scan, X-ray, blood test or a biopsy. Once the results show a patient has cancer, they are then referred to either Pietermaritzburg (Grey’s Hospital) or Durban (IALCH and Addington Hospital).
Questions on how many oncologists the department should have went unanswered by the department, but ANA understands that until Govender’s departure there were five oncologists in the Durban area. Ngidi and Govender have not been replaced so far.
And if the two remaining oncologists reported to be leaving do indeed quit, the department will be left with one oncologist in Durban.
Several sources said the resignations were attributable to the dire situation, with more and more treatment being palliative rather than curative.
The lack of oncologists is only one of the problems facing the department.
Radiographers are also in short supply. 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 patients daily, but by the end of October the capacity had reportedly dropped to 26 patients for each machine. The situation has become so dire, that ANA is even aware of registrars leaving because they do not believe they are being properly trained.
But 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 R120-million Varian Rapid Arc Linear Accelerator machines at Addington Hospital haven’t 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 mainten- ance, with Health MEC Sibongiseni Dhlomo accusing them of corruption. A seven-year corruption investigation by the Hawks hasn’t seen the light of day to date 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.
Ever since the contract to appoint KZN Oncology Inc was signed by health department head Dr Sifiso Mtshali on December 17, only one of the machines has ever worked – and intermittently at that. As of Thursday, both machines were not working.
Staff were told by the 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 chief executive, Dr Nkhanyiso Zwane.
It is also understood that, as of Thursday, the single working cancer radiotherapy machine at Grey’s Hospital in Pietermaritzburg is also not functioning and the department had yet to issue an order for that machine to be repaired.
The oncologists, radiologists, and six cancer radiotherapy machines at Grey’s, IALCH and Addington are the only cancer treatment available to about 85 percent of the prov- ince’s population of 11 million who do not have access to private medical care.
It is understood that even if a patient gets an appointment to see a specialist consultant, for patients at Addington, who have to be transferred to the backlogged IALCH, the first chance they will have for access to a cancer radiation therapy machine is August 2017.
Ideally, a patient should start receiving cancer radiation therapy within four to six weeks, if that was the treatment recommended by the oncologist. It is medically accepted that early detection leads to higher rates of successful treatment. However, 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, IALCH, and Grey’s Hospital in Pietermaritzburg, have functioning mammography machines. Those at Prince Mshiyeni Hospital and RK Khan Hospital do not work. – ANA